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COVID-19 Vaccines in Patients With Cancer—A Welcome Addition, but There Is Need for Optimization

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

The urgency of the COVID-19 pandemic led to the scientific triumph of rapid vaccine development against SARS-CoV-2 within less than a year, a period much faster to traditional vaccine development, which spans decades. That impressive speed is credited to a novel approach to vaccine development, with vaccines encoding genetic information in the form of messenger RNA (mRNA) and inducing the body to produce neutralizing antibodies against the SARS-CoV-2 spike protein, the attachment protein for viral entry to cells via the angiotensin-converting enzyme–2 receptor. There are currently 2 mRNA vaccines (Pfizer-BioNTech and Moderna) and 2 adenovirus-based vaccines (Oxford–AstraZeneca and Johnson & Johnson) for which phase 3 placebo-controlled randomized clinical trials (RCTs) published in high-profile journals show an impressive efficacy, although real world effectiveness remains to be further validated in postlicense assessment.1 As very few patients with underlying cancer were enrolled in those studies,2 many unanswered questions remain about the risk-benefit ratio of these new COVID-19 vaccines in patients with cancer.

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Article Information

Corresponding Author: Dimitrios P. Kontoyiannis, MD, ScD, PhD, Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1460, Houston, TX 77030 (dkontoyi@mdanderson.org).

Published Online: May 13, 2021. doi:10.1001/jamaoncol.2021.1218

Conflict of Interest Disclosures: Dr Kontoyiannis has received research support from Gilead and honoraria from Merck and Gilead. He is member of the data review committee of Cidara and AbbVie. He acknowledges the Robert C. Hickey Chair endowment. No other disclosures were reported.

References
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Chamilos  G , Lionakis  MS , Kontoyiannis  DP .  Are all patients with cancer at heightened risk for severe coronavirus disease 2019 (COVID-19)?   Clin Infect Dis. 2021;72(2):351-356.PubMedGoogle ScholarCrossref
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UK Government. Guidance on shielding and protecting people who are clinically extremely vulnerable from COVID-19. Accessed March 22, 2021. https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19
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