“Even though we understand the objectives, we are very concerned about the decision of the Scientific Technical Committee to extend the interval between the first and second dose of the two Covid mRNA vaccines from 21 and 28 days to 42 even for frail patients”. To speak is the Federation of oncologists, cardiologists and hematologists (Foce), from the beginning at the forefront to ensure the priority of vaccination for frail patients. In particular – the doctors write – oncological patients undergoing active treatment (for which the use of the vaccine produced by Pfizer is expected) must receive the second injection within 21 days. This is because “people with cancer do not develop an adequate antibody response after the first administration and therefore the time for the booster should not be extended”.
Pfizer vaccine, delaying the second dose may not be suitable for those with cancer
by Tina Simoniello
Francesco Cognetti, Director of Medical Oncology Regina Elena of Rome and President of FOCE, then asks the Technical Scientific Committee and the Minister of Health, Roberto Speranza, that the circular on extending the anti Covid immunization intervals to cancer patients and also to all those who are considered extremely fragile is not applied. “Citizens affected by cancer have a greater risk of complications if infected with Covid, with a mortality rate of 30% in case of hospitalization”, underlines the expert: “A recent study published in the prestigious scientific journal Lancet Oncology has shown that the antibody response of patients with solid and blood tumors after the first dose of vaccine is much lower than in normal people, and that this response is consolidated only after the second dose. The best time for the recall must therefore remain after 21 days ”.
The study was conducted by King’s College London. 151 patients with solid or haematological tumors and 54 healthy people who received the first dose of Pfizer’s vaccine were enrolled. Approximately 21 days after inoculation, only 38% of patients with solid tumors and 18% with haematological malignancies had a positive immunoglobulin titer compared with 94% of healthy people. And the analysis of IgG titers suggests that the main difference between the latter and patients with cancer is precisely the lack of response. Considering those who received the second dose within three weeks, 95% of patients with solid tumors and 60% of patients with haematological malignancies showed an adequate antibody response. In contrast, among those who did not receive the second dose on day 21, only 30% of patients with solid tumors and 11% of patients with haematological tumors developed a response against the virus.
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by Tiziana Moriconi
“These results – continues Cognetti – are similar to the preliminary ones achieved so far in a study still underway at the Regina Elena Institute in Rome and the San Gallicano Institute in Rome in 816 patients with solid neoplasms undergoing active treatment or who have received treatment in the past six months. Out of more than 700 patients examined so far, only about half will be immunized after the first dose and about 70% after one month from the second dose. These results also show significantly lower values than those obtained in a series of several hundred healthy doctors and / or nurses from the same Institute. It should also be emphasized that immunocompromised patients have a higher incidence of persistent SARS-CoV-2 infection, which can represent an important reservoir for the development of new viral variants ”. The partial or incomplete vaccination of these people – the experts recall – is still one of the most important causes in determining the persistent high mortality of the infected recorded in our country.
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