INTRODUCTION
The burden from severe acute respiratory syndrome coronavirus 2
(SARS-CoV2) has significantly impacted the healthcare system, and
vaccination remains our best protection against this virus. Children
with cancer have a higher morbidity and mortality from SARS-CoV2
infection compared to healthy children.1,2 This
includes need for oxygen administration, pleural effusions,
pneumothorax, pulmonary arterial hypertension, bronchiolitis, diffuse
alveolar hemorrhage, and septic shock.1 Additionally,
infection has been associated with postponement and modification of
chemotherapy, which may impact outcome.
Unfortunately, immunocompromised patients were excluded from original
vaccine studies, leaving the oncology community to speculate the level
of protection achieved with vaccination. A few recent studies from
Europe have identified an impaired immune response in pediatric oncology
patients after the BNT162b2 COVID-19 vaccination, especially those with
hematologic malignancies or those undergoing intensive
therapy.3,4 In the adult oncology literature,
vaccination has high rates of seroconversion, with hematologic
malignancies showing lower immunogenicity.5–7 In
solid organ transplant recipients, a third dose of an mRNA vaccine was
needed to achieve a substantial immune response.8,9The primary goal of this study was to understand immunogenicity after
vaccination with BNT162b2 or mRNA-1273 in pediatric oncology patients
and determine if certain clinical factors impacted response.