{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T23:38:24Z","timestamp":1783726704770,"version":"3.55.0"},"reference-count":59,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T00:00:00Z","timestamp":1623283200000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Immunother Cancer"],"accepted":{"date-parts":[[2021,5,19]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p>SARS-CoV-2 infection and the resulting COVID-19 have afflicted millions of people in an ongoing worldwide pandemic. Safe and effective vaccination is needed urgently to protect not only the general population but also vulnerable subjects such as patients with cancer. Currently approved mRNA-based SARS-CoV-2 vaccines seem suitable for patients with cancer based on their mode of action, efficacy, and favorable safety profile reported in the general population. Here, we provide an overview of mRNA-based vaccines including their safety and efficacy. Extrapolating from insights gained from a different preventable viral infection, we review existing data on immunity against influenza A and B vaccines in patients with cancer. Finally, we discuss COVID-19 vaccination in light of the challenges specific to patients with cancer, such as factors that may hinder protective SARS-CoV-2 immune responses in the context of compromised immunity and the use of immune-suppressive or immune-modulating drugs.<\/jats:p>","DOI":"10.1136\/jitc-2021-002932","type":"journal-article","created":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T10:44:35Z","timestamp":1623408275000},"page":"e002932","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Implications of mRNA-based SARS-CoV-2 vaccination for cancer patients"],"prefix":"10.1136","volume":"9","author":[{"given":"Emanuela","family":"Romano","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Center for Cancer Immunotherapy, Institut Curie, Paris, \u00cele-de-France, France"},{"name":"INSERM U932, Department of Immunology, PSL Research University, Institut Curie, Paris, \u00cele-de-France, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Pascolo","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital of Z\u00fcrich, Z\u00fcrich, Switzerland"},{"name":"Faculty of Medicine, University of Z\u00fcrich, Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Ott","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA"},{"name":"Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA, USA"},{"name":"Harvard Medical School, Boston, MA, USA"},{"name":"Broad Institute of MIT and Harvard, Cambridge, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,6,11]]},"reference":[{"key":"2025100303294178000_9.6.e002932.1","doi-asserted-by":"crossref","unstructured":"Desai A et al . Mortality in hospitalized patients with cancer and coronavirus disease 2019: a systematic review and meta\u2010analysis of cohort studies. Cancer cncr 2020;33386.","DOI":"10.1002\/cncr.33386"},{"key":"2025100303294178000_9.6.e002932.2","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1016\/S0140-6736(20)31187-9","article-title":"Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study","volume":"395","author":"Kuderer","year":"2020","journal-title":"The Lancet"},{"key":"2025100303294178000_9.6.e002932.3","doi-asserted-by":"publisher","DOI":"10.1517\/14712598.4.8.1285"},{"key":"2025100303294178000_9.6.e002932.4","first-page":"23","article-title":"Vaccination with messenger RNA","volume":"127","author":"Pascolo","year":"2006","journal-title":"Methods Mol Med"},{"key":"2025100303294178000_9.6.e002932.5","first-page":"221","volume-title":"in Toll-Like Receptors (TLRs) and Innate Immunity","volume":"vol. 183","author":"Pascolo","year":"2008"},{"key":"2025100303294178000_9.6.e002932.6","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1586\/14760584.2015.1000871","article-title":"The messenger's great message for vaccination","volume":"14","author":"Pascolo","year":"2015","journal-title":"Expert Rev Vaccines"},{"key":"2025100303294178000_9.6.e002932.7","doi-asserted-by":"crossref","DOI":"10.3390\/v13020270","article-title":"Synthetic messenger RNA-based vaccines: from Scorn to hype","volume":"13","author":"Pascolo","year":"2021","journal-title":"Viruses"},{"key":"2025100303294178000_9.6.e002932.8","doi-asserted-by":"publisher","DOI":"10.1038\/sj.gt.3302964"},{"key":"2025100303294178000_9.6.e002932.9","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1056\/NEJMoa2034577","article-title":"Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine","volume":"383","author":"Polack","year":"2020","journal-title":"N Engl J Med Overseas Ed"},{"key":"2025100303294178000_9.6.e002932.10","doi-asserted-by":"publisher","DOI":"10.1097\/CJI.0b013e31815ce501"},{"key":"2025100303294178000_9.6.e002932.11","doi-asserted-by":"publisher","DOI":"10.1097\/CJI.0b013e3181a00068"},{"key":"2025100303294178000_9.6.e002932.12","doi-asserted-by":"publisher","DOI":"10.1038\/mt.2010.289"},{"key":"2025100303294178000_9.6.e002932.13","doi-asserted-by":"publisher","DOI":"10.1038\/nature18300"},{"key":"2025100303294178000_9.6.e002932.14","doi-asserted-by":"publisher","DOI":"10.1038\/nature23003"},{"key":"2025100303294178000_9.6.e002932.15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2035389"},{"key":"2025100303294178000_9.6.e002932.16","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s40425-019-0520-5","article-title":"Phase Ib evaluation of a self-adjuvanted protamine formulated mRNA-based active cancer immunotherapy, BI1361849 (CV9202), combined with local radiation treatment in patients with stage IV non-small cell lung cancer","volume":"7","author":"Papachristofilou","year":"2019","journal-title":"j. immunotherapy cancer"},{"key":"2025100303294178000_9.6.e002932.17","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1007\/s00262-019-02315-x","article-title":"A phase I\/IIa study of the mRNA-based cancer immunotherapy CV9201 in patients with stage IIIB\/IV non-small cell lung cancer","volume":"68","author":"Sebastian","year":"2019","journal-title":"Cancer Immunol Immunother"},{"key":"2025100303294178000_9.6.e002932.18","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1707304114"},{"key":"2025100303294178000_9.6.e002932.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.immuni.2005.06.008"},{"key":"2025100303294178000_9.6.e002932.20","doi-asserted-by":"publisher","DOI":"10.1038\/nature21428"},{"key":"2025100303294178000_9.6.e002932.21","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1038\/s41586-021-03324-6","article-title":"mRNA vaccine-elicited antibodies to SARS-CoV-2 and circulating variants","volume":"592","author":"Wang","year":"2021","journal-title":"Nature"},{"key":"2025100303294178000_9.6.e002932.22","doi-asserted-by":"crossref","unstructured":"Dagan N et al . BNT162b2 mRNA Covid-19 vaccine in a nationwide mass vaccination setting. N Engl J Med NEJMoa2101765 2021.","DOI":"10.1056\/NEJMoa2101765"},{"key":"2025100303294178000_9.6.e002932.23","first-page":"1663","article-title":"COVID-19 vaccines: comparison of biological, pharmacological characteristics and adverse effects of Pfizer\/BioNTech and Moderna vaccines","volume":"25","author":"Meo","year":"2021","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"2025100303294178000_9.6.e002932.24","doi-asserted-by":"crossref","unstructured":"Greinacher A , Thiele T , Warkentin TE , et al . Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination. N Engl J Med Overseas Ed 2021.doi:10.1056\/NEJMoa2104840","DOI":"10.1056\/NEJMoa2104840"},{"key":"2025100303294178000_9.6.e002932.25","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12054"},{"key":"2025100303294178000_9.6.e002932.26","first-page":"CD008983","article-title":"Influenza vaccines in immunosuppressed adults with cancer","volume":"2","author":"Bitterman","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"2025100303294178000_9.6.e002932.27","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21203"},{"key":"2025100303294178000_9.6.e002932.28","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.11.1.1"},{"key":"2025100303294178000_9.6.e002932.29","article-title":"Update: recommendations of the Advisory Committee on immunization practices (ACIP) regarding use of CSL seasonal influenza vaccine (Afluria) in the United States during 2010-11","volume":"59","year":"2010","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025100303294178000_9.6.e002932.30","doi-asserted-by":"publisher","DOI":"10.1007\/s005200000186"},{"key":"2025100303294178000_9.6.e002932.31","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdn531"},{"key":"2025100303294178000_9.6.e002932.32","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6690342"},{"key":"2025100303294178000_9.6.e002932.33","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197911)44:5<1629::AID-CNCR2820440514>3.0.CO;2-7"},{"key":"2025100303294178000_9.6.e002932.34","doi-asserted-by":"publisher","DOI":"10.1054\/bjoc.1999.1088"},{"key":"2025100303294178000_9.6.e002932.35","doi-asserted-by":"publisher","DOI":"10.3121\/cmr.3.4.214"},{"key":"2025100303294178000_9.6.e002932.36","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197811)42:5<2244::AID-CNCR2820420523>3.0.CO;2-7"},{"key":"2025100303294178000_9.6.e002932.37","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.02.041"},{"key":"2025100303294178000_9.6.e002932.38","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2005.05582.x"},{"key":"2025100303294178000_9.6.e002932.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2010.11.013"},{"key":"2025100303294178000_9.6.e002932.40","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1093\/cid\/ciz1092","article-title":"Immunogenicity of influenza vaccination in patients with cancer receiving immune checkpoint inhibitors","volume":"71","author":"Keam","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2025100303294178000_9.6.e002932.41","doi-asserted-by":"crossref","first-page":"1902","DOI":"10.1093\/infdis\/jiaa291","article-title":"Cell-Mediated immunogenicity of influenza vaccination in patients with cancer receiving immune checkpoint inhibitors","volume":"222","author":"Kang","year":"2020","journal-title":"J Infect Dis"},{"key":"2025100303294178000_9.6.e002932.42","doi-asserted-by":"publisher","DOI":"10.1177\/1078155206070868"},{"key":"2025100303294178000_9.6.e002932.43","doi-asserted-by":"crossref","unstructured":"Dai M , Liu D , Liu M , et al . Patients with cancer appear more vulnerable to SARS-COV-2: a multi-center study during the COVID-19 outbreak. Cancer Discov 2020:CD-20-0422. doi:10.1158\/2159-8290.CD-20-0422","DOI":"10.1158\/2159-8290.CD-20-0422"},{"key":"2025100303294178000_9.6.e002932.44","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00195-2020"},{"key":"2025100303294178000_9.6.e002932.45","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1038\/s41586-021-03291-y","article-title":"SARS-CoV-2 evolution during treatment of chronic infection","volume":"592","author":"Kemp","year":"2021","journal-title":"Nature"},{"key":"2025100303294178000_9.6.e002932.46","doi-asserted-by":"crossref","DOI":"10.1126\/scitranslmed.aaz8235","article-title":"Strong vaccine responses during chemotherapy are associated with prolonged cancer survival","volume":"12","author":"Melief","year":"2020","journal-title":"Sci Transl Med"},{"key":"2025100303294178000_9.6.e002932.47","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1718217115"},{"key":"2025100303294178000_9.6.e002932.48","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1038\/s41590-019-0441-y","article-title":"Pd-1 blockade in subprimed CD8 cells induces dysfunctional PD-1+CD38hi cells and anti-PD-1 resistance","volume":"20","author":"Verma","year":"2019","journal-title":"Nat Immunol"},{"key":"2025100303294178000_9.6.e002932.49","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1111\/bjh.16690","article-title":"Reactive lymphocytes in patients with COVID-19","volume":"189","author":"Chong","year":"2020","journal-title":"Br J Haematol"},{"key":"2025100303294178000_9.6.e002932.50","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/S1470-2045(21)00155-8","article-title":"Short-Term safety of the BNT162b2 mRNA COVID-19 vaccine in patients with cancer treated with immune checkpoint inhibitors","volume":"22","author":"Waissengrin","year":"2021","journal-title":"Lancet Oncol"},{"key":"2025100303294178000_9.6.e002932.51","doi-asserted-by":"crossref","unstructured":"Herishanu Y , Avivi I , Aharon A , et al . Efficacy of the BNT162b2 mRNA COVID-19 vaccine in patients with chronic lymphocytic leukemia. Blood 2021.doi:10.1182\/blood.2021011568","DOI":"10.1182\/blood.2021011568"},{"key":"2025100303294178000_9.6.e002932.52","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1038\/s41586-018-0792-9","article-title":"Neoantigen vaccine generates intratumoral T cell responses in phase Ib glioblastoma trial","volume":"565","author":"Keskin","year":"2019","journal-title":"Nature"},{"key":"2025100303294178000_9.6.e002932.53","doi-asserted-by":"crossref","DOI":"10.1080\/2162402X.2020.1758004","article-title":"Dexamethasone premedication suppresses vaccine-induced immune responses against cancer","volume":"9","author":"Vormehr","year":"2020","journal-title":"Oncoimmunology"},{"key":"2025100303294178000_9.6.e002932.54","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30600-5"},{"key":"2025100303294178000_9.6.e002932.55","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2009.263"},{"key":"2025100303294178000_9.6.e002932.56","doi-asserted-by":"crossref","unstructured":"\u00d6z\u00fctemiz C et al . Lymphadenopathy in COVID-19 vaccine recipients: diagnostic dilemma in oncology patients. Radiology 2021;210275.","DOI":"10.1148\/radiol.2021210275"},{"key":"2025100303294178000_9.6.e002932.57","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijrobp.2021.02.048","article-title":"COVID-19 vaccine-induced radiation recall phenomenon","author":"Soyfer","year":"2021","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2025100303294178000_9.6.e002932.58","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2009-0090"},{"key":"2025100303294178000_9.6.e002932.59","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2005.07.008"}],"container-title":["Journal for ImmunoTherapy of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jitc-2021-002932","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T10:29:54Z","timestamp":1759487394000},"score":1,"resource":{"primary":{"URL":"https:\/\/jitc.bmj.com\/lookup\/doi\/10.1136\/jitc-2021-002932"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":59,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6,11]]},"published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1136\/jitc-2021-002932"],"URL":"https:\/\/doi.org\/10.1136\/jitc-2021-002932","relation":{},"ISSN":["2051-1426"],"issn-type":[{"value":"2051-1426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6]]}}}