{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T17:59:47Z","timestamp":1781632787374,"version":"3.54.5"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":53,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>During the Omicron era, COVID-19 vaccines demonstrated over 90% effectiveness against severe disease in the general population. However, vaccine effectiveness (VE) in patients with lung cancer, who are at high risk for severe COVID-19, has not been well characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this population-based cohort, we employed a test-negative design using linked data from the Ontario Cancer Registry, health administrative databases, and the Ontario vaccination registry. We included all patients with active lung cancer or mesothelioma residing in Ontario, Canada, who were symptomatic and underwent SARS-CoV-2 RT-PCR testing from January 2, 2022, to June 30, 2025. The outcome of interest was a severe outcome, defined as hospitalization within 14\u2009days or death within 30\u2009days following SARS-CoV-2 test. We constructed an analytic cohort that included the earliest testing episode among test-positive and test-negative patients with severe outcomes. We also performed a sensitivity analysis comparing test-positive patients with severe outcomes to randomly selected testing episodes among test-negative patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 47,344 tested patients, 3,332 (7.0%) were SARS-CoV-2 test-positive, of whom 1,967 (59%) experienced severe outcomes; 16,257 test-negative patients also developed severe outcomes. Adjusted VE against severe COVID-19 was 52% (95% CI: 42%, 60%) within 7\u2013179\u2009days post-vaccination, declining to 16% (95%CI: 0%, 30%) thereafter. In sensitivity analyses comparing 1,967 test-positive patients with severe outcomes to 18,922 randomly selected test-negative patients, adjusted VE was 49% (95% CI: 39%, 58%), declining to 12% (95% CI: \u22124% 26%) thereafter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large population-based study of patients with lung cancer and mesothelioma, COVID-19 vaccination was associated with moderate protection against severe outcomes, including hospitalization and death. These findings emphasize the importance of optimizing alternative preventive strategies, such as masking, social distancing, ensuring household and caregiver vaccinations, and improving post-infection management through early antiviral therapy and close monitoring for severe disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-026-12741-9","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T05:06:31Z","timestamp":1770354391000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["COVID-19 vaccine effectiveness in patients with lung cancer: challenges in the Omicron era"],"prefix":"10.1186","volume":"26","author":[{"given":"Seyed M.","family":"Hosseini-Moghaddam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Swayze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey C.","family":"Kwong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances A.","family":"Shepherd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"12741_CR1","doi-asserted-by":"crossref","unstructured":"Huang J, Deng Y, Tin MS, Lok V, Ngai CH, Zhang L, et al. Distribution, risk factors, and temporal trends for lung cancer incidence and mortality: a global analysis. Chest [Internet]. 2022, Apr, 1;161(4):1101\u201311. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/35026300\/. cited 2024 Jun 3.","DOI":"10.1016\/j.chest.2021.12.655"},{"key":"12741_CR2","doi-asserted-by":"crossref","unstructured":"Tian J, Yuan X, Xiao J, Zhong Q, Yang C, Liu B, et al. Clinical characteristics and risk factors associated with COVID-19 disease severity in patients with cancer in Wuhan, China: a multicentre, retrospective, cohort study. Lancet Oncol [Internet]. 2020, Jul, 1;21(7):893\u2013903. Available from: http:\/\/www.thelancet.com\/article\/S1470204520303090\/fulltext. cited 2024 Jun 4.","DOI":"10.1016\/S1470-2045(20)30309-0"},{"key":"12741_CR3","doi-asserted-by":"crossref","unstructured":"Wang L, Wang Y, Cheng X, Li X, Li J. Impact of coronavirus disease 2019 on lung cancer patients: a meta-analysis. 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[cited 2024 Dec 29].Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/35020982\/.","DOI":"10.1056\/NEJMoa2117128"},{"key":"12741_CR31","doi-asserted-by":"crossref","unstructured":"Passaro A, Bestvina C, Velez Velez M, Garassino MC, Garon E, Peters S. Severity of COVID-19 in patients with lung cancer: evidence and challenges. J Immunother Cancer [Internet]. 2021, Mar, 18;9(3):2266. [cited 2024 Jun 23.] Available from: https:\/\/doi.org\/\/pmc\/articles\/PMC7978268\/","DOI":"10.1136\/jitc-2020-002266"},{"key":"12741_CR32","doi-asserted-by":"crossref","unstructured":"Prado-Garcia H, Romero-Garcia S, Aguilar-Cazares D, Meneses-Flores M, Lopez-Gonzalez JS. Tumor-induced CD8+ T-Cell dysfunction in lung cancer patients. J Immunol Res [Internet]. 2012, Jan, 1;2012(1):741741. [cited 2024 Jun 23] Available from: https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1155\/2012\/741741.\u00a0","DOI":"10.1155\/2012\/741741"},{"key":"12741_CR33","doi-asserted-by":"crossref","unstructured":"Carbone DP, Gandara DR, Antonia SJ, Zielinski C, Paz-Ares L. Non-small Cell lung cancer: role of the immune System and potential for immunotherapy. J Thorac Oncol [Internet]. 2015, Jul, 4;10(7):974. [cited 2024 Jun 23.] Available from: https:\/\/doi.org\/\/pmc\/articles\/PMC4618296\/","DOI":"10.1097\/JTO.0000000000000551"},{"key":"12741_CR34","doi-asserted-by":"crossref","unstructured":"Trivanovi\u0107 D, Per\u0161uri\u0107 \u017d, Agaj A, Jakopovi\u0107 M, Samar\u017eija M, Bitar L, et al. The interplay of lung cancer, COVID-19, and vaccines. Int J Mol Sci [Internet]. 2022, Dec, 1;23(23):23. 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Comorbidities in lung cancer. Pneumonol Alergol Pol [Internet]. 2016;84(3):186\u201392. [cited 2024 Jun 23] Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/27238182\/.\u00a0","DOI":"10.5603\/PiAP.2016.0022"},{"key":"12741_CR38","doi-asserted-by":"crossref","unstructured":"Murawski M, Walter J, Schwarzkopf L. Assessing the lung cancer comorbidome: an analysis of German claims data. Lung Cancer [Internet]. 2019, Jan, 1;127:122\u201329. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/30642540\/. cited 2024 Jun 23.","DOI":"10.1016\/j.lungcan.2018.11.030"},{"key":"12741_CR39","doi-asserted-by":"crossref","unstructured":"Baldessari C, Guaitoli G, Valoriani F, Bonacini R, Marcheselli R, Reverberi L, et al. Impact of body composition, nutritional and inflammatory status on outcome of non-small cell lung cancer patients treated with immunotherapy. Clin Nutr ESPEN [Internet]. 2021, Jun, 1;43:64\u201375. [cited 2024 Jun 23] Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/34024567\/.\u00a0","DOI":"10.1016\/j.clnesp.2021.02.017"},{"key":"12741_CR40","doi-asserted-by":"crossref","unstructured":"Polanski J, Jankowska-Polanska B, Rosinczuk J, Chabowski M, Szymanska-Chabowska A. Quality of life of patients with lung cancer. Onco Targets Ther [Internet]. 9:1023. Available from: https:\/\/doi 2016 Feb 29 [cited 2024 Jun 23.","DOI":"10.2147\/OTT.S100685"},{"key":"12741_CR41","doi-asserted-by":"crossref","unstructured":"Sheikh A, Kerr S, Woolhouse M, McMenamin J, Robertson C, Simpson CR, et al. Severity of omicron variant of concern and effectiveness of vaccine boosters against symptomatic disease in Scotland (EAVE II): a national cohort study with nested test-negative design. Lancet Infect Dis [Internet]. 2022, Jul, 1;22(7):959. [cited 2024 Jun 23.] Available from: https:\/\/doi.org\/\/pmc\/articles\/PMC9033213\/","DOI":"10.1016\/S1473-3099(22)00141-4"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-026-12741-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-026-12741-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-026-12741-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T17:38:41Z","timestamp":1781631521000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12879-026-12741-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,6]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["12741"],"URL":"https:\/\/doi.org\/10.1186\/s12879-026-12741-9","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,6]]},"assertion":[{"value":"15 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The use of the data in this project is authorized under section 45 of Ontario\u2019s Personal Health Information Protection Act (PHIPA) and does not require review by a Research Ethics Board. The provincial government of Ontario provides a universal, publicly funded, single-payer health insurance system to residents. Under Ontario\u2019s health information privacy law allows us to use the healthcare and demographic databases held at ICES without consent. This project\u2019s. data access and use were authorized under section 45 of Ontario\u2019s Personal Health Information Protection Act, which does not require Research Ethics Board approval.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Public Health Ontario provided access to vaccination data from COVaxON, case-level data from the Public Health Case and Contact Management System (CCM), COVID-19 laboratory data, and assistance with data interpretation. The staff of Ontario\u2019s public health units were responsible for COVID-19 case and contact management and data collection within the CCM. IQVIA Solutions Canada Inc. permitted the use of its Drug Information File. The CIRN provided networking support. We thank the Ontario residents, without whom this research would be impossible.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Additional contributions"}},{"value":"The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources. No endorsement by ICES, the MOH, the MLTC, the OHDP, or their partners; the Province of Ontario; the CIHI; or OH is intended or should be inferred.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}},{"value":"The authors declare no competing interests.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"692"}}