The Uro-oncology Patient and Vaccination Against SARS-CoV-2

Moises Rodriguez Socarrás; Juan Gómez Rivas; Jeremy Yuen-Chun Teoh; Javier Puente; Marco Moschini; Jesús Moreno-Sierra

doi:10.1016/j.euros.2021.05.007

The Uro-oncology Patient and Vaccination Against SARS-CoV-2

Eur Urol Open Sci. 2021 Jul:29:77-81. doi: 10.1016/j.euros.2021.05.007. Epub 2021 May 27.

Authors

Moises Rodriguez Socarrás¹, Juan Gómez Rivas², Jeremy Yuen-Chun Teoh³, Javier Puente⁴, Marco Moschini⁵, Jesús Moreno-Sierra²

Affiliations

¹ Instituto de Cirugía Urológica Avanzada, Madrid, Spain.
² Department of Urology, Hospital Clínico San Carlos, Madrid, Spain.
³ Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
⁴ Department of Oncology, Hospital Clínico San Carlos, Madrid, Spain.
⁵ Department of Urology, San Raffaele University and IRCCS San Raffaele Hospital and Scientific Institute, Milan, Italy.

Abstract

As of April 13, 2021, 137 million cases of COVID-19 and 2.95 million deaths have been reported worldwide. On December 21, 2020, the Pfizer-BioNTech vaccine was approved for use in the European Union, with efficacy of 95% protection against COVID-19 infection. Several other vaccines are at different stages of assessment by the European Medicines Agency. In addition to the elderly, oncology patients are a vulnerable population in which COVID-19 infection may be more severe. However, owing to the design of the initial studies, evidence on the safety and efficacy of vaccination against SARS-CoV-2 in these patients is scarce and recommendations are based on the opinion of associations, stakeholders, and experts via extrapolation of information and experience for other vaccines, especially influenza vaccines. Despite the limited evidence, the consensus is that SARS-CoV-2 vaccines are safe and vaccination of oncology patients and their close relatives is recommended, although efficacy may be lower in patients with an impaired immune response and the need for additional booster doses is not yet clear. Recommendations include avoiding the use of vaccines based on viral vectors for patients with an impaired immune response, deferring vaccination for immunosuppressed patients or administering the vaccine before immunosuppression, and avoiding chemotherapy receipt between the two doses of a vaccine or on the same day that the vaccine is administered. These recommendations can be extrapolated to urology patients and although evidence is lacking, there should not be greater interference with SARS-CoV-2 vaccines from androgen deprivation therapy or intravesical bacillus Calmette-Guérin. However, large studies to provide strong evidence for uro-oncology patients are needed.

Patient summary: We looked at the effects of COVID-19 vaccination for patients with urological cancers. The consensus is that the vaccines are safe, and vaccination of cancer patients and their close relatives is recommended.

Keywords: COVID-19; Cancer; Uro-oncology; Vaccine.