Antibody response to a third booster dose of SARS-CoV-2 vaccination in adults with haematological and solid cancer: a systematic review

Br J Cancer. 2022 Nov;127(10):1827-1836. doi: 10.1038/s41416-022-01951-y. Epub 2022 Oct 12.


Background: Patients living with cancer are at a significantly increased risk of morbidity and mortality after infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This systematic review aims to investigate the current available evidence about the immunogenicity of SARS-CoV-2 booster vaccines in patients living with cancer.

Methods: A systematic search was undertaken for studies published until March 1, 2022. A systematic narrative review was undertaken to include all studies that evaluated the efficacy of booster vaccines against SARS-CoV-2 in patients with cancer.

Results: Fifteen studies encompassing 1205 patients with cancer were included. We found that a booster vaccine dose induced a higher response in patients with solid cancer as compared to haematological malignancies. Recent systemic anticancer therapy does not appear to affect seroconversion in solid organ malignancies, however, there is an association between B-cell depleting therapies and poor seroconversion in haematological patients.

Conclusions: Third booster vaccination induces an improved antibody response to SARS-CoV-2 in adults with haematological and solid cancer, relative to patients who only receive two doses. Access to vaccination boosters should be made available to patients at risk of poor immunological responses, and the provision of fourth doses may be of benefit to this vulnerable population.

Registration: PROSPERO number CRD42021270420.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Antibodies, Viral
  • Antibody Formation
  • COVID-19 Vaccines* / administration & dosage
  • COVID-19* / prevention & control
  • Humans
  • Neoplasms* / chemically induced
  • Neoplasms* / therapy
  • SARS-CoV-2
  • Vaccination
  • Viral Vaccines / adverse effects


  • Antibodies, Viral
  • COVID-19 Vaccines
  • Viral Vaccines

Supplementary concepts

  • COVID-19 vaccine booster shot