Herpes zoster after the third dose of SARS-CoV-2 mRNA-BNT162b2 vaccine in actively treated cancer patients: a prospective study.

Herpes zoster after the third dose of SARS-CoV-2 mRNA-BNT162b2 vaccine in actively treated cancer patients: a prospective study.

Publication date: Jan 20, 2024

Several concerns have been raised about a causal relationship between COVID-19 mRNA-based vaccines and the development of herpes zoster (HZ). We performed a prospective analysis of the Vax-On-Third-Profile study to investigate the incidence of HZ after the third dose of mRNA-BNT162b2 (tozinameran) and its correlation with immune responses. Patients who had received a booster dose and had been actively treated for at least 8 weeks were eligible. Serologic assessment was performed before the third dose of tozinameran (timepoint-1) and 4 weeks later (timepoint-2). We also assessed the incidence of SARS-CoV-2 breakthrough infections at predefined time points. The current analysis included 310 patients, of whom 109 (35. 2%) and 111 (35. 8%) were being treated with targeted therapies and cytotoxic chemotherapy, respectively. All participants received a third dose of tozinameran between September 26 and October 30, 2021. After a mean follow-up of 17. 3 (IQR 15. 1-18. 4) months, HZ occurred in 8 recipients, for a cumulative incidence of 2. 6%, and an incidence rate of 0. 310 per person-year (95% CI 0. 267-0. 333). All HZ cases occurred within 30 days of booster dosing (range 5-29 days), with a median time to onset of 15 (IQR 9-22) days. Among the 7 patients (2. 2%) who also contracted a SARS-CoV-2 infection, all cases preceded COVID-19 outbreaks. No instances of complicated HZ were reported. In multivariate analysis, impaired T helper and T cytotoxic cell counts independently correlated with HZ occurrence. These findings provide the first evidence that cancer patients on active treatment have a not negligible risk of developing HZ within 30 days after the third dose of tozinameran. The favorable clinical outcome of all observed cases confirms that protective effects of boosters in reducing the risk of severe COVID-19 outweigh the potential risk of HZ occurrence.

Concepts Keywords
4weeks Active treatment
Chemotherapy COVID-19 vaccine
October Herpes zoster
Protective SARS-CoV-2
Vaccine Solid tumors
T cell
Third dose

Semantics

Type Source Name
disease MESH Herpes zoster
disease VO dose
disease VO vaccine
disease MESH cancer
disease MESH COVID-19
disease MESH breakthrough infections
disease VO time
pathway REACTOME SARS-CoV-2 Infection
disease IDO cell
disease VO COVID-19 vaccine

Original Article

(Visited 1 times, 1 visits today)