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Transplant Cell Ther . Association of Self-Reported COVID-19 Vaccination Status with COVID-19 Infection Among Adult Long-Term Hematopoietic Cell Tra

tetano

Editor, Senior Moderator
Transplant Cell Ther


. 2023 Jun 30;S2666-6367(23)01364-7.
doi: 10.1016/j.jtct.2023.06.017. Online ahead of print. Association of Self-Reported COVID-19 Vaccination Status with COVID-19 Infection Among Adult Long-Term Hematopoietic Cell Transplantation Survivors

Emily C Liang[SUP] 1 [/SUP], Lynn E Onstad[SUP] 2 [/SUP], Paul Carpenter[SUP] 3 [/SUP], Steven A Pergam[SUP] 4 [/SUP], Mary E Flowers[SUP] 1 [/SUP], Stephanie J Lee[SUP] 1 [/SUP], Catherine Liu[SUP] 5 [/SUP]



Affiliations
Abstract

Background: Hematopoietic cell transplantation (HCT) recipients experience significant morbidity and mortality from coronavirus disease 19 (COVID-19) infection. Data are limited regarding long-term HCT survivors' uptake of and experiences with COVID-19 vaccination and infection.
Objective: To characterize COVID-19 vaccination uptake, use of other prevention measures, and COVID-19 infection outcomes in adult HCT recipients at our institution.
Study design: From July 1, 2021 to June 30, 2022, long-term adult HCT survivors were surveyed regarding overall health, chronic graft-versus-host (cGVHD) status, and experiences with COVID-19 vaccinations, prevention measures, and infections. Patient-reported COVID-19 vaccination status, vaccine-related adverse effects, use of non-pharmaceutical prevention measures, and infection. Comparisons by response and vaccination status were performed using Chi-square test and Fisher's exact test for categorical variables and Kruskal-Wallis test for continuous variables.
Results: Of 4758 adult HCT survivors who underwent HCT from 1971-2021 and consented to receive annual surveys, 1719 (36%) completed the COVID-19 module. 1598/1705 (94%) reported receiving ≥1 dose of COVID-19 vaccine. Severe vaccine-related adverse effects were infrequent (5%). Among respondents receiving mRNA vaccine, completion of doses according to the Centers for Disease Control (CDC) vaccine recommendations at time of survey return was: 2 doses (675/759 [89%]); 3 (610/778 [78%]); 4 doses (26/55 [47%]). 250 (15%) respondents reported COVID-19 infection; 25 (10%) required hospitalization. Vaccinated respondents reported significantly higher uptake of household vaccination (1284/1404 [91%] vs. 18/88 [20%], p < 0.001) and use of non-pharmaceutical interventions (p < 0.001). Among those vaccinated prior to infection, vaccinated respondents were significantly less likely to have contracted COVID-19 (85/1480 [6%] vs. 130/190 [68%], p < 0.001) as were their household members (149/1451 [10%] vs. 85/185 [46%], p < 0.001). Receipt of additional COVID-19 vaccine doses beyond the first dose was associated with a reduced risk of COVID-19 infection (OR = 0.63, 95% CI, 0.47-0.85, p = 0.002).
Conclusions: Vaccination was well-tolerated and associated with a lower risk of COVID-19 infection among HCT survivors and their household contacts. Vaccination and booster doses should be encouraged as part of a multi-faceted approach in this high-risk population.

Keywords: COVID-19; hematopoietic cell transplantation; survivorship.

 
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