One person was diagnosed, and the whole city was affected...
In just one week, 38,000 new cases were confirmed across the country.
The new crown epidemic in the mainland broke out in Wuhan at the end of 2019, and since then, it has continuously refreshed human cognition of the virus, and a variety of virus variants have appeared... Wu Zunyou, chief expert in epidemiology at the Chinese Center for Disease Control and Prevention, analyzed that the virus that caused the fourth wave of the global epidemic was mainly the Olmi kerong strain, which spread 77% faster than the Delta strain.
On 15 March, World Health Organization experts confirmed the existence of a strain of "Delta Kerong", which was recombined from the Delta strain and the subspecies of the Omilkeron strain. The epidemic is "escalating" again and again...
Is the vaccine still effective?
Current studies have shown that even with major mutations in the new coronavirus strain, the protective efficacy of existing COVID-19 vaccines is still available, but depending on the variant, its protective efficacy may be reduced to varying degrees, while the effectiveness against severe illness, hospitalization, and death caused by the variant strain remains high [1].
What about the special group of cancer patients under the epidemic?
Can they get the COVID-19 vaccine?
According to the results of previous studies, if a tumor patient is infected with COVID-19, the proportion of severe illness and the case fatality rate are higher than those of other populations, so they should be vaccinated [2].
Let's look at a set of data
The study included 151 cancer patients (95 solid tumor patients and 56 patients with hematologic malignancies), and 54 completely healthy controls. Blood samples from more than one of the controls were taken 2 weeks after the second dose of the vaccine, and the results showed that 95% of patients with solid tumors and 60% of patients with hematologic malignancies were seropositive, indicating antibodies, while the healthy control group had antibodies in all of this population.
And cancer patients tolerate the vaccine well, there are no new unintended signs of toxicity, indicating that the new crown vaccine for cancer patients is safe and effective. Exceptions, however, are the possible reduction in protective efficacy of vaccines for hematologic malignancies [3].
Is the "reinforcement needle" necessary?
Up to now, a total of 5 vaccines in mainland China have been approved for conditional marketing, namely 3 inactivated vaccines, 1 adenovirus vector vaccine, and 1 recombinant protein vaccine.
Take the recombinant protein vaccine as an example, it is administered as a "booster needle" 4 to 8 months after inactivated vaccine, and its clinical effect is remarkable, which can greatly increase the level of antibodies, and for several major variants, this recombinant protein vaccine can also greatly improve antibody neutralization activity. Among them, for the Delta strain, the third dose increased the antibody activity to the initial 88 times.
Considering the complex mechanism and development of tumorigenesis, whether tumor patients can be vaccinated against COVID-19 should depend on the "disease type", "treatment stage" and "treatment plan"
Xiaobian made the following summary according to the relevant policy documents
Varies by disease type
Vaccination is recommended for patients with solid tumors including liver cancer, stomach cancer, lung cancer, breast cancer, prostate cancer, etc.
This varies depending on the stage of treatment and the treatment regimen
Vaccination is recommended
1. Patients with early tumors who have undergone radical surgical resection therapy and are currently in good physical condition, or patients who have completed radiotherapy, targeted therapy, endocrine therapy, immunotherapy, etc. for at least 1 month of rehabilitation;
2. Patients who are receiving endocrine therapy and have no obvious adverse reactions;
3. For malignant tumors more than three years after surgery, chemoradiation and chemotherapy are no longer performed, and inactivated vaccines and recombinant subunit vaccines are recommended.
Vaccination is suspended
1. Patients with malignant tumors who are undergoing chemotherapy, radiotherapy, immunotherapy and other patients before and after surgery;
2. There are obvious adverse reactions in endocrine therapy, and the vaccination needs to be suspended after the condition is stable;
3. In the case of endocrine therapy combined with chemoradiotherapy, targeted therapy, and immunotherapy, it is necessary to vaccinate after the end of the combination therapy and after the autoimmune cells and immune barrier return to normal;
4. Tumor patients are in stable condition, but during the acute onset of fever, gout, severe cold, myocardial infarction, cerebral infarction and other diseases, vaccination needs to be suspended.
Vaccination is not recommended
1. For the previous dose of the vaccine or any component of the vaccine, the occurrence of a severe allergic reaction or anaphylaxis is a contraindication to vaccination;
2. Patients who are 2 weeks before the start of chemotherapy, undergoing chemotherapy, or within 3 months of the end of chemotherapy;
3. Patients who are receiving immunotherapy;
4. Patients with advanced tumors receive long-term combination therapy such as radiotherapy and chemotherapy, targeted therapy, endocrine and immunotherapy, etc., these drugs have different degrees of hematogenic toxicity, which will inhibit the body's immune response to the new crown vaccine, and the advanced tumor patients are in a poor physical state, the overall function of the immune system is weakened, and vaccination with the new crown vaccine is easy to lead to viral infection.
Vaccinate as appropriate
1. Adenovirus vector vaccine, although the vector virus used is a replication defect type, but there is no safety data on the use of the same type of vaccine in the past, it is recommended to discuss with a physician, weigh the pros and cons, and give it after knowing the choice [4];
2. If there is any unclear situation, you can communicate and confirm with the doctor in charge, or go to the vaccination assessment clinic of the local top three hospitals for evaluation.
Write at the end
At present, the country has received more than 3 billion doses of the new crown virus vaccine, in the face of the epidemic, scientific response, do a good job of protection, enhance immunity, I believe we will be able to defeat the virus as soon as possible!
bibliography
[1] Interim Estimates of COVID-19 Vaccine Effectiveness Against COVID-19-Associated Emergency Department or Urgent Care Clinic Encounters and Hospitalizations Among Adults During SARS-CoV-2 B.1.617.2 (Delta) Variant Predominance - Nine States, June-August 2021.
[2] Impact of active cancer on COVID-19 survival: a matched-analysis on 557 consecutive patients at an Academic Hospital in Lombardy, Italy.Bertuzzi AF, Ciccarelli M, Marrari A, Gennaro N, Dipasquale A, Giordano L, Cariboni U, Quagliuolo VL, Alloisio M, Santoro A Br J Cancer. 2021;125(3):358. Epub 2021 May 11.
[3] Thakkar A, Gonzalez-Lugo JD, Goradia N, et AL Cancer Cell. 2021;39:1.
[4] Technical Guidelines for COVID-19 Vaccination (First Edition)