by ecancer reporter Saira Ahmed

COVID-19 pandemic has led to substantial disruptions to the diagnosis and treatment of cancer in many parts of the world. Cancer patients are also at a high risk of severe COVID-19 infection due to their age, disease, cancer treatment, and medical co-morbidities.

Patients with cancer in low-income and middle-income countries (LMICs) are further disadvantaged than those in high-income settings because of unequal access to COVID-19 vaccines in already fragile healthcare systems.

Most guidelines now recommend COVID-19 vaccination for patients with cancer. A recent survey published in The Lancet Oncology explores the global picture regarding COVID-19 vaccination of cancer patients.

It reflects both strengths and weaknesses in the COVID-19 vaccination programme for patients with cancer across different income settings.

The absence of access to vaccines (of any type) remains the major rate-limiting step for many patients with cancer in some of the most vulnerable conditions.

However, even in well-resourced health systems, some issues urgently need to be addressed; prioritising, rapid COVID-19 vaccination of healthcare workers and cancer patients which is essential to aid the recovery of cancer care systems as they seek to mitigate the impact of delays and backlogs in diagnosis and treatment.

Considering the challenging and rapidly changing vaccine landscape for patients with cancer, the COVID-19 Cancer Taskforce undertook a rapid assessment of the current global availability of COVID-19 vaccines and their strategies for covering cancer patients and healthcare workers, up to and including March 31, 2021.

Members of the Taskforce from 38 countries were surveyed, covering the full spectrum of development from low-income to high-income settings and received completed responses from 33 countries.

The findings of this Taskforce reflect a complex and heterogeneous picture, ranging from well-advanced vaccination programmes for patients with cancer (e.g., in the UK) through to countries such as Iraq and Guatemala that have yet to receive any vaccine supplies.

It was observed that countries are at very different stages of their vaccination rollout, with varying levels of planning, procurement, and distribution using a wide variety of COVID-19 vaccines.

Some countries had clear national strategies, policies, and infrastructure in place and had made substantial progress in their vaccination programme, whilst many countries still did not have a clear plan or resources to facilitate COVID-19 vaccination, even to priority groups.

Some countries have national vaccination plans that are only beginning to roll out (e.g., New Zealand).

The lack of vaccination programmes across sub-Saharan Africa also stood in contrast to better access and deployment across Latin America and Southeast Asia.

Moreover, none of the 29 poorest countries globally, of which the majority are in sub-Saharan Africa, have started vaccination against COVID-19.

Overall, most countries (n=22; 67%) had national vaccination strategies in place, with only five countries having no plans. Prioritising vaccination of healthcare workers was uppermost in most national strategies, but many countries have yet to organise vaccination of cancer patients.

Of the 29 countries with access to any type of COVID-19 vaccine, only nine (26%) are routinely immunising their patients with cancer as part of a national vaccination strategy.

Although many countries intend to roll out vaccines to all clinically vulnerable groups, including patients with cancer, there are some for whom there is no national strategy to this effect.

The survey also found that there has been very little planning for systematically collecting data from patients with cancer receiving COVID-19 vaccines.

There are a few exceptions; for example, the VOICE study in the Netherlands. Countries like Malaysia, India and Turkey have developed mobile apps through which people can register for vaccination.

This programme enables the government to study the uptake, safety, and efficacy of COVID-19 vaccinations.

The Taskforce strongly advocates for countries to conduct prospective studies on understanding the efficacy of different vaccines in different cancer populations.

The author of this study suggests that a global effort to obtain homogeneous, high-quality data from diverse geographical and resource settings is needed for this information to have a valuable impact scientifically and socially.