medicina59巻3号

2022年03月発行

特集 成人が必要とするワクチン—生涯を通した予防接種の重要性

予防接種を必要とする成人 〈基礎疾患を持つ人〉

免疫不全者—がん患者へのワクチン接種について

著者： 冲中敬二¹²

所属機関： ¹国立がん研究センター東病院総合内科 ²国立がん研究センター中央病院造血幹細胞移植科

ページ範囲：P.446 - P.452

文献概要

Point
◎個々のがん患者における感染症リスクは異なる．
◎がん患者が感染症に罹患した場合，がん診療への影響（治療の遅れ・中止）も懸念される．
◎健常人よりワクチンの効果は劣るが，一定の効果は示されており接種が推奨される．
◎インフルエンザ，新型コロナウイルスに関しては患者家族への接種も推奨される．

参考文献

1）National Comprehensive Cancer Network：NCCN Guidelines Version 3.2021 Survivorship　https://www.nccn.org/guidelines/nccn-guidelines/guidelines-detail?category=3＆id=1466（2021年10月閲覧）

2）National Comprehensive Cancer Network：NCCN guidelines Version 1.2021 Prevention and Treatment of Cancer-Related Infections　https://www.nccn.org/guidelines/nccn-guidelines/guidelines-detail?category=3＆id=1457（2021年10月閲覧）

3）Li J, et al：Influenza in hospitalised patients with malignancy；A propensity score matching analysis. ESMO Open 5：e000968, 2020

4）Collins JP, et al：Outcomes of immunocompromised adults hospitalized with laboratory-confirmed influenza in the United States, 2011-2015. Clin Infect Dis 70：2121-2130, 2020

5）Vinograd I, et al：Clinical effectiveness of seasonal influenza vaccine among adult cancer patients. Cancer 119：4028-4035, 2013

6）Bersanelli M, et al：Influenza vaccine indication during therapy with immune checkpoint inhibitors；A multicenter prospective observational study（INVIDIa-2）. J Immunother Cancer 9：e002619, 2021

7）Yri OE, et al：Rituximab blocks protective serologic response to influenza A（H1N1）2009 vaccination in lymphoma patients during or within 6 months after treatment. Blood 118：6769-6771, 2011

8）Maeda T, et al：Surveillance of the current situation regarding influenza vaccination according to medical oncologists in Japan. Cancer Sci 112：433-443, 2021

9）Spagnolo F, et al：Influenza vaccination in cancer patients receiving immune checkpoint inhibitors；A systematic review. Eur J Clin Invest 51：e13604, 2021

10）Andersen MA, et al：Differences and temporal changes in risk of invasive pneumococcal disease in adults with hematological malignancies；Results from a nationwide 16-year cohort study. Clin Infect Dis 72：463-471, 2021

11）Chiou WY, et al：Effectiveness of 23-valent pneumococcal polysaccharide vaccine on elderly long-term cancer survivors；A population-based propensity score matched cohort study. BMJ Open 8：e019364, 2018

12）日本呼吸器学会呼吸器ワクチン検討委員会/日本感染症学会ワクチン委員会/日本ワクチン学会・合同委員会，他：6歳から64歳までのハイリスク者に対する肺炎球菌ワクチン接種の考え方（2021年3月17日）　https://www.kansensho.or.jp/uploads/files/guidelines/210317_teigen.pdf（2021年10月閲覧）

13）McKay SL, et al：Herpes zoster risk in immunocompromised adults in the United States；A systematic review. Clin Infect Dis 71：e125-e134, 2020

14）Habel LA, et al：The epidemiology of herpes zoster in patients with newly diagnosed cancer. Cancer Epidemiol Biomarkers Prev 22：82-90, 2013

15）Oxman MN, et al：A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med 352：2271-2284, 2005

16）Lal H, et al：Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. N Engl J Med 372：2087-2096, 2015

17）Cunningham AL, et al：Efficacy of the herpes zoster subunit vaccine in adults 70 years of age or older. N Engl J Med 375：1019-1032, 2016

18）Centers for Disease Control and Prevention：Adult Immunization Schedule（19＋）　https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html（2021年10月閲覧）

19）Wang Q, et al：Analyses of risk, racial disparity, and outcomes among US patients with cancer and COVID-19 infection. JAMA Oncol 7：220-227, 2021

20）Williamson EJ, et al：Factors associated with COVID-19-related death using OpenSAFELY. Nature 584：430-436, 2020

21）Sharafeldin N, et al：Outcomes of COVID-19 in patients with cancer；Report from the National COVID Cohort Collaborative（N3C）. J Clin Oncol 39： 2232-2246, 2021

22）Lazarus G, et al：Does immune checkpoint inhibitor increase the risks of poor outcomes in COVID-19-infected cancer patients? A systematic review and meta-analysis. Cancer Immunol Immunother, 2021［Online ahead of print］

23）Addeo A, et al：Immunogenicity of SARS-CoV-2 messenger RNA vaccines in patients with cancer. Cancer Cell 39：1091-1098.e2, 2021

24）Palich R, et al：High seroconversion rate but low antibody titers after two injections of BNT162b2（Pfizer-BioNTech）vaccine in patients treated with chemotherapy for solid cancers. Ann Oncol 32：1294-1295, 2021

25）Ligumsky H, et al：Immunogenicity and safety of the BNT162b2 mRNA COVID-19 vaccine among actively treated cancer patients. J Natl Cancer Inst：djab174, 2021

26）Woodfield MC, et al：Cocooning against COVID-19；The argument for vaccinating caregivers of patients with cancer. Cancer 127：2861-2863, 2021

27）Monin L, et al：Safety and immunogenicity of one versus two doses of the COVID-19 vaccine BNT162b2 for patients with cancer；Interim analysis of a prospective observational study. Lancet Oncol 22：765-778, 2021

28）Thakkar A, et al：Seroconversion rates following COVID-19 vaccination among patients with cancer. Cancer Cell 39：1081-1090.e2, 2021

29）Waissengrin B, et al：Short-term safety of the BNT162b2 mRNA COVID-19 vaccine in patients with cancer treated with immune checkpoint inhibitors. Lancet Oncol 22：581-583, 2021

30）Greenberger LM, et al：Antibody response to SARS-CoV-2 vaccines in patients with hematologic malignancies. Cancer Cell 39：1031-1033, 2021

31）Mair MJ, et al：Humoral immune response in hematooncological patients and health care workers who received SARS-CoV-2 vaccinations. JAMA Oncol：1-8, 2021

32）Maneikis K, et al：Immunogenicity of the BNT162b2 COVID-19 mRNA vaccine and early clinical outcomes in patients with haematological malignancies in Lithuania；A national prospective cohort study. Lancet Haematol 8：e583-e592, 2021

33）Shroff RT, et al：Immune responses to two and three doses of the BNT162b2 mRNA vaccine in adults with solid tumors. Nat Med, 2021［Online ahead of print］

34）Greenberger LM, et al：Anti-spike antibody response to SARS-CoV-2 booster vaccination in patients with B cell-derived hematologic malignancies. Cancer Cell 39：1297-1299, 2021