INTRODUCTION
The burden from severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has significantly impacted the healthcare system, and vaccination remains our best protection against this virus. Children with cancer have a higher morbidity and mortality from SARS-CoV2 infection compared to healthy children.1,2 This includes need for oxygen administration, pleural effusions, pneumothorax, pulmonary arterial hypertension, bronchiolitis, diffuse alveolar hemorrhage, and septic shock.1 Additionally, infection has been associated with postponement and modification of chemotherapy, which may impact outcome.
Unfortunately, immunocompromised patients were excluded from original vaccine studies, leaving the oncology community to speculate the level of protection achieved with vaccination. A few recent studies from Europe have identified an impaired immune response in pediatric oncology patients after the BNT162b2 COVID-19 vaccination, especially those with hematologic malignancies or those undergoing intensive therapy.3,4 In the adult oncology literature, vaccination has high rates of seroconversion, with hematologic malignancies showing lower immunogenicity.5–7 In solid organ transplant recipients, a third dose of an mRNA vaccine was needed to achieve a substantial immune response.8,9The primary goal of this study was to understand immunogenicity after vaccination with BNT162b2 or mRNA-1273 in pediatric oncology patients and determine if certain clinical factors impacted response.