COVID-19 More Deadly for Unvaccinated Cancer Patients

Unvaccinated people diagnosed with cancer were seven times more likely to die from any cause if they contracted COVID-19 versus if they didn’t.

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Oct 26, 2022

People diagnosed with cancer who weren’t vaccinated were seven times more likely to die from any cause if they contracted COVID-19 versus if they didn’t contract the virus, according to a study of people in Indiana.

The research was published in the October-December 2022 issue of the journal JMIR Cancer. Read the abstract of “COVID-19 Diagnosis and Risk of Death Among Adults With Cancer in Indiana: Retrospective Cohort Study.”

About the study

Earlier studies have shown that people diagnosed with cancer have a higher risk of severe illness if they contract COVID-19. Still, these studies didn’t quantify how much higher this risk is. Many of these earlier studies also used information from a single institution and had small sample sizes.

In this study, the researchers used statewide data and calculated the increase in risk.

The researchers used electronic health records in the Indiana Network for Patient Care to look for people diagnosed with cancer in 2019 and 2020, before COVID-19 vaccines were available. They then checked to see how many people diagnosed with cancer also were diagnosed with COVID-19.

Overall, 41,924 people were diagnosed with cancer:

78.4% of the people were white
50.9% of the people were male
17% of the people had at least one other health condition, and 9.6% had two or more other health conditions
13.8% of the people had been diagnosed with breast cancer
13% of the people had been diagnosed with prostate cancer
12.8% of the people had been diagnosed with melanoma, the most serious type of skin cancer

Of the 41,924 people diagnosed with cancer, 2,894 people (6.9%) also tested positive for COVID-19.

During the entire study period — Jan. 1, 2019 to Dec. 31, 2020 — 3,398 people (8.1%) died.

During the time the researchers called the COVID-19 period — Jan. 15 to Dec. 31, 2020 — 1,324 people died. Of the people who died during the COVID-19 period, 127 people tested positive for COVID-19.

The researchers’ analysis found that death rates were 91% higher during the COVID-19 period versus the period before COVID-19.

The risk of dying was higher for:

people age 65 and older
people with two or more other health conditions
men
people who lived in rural areas

People diagnosed with lung or digestive cancers who contracted COVID-19 had the highest risk of death. This partially explains the higher death rate among men because men are more likely to be diagnosed with these two types of cancer.

“Our findings highlight the increased risk of death for adult cancer patients who test positive for COVID and underscore the importance to cancer patients — including those in remission — of vaccinations, boosters, and regular COVID testing,” senior author Brian Dixon, PhD, MPA, said in a statement. Dr. Dixon is director of public health informatics at the Regenstrief Institute and Richard M. Fairbanks School of Public Health at Indiana University. “Our results should encourage individuals diagnosed with cancer not only to take preventive action, but also to expeditiously seek out treatments available in the marketplace should they test positive for COVID.”

What this means for you

Although the results of this study are troubling, they do underscore how important COVID-19 vaccines can be for many people diagnosed with cancer who have weakened immune systems because of cancer treatments.

According to the U.S. Centers for Disease Control and Prevention (CDC), people with weakened immune systems who are age 18 and older should receive the Pfizer or Moderna vaccines as follows:

the first dose of the primary series of the vaccine
the second dose of the primary series of the vaccine three or four weeks after the first dose
a third dose of the primary series of the vaccine at least four weeks after the second dose
a fourth dose — the updated bivalent booster — at least two months after the third dose or the last booster

Adults with weakened immune systems should receive the Johnson & Johnson (J&J) vaccine as follows:

the first dose of the primary series of the vaccine
the second dose of either the Pfizer or Moderna vaccine at least four weeks after the first dose of the J&J vaccine
a third dose — the updated bivalent booster — at least two months after the second dose or the last booster

Adults with weakened immune systems should receive the Novavax vaccine as follows:

the first dose of the primary series of the vaccine
the second dose of the primary series of the vaccine three weeks after the first dose
a third dose — the updated bivalent booster — at least two months after the second dose

Still, each person’s health situation is unique. So it makes sense to talk to your doctor about whether a COVID-19 vaccine and booster shots are right for you.