Did we get it right? Lessons learnt in the last 6 months

Dr Lennard Lee- Opinion Editorial (UK COVID/cancer clinical lead)

Back in November 2021, our team at the UK Coronavirus cancer programme went public with the provocative statement, “As COVID-19 cases surge despite mass vaccination, it’s time to focus on the vulnerable”.

In our 2021 editorial, we made three points. Firstly, the need for data and science to inform strategy, secondly a prediction that coronavirus will have minimal impact on the wider population and be focussed on vulnerable group, and thirdly advocating that all levers must be utilised to protect the vulnerable.  

Six months down the line, we thought it useful to examine the impact following our call for action to the clinical community.

The first point for data/science to assist strategy was successfully achieved through our major flagship study which was published in the Lancet Oncology this month. Demonstrating the strengths of the NHS and the UK Coronavirus Cancer programme, this was delivered successfully within months of initiation and the largest covid/cancer study in the world consisting of nearly 400,000 cancer patients. It showed: 

COVID-19 vaccination is effective in the majority of people with cancer, despite many being immunocompromised due to their cancer and treatments 

Cancer patients show a more rapid waning of COVID-19 vaccine effectiveness by 3-6 months compared to the general population  

Vaccine effectiveness is much lower in people with the blood cancers leukaemia or lymphoma, those with a recent cancer diagnosis and those who have received anti-cancer treatment within the last year 

COVID-19 vaccination boosters are incredibly important for cancer patients.

This work has fed directly into the May 2022 Department of health independent report and we now have the data and science to inform us of which patients with cancer are at risk.

Our second point turned out to be more accurate than we could ever have envisaged. Just 4 months after our editorial, the Living with COVID-19 strategy was released by the Cabinet office. It removed restrictions and the testing infrastructure for the population. It did signpost the need to protect the most vulnerable to COVID-19.

It is however our third call to action that potentially still needs to be carefully considered- “that all levers must be utilised to protect the vulnerable”. Vaccination is the most effective way of protecting cancer patients from coronavirus. We have worked with other groups to ensure that the processes for access to coronavirus vaccination is as easy and as patient-centred as possible. However, our data shows that excess risk still remains to certain subgroups of cancer patients.  

These vulnerable cancer subgroups are likely to derive the most benefit from new interventions. This will enable them to get more protection sooner. With regulatory approval achieved in March 2022 for preventative treatments, we believe that it is now important that treatment options are as easy to access and as patient-focussed as the coronavirus vaccination programme.  

Our vision is that cancer patients will be safeguarded and protected. Our programme is one of the longest pandemic response programmes pulling 250 of the best cancer clinicians and academics from across the country who continue to work on this vision. Cancer patients must have the confidence they have the same protection from coronavirus as the rest of the population, in order to give them the best quality of life to see friends and family and exit shielding, opportunities that much of us have taken for granted.