Humoral and cellular immunity to delayed second dose of SARS-CoV-2 BNT162b2 mRNA vaccination in patients with cancer

Patients with cancer are considered to be at high-risk for SARS-CoV-2 infection and severe COVID-19 (Bakouny et al., 2020). Our “SOAP-02” (Sars-CoV-2 fOr cAncer Patients) study has assessed their responses to COVID-19 vaccination. Our interim results provided safety and immune efficacy data for any COVID-19 vaccine in an immunocompromised patient population and showed that at 3 weeks following a single dose of BNT162b2 mRNA vaccine, seroconversion was conspicuously low (38%) in patients with solid cancer and very low (<20%) in patients with hematologic cancer (Monin et al., 2021). Importantly, however, a small sub-cohort of patients with solid cancer who received a second dose of vaccine at day 21 after the first shot showed substantially increased seroconversion (95%) as measured 2 weeks later. Conversely, too few patients with hematologic cancer had received a second shot at day 21 to permit their interim reporting. Recently, it was reported that a subset of patients with hematologic cancer failed to develop humoral responses despite receiving two vaccine doses 21 days apart (Addeo et al., 2021; Greenberger et al., 2021; Thakkar et al., 2021). However, no data are available regarding whether such patients might be seroconverted by delaying the second dose, which became UK government policy on December 29, 2020 and as has been considered by other nations. The completed results of the SOAP-02 study presented here provide those data.

Author list


Duncan R.McKenzie1

Miguel Muñoz-Ruiz1

Leticia Monin1

Thanussuyah Alaguthurai2,3

Thomas Lechmere4

Sultan Abdul-Jawad2

Carl Graham4

Emily Pollock5

Rosalind Graham2

Kamila Sychowska5

Jeffrey Seow4

Catherine Tremain6

Charalampos Gousis6

Clara Domingo-Vila5

Jack Cooper6

Jennifer Vidler7

Kasia Owzarczyk6

Angela Swampillai3,6

Hartmut Kristeleit6

Michael H. Malim4

Paul Fields2,6

Piers E. M. Patten2,7

Sophie Papa2,6

Bernard V. North8

Timothy Tree5

Katie J. Doores4

Adrian C. Hayday

Sheeba Irshad

1 The Francis Crick Institute, London, UK

2 Comprehensive Cancer Centre, School of Cancer and Pharmaceutical Sciences, King’s College London, UK

3 Breast Cancer Now Research Unit, King’s College London, London, UK

4 Department of Infectious Diseases, School of Immunology and Microbial Sciences, King’s College London, UK

5 Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King’s College London, UK

6 Guy’s and St. Thomas’ NHS Foundation Trust, London, UK

7 Department of Haematological Medicine, King’s College Hospital, London, UK

8 Clinical Trials Unit, King’s College London, UK

9 Cancer Research UK (CRUK) Clinician Scientist, London, UK

Novel Coronavirus SARS-CoV-2


Cancer Cell