on the commemoration of the World Cancer Day 2021

The outbreak of SARS-CoV-2 infection has caused disruption and challenges across the world and we are facing a difficult time, unprecedented since the influenza pandemic of 1918^1,2. There are more than 100 million registered cases worldwide, prompting the WHO to declare a Public Health Emergency in late January 2020 and a pandemic in March 2020.³

Currently, being vaccinated against SARS-CoV-2 seems the only way to break the pandemic chain. There are over 60 vaccines in clinical and more than 170 others in preclinical development stages. Nine of these have been offered for mass vaccination.⁴

We acknowledge the fact that, in the short term, vaccines against SARS-CoV-2 will not be available in sufficient quantities to vaccinate everyone; there is a necessity in making quick decisions to prioritise high risk groups to get the vaccination operational without further delay. It can be seen that this prioritisation is different in many countries and some are not in compliance with medical, ethical and legal principles in general⁵. Cancer care has been affected and, shadowed by the focus of the pandemic, is further worsened by indecisive priority vaccination listings, often excluding cancer patients and creating fear, anxiety, isolation and frustration.^6,7

On the occasion of WORLD CANCER DAY we, INSPIRE2LIVE, a worldwide platform of patients, patient advocates, researchers and clinicians are working collectively in the World Campus to place more emphasis on patients with cancer through highlighting some crucial points for SARS-CoV-2 vaccination.

• This is a call for action for cancer societies. We must overcome the underestimation of cancer patients in priority vaccination and to endorse Research and Clinical Trials to include more cancer patients. Only then are we able to find out at what stage of cancer and treatment, vaccination provides the most efficient and effective outcomes. This is necessary so that measures can be taken to overcome the inequality for cancer patients regarding priority vaccination before it is too late.
• We believe priority vaccination should include CANCER PATIENTS. Cancer patients appear to be more vulnerable to COVID-19 and they experience COVID-19 symptoms more severely^8,9. Vaccinating cancer patients should be considered as a tertiary preventive measure given the fact that screening, diagnosis, treatment and follow-ups have either been delayed or halted with lives of cancer patients hanging in the balance.
• Priority vaccination should include not only HEALTHCARE PROFESSIONALS such as doctors, nurses, and professional caregivers but also volunteer CAREGIVERS and primary FAMILY members who are repeatedly in contact with cancer patients. The latter two groups have often been neglected in the recommendations and guidelines for priority vaccination. This is crucial to minimise nosocomial transmission.¹⁰ If the priority list covers volunteer caregivers, it would have to be restructured unless the production capacities of vaccines increase. In such a case decision makers have to consider who to prioritise.
• Many local, regional repositories of available data and registries are confusing. There is an urgent need for a centralised, open, transparent repository and registry with evidence based policies. This statement should be considered as a call for action for trusted global organisations such as the WHO. Data mining and analysis will certainly help identify and quantify side/adverse effects and provide valuable information for further priority vaccination updates. This data should also include Patient Reported Outcomes (PROs) as we know much feedback may otherwise go unnoticed.¹¹
• EDUCATE HEALTHCARE PROFESSIONALS with evidence based, scientific facts and a common message on vaccination. It has been stated that the overall proportion of healthcare professionals who are in favour of vaccinating cancer patients was only 55.9%, which makes their call for vaccination unconvincing.¹²
• There is so much misleading information that is lacking or even false on the web and on social media. There is a need to AGREE on a UNIVERSAL COMMON language and evidence based scientific information to be shared with Healthcare Professionals so they can reliably and convincingly communicate with their cancer patients.

Authors: Diler S, Kyosovska G, Moss B, Moss M, Mao M, Rath N, Parelta P, Stavru F, Schuurman JG

Contributors: Kapitein P, Malats N, Ibrahim G, Lourdes M, Kranen H van

External reviewers: Andre Krom (Leiden University Medical Centre), Carlo la Vecchia (Università degli Studi di Milano “La Statale”)

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