A study to see how the COVID-19 vaccination affects how the body fights infection (OCTAVE)

The team looked at the blood and spit samples of 2,686 people. This included people with a number of different autoimmune diseases  and some people with cancer. 

Those who had cancer were:

• 112 people with breast cancer or lung cancer
• 33 people with acute myeloid leukaemia (AML) or myeloma

The team included people who had a stem cell transplant. They were:

• 58 people who had a transplant of their own stem cells, an autologous stem cell transplant
• 207 people who had a transplant of a donor’s stem cells, an allogeneic stem cell transplant

They also included:

• 13 people who had CAR T-cell therapy
• 29 people who were having rituximab

How well the immune system responded
Four weeks after the 2nd vaccine injection the team found that the immune system responded in:

• everyone (100%) who had breast cancer or lung cancer
• everyone (100%) who had AML or myeloma 
• 85 out of every 100 people (85%) who had an autologous stem cell transplant
• 86 out of every 100 people (86%) who had an allogeneic stem cell transplant
• half the people (50%) who had CAR T-cell therapy
• 28 out of every 100 people (28%) who had rituximab

Predicting how well the immune system responds 
The team found that the immune system of people with certain diseases or having particular treatments were more likely to have a low to moderate response to the vaccine. This means that they would be less able to fight COVID-19. This included people with:

• inflammatory arthritis
• kidney problems
• Crohn’s disease

It also included people who had:

• an allogeneic stem cell transplant
• corticosteroids
• some types of chemotherapy
• certain drugs that affected the immune system 

COVID-19 infection and how bad it was
The team looked at how many people had COVID-19 up to a year after their 2nd vaccine. They had the results of 1,648 people. Of these, there were 474 people with COVID-19. For just over 90 in every 100 people (90.2%) it was a mild infection.

Most infections happened in people who had:

• a kidney transplant
• Crohn’s disease
• inflammatory arthritis

They also found that for some people who had an autologous stem cell transplant or CAR T-cell treatment the infection rate of COVID-19 was low. But the people who had COVID-19 had a severe infection. 

Side effects
The majority of people had side effects after the vaccine. For over 97 out of every 100 people (97%) they were mild or moderate. 

The most common side effects included:

• a reaction where they had the injection
• headache
• chills
• sore muscles
• high temperature (fever)

Conclusion
The trial team concluded that the immune system of these people had a moderate response after 2 vaccines. And if they did have COVID-19 after the vaccine it would be most likely be mild.

More detailed information
There is more information about this research in the references below. 

Please note, the information we links to here is not in plain English. It has been written for healthcare professionals and researchers.

SARS-CoV-2-specific immune responses and clinical outcomes after COVID-19 vaccination in patients with immune-suppressive disease
E Barnes and others
Nature Medicine, 2023. Volume 29, pages 1760 to 17740.

Examining the Immunological Effects of COVID-19 Vaccination in Patients with Conditions Potentially Leading to Diminished Immune Response Capacity – The OCTAVE Trial
P Kearns and others
Preprint with The Lancet

Where this information comes from    
We have based this summary on the information in the articles above. These have been reviewed by independent specialists (peer reviewed ) and published in medical journals. We have not analysed the data ourselves. As far as we are aware, the links we list above are active and the articles are free and available to view.