{"doi":"10.1016/j.jtocrr.2021.100250","title":"Reply to K. Takada et al.","abstract":"We thank Takada et al.1Takada K. Takamori S. Miura N. et al.Correspondence regarding “tolerability of coronavirus disease 2019 vaccines, BNT162b2 and mRNA-1273, in patients with thymic epithelial tumors”.JTO Clin Res Rep. 2021; 2: 100238Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar for their insightful comments on our recent article that describes the tolerability of coronavirus disease 2019 (COVID-19) vaccines, BNT162b2 and mRNA-1273, in patients with thymic epithelial tumors (TETs).2Ballman M. Swift S. Mullenix C. et al.Tolerability of coronavirus disease 2019 vaccines, BNT162b2 and mRNA-1273, in patients with thymic epithelial tumors.JTO Clin res rep. 2021; 2: 100229Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar Takada et al. raise an important point on the potential impact of concomitant medications on the tolerability of vaccination and highlight a recent article by Nelli et al.3Nelli F, Fabbri A, Onorato A, et al. Effects of active cancer treatment on safety and immunogenicity of COVID-19 mRNA-BNT162b2 vaccine: preliminary results from the prospective Vax-On study [e-pub ahead of print]. Ann Oncol. https://doi.org/10.1016/j.annonc.2021.09.009, Accessed October 21, 2021.Google Scholar which found that patients receiving granulocyte colony-stimulating factor (G-CSF) had a statistically significant increase in the risk of fever after vaccination with the BNT162b2 vaccine (OR = 3.37, p = 0.022). Recognizing the impact of concomitant medications, especially those that can suppress potential vaccine-related adverse events (AEs), we had reported use of immunosuppressants, including corticosteroids, nonsteroidal anti-inflammatory drugs, and acetaminophen in our article.2Ballman M. Swift S. Mullenix C. et al.Tolerability of coronavirus disease 2019 vaccines, BNT162b2 and mRNA-1273, in patients with thymic epithelial tumors.JTO Clin res rep. 2021; 2: 100229Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar To address the observation of an increase in the risk of systemic AEs after vaccination with BNT162b2 in patients receiving concomitant G-CSF which was reported after publication of our article, we have evaluated the effect of concurrent anticancer therapy and G-CSF on the tolerability of the BNT162b2 and mRNA-1273 vaccines in our patient cohort. Information on anticancer therapy at the time of administration of the first dose of these vaccines was available for 52 patients. A total of 26 patients (50%) were receiving anticancer therapy (chemotherapy, n = 12; immunotherapy, n = 9; other anticancer therapy, n = 5). No substantial differences in the tolerability of the BNT162b2 or mRNA-1273 vaccine were observed between individuals receiving anticancer therapy and those who were not on active anticancer treatment (Table 1). Furthermore, information on concurrent G-CSF use was available for 50 patients, and only two patients (4%) were receiving G-CSF at the time of vaccination (BNT162b2, n = 1; mRNA-1273, n = 1). Neither patient developed fever or other systemic AEs after either dose of the vaccine, except for moderate, self-limited fatigue after the second dose of the BNT162b2 vaccine, which could also have been related to concurrent chemotherapy. Although comparisons are limited by the relatively small number of participants reporting AEs in each group, our results reveal no substantial effect of concurrent anticancer therapy or G-CSF use on the tolerability of the BNT162b2 and mRNA-1273 vaccines in patients with TETs.Table 1Effect of Anticancer Treatment on the Tolerability of the BNT162b2 and mRNA-1273 Vaccines in Patients With Thymic Epithelial TumorsBoth Vaccines CombinedSymptomsAEs After Vaccination, n (%)p ValueAEs After Vaccination, n (%)p ValueOn Concurrent Anticancer TreatmentNo Concurrent Anticancer TreatmentOn Concurrent ChemotherapyNo Concurrent ChemotherapyLocal pain20 (76.9)20 (76.9)1.008 (66.7)32 (80)0.44Local redness1 (3.9)1 (3.9)1.001 (8.3)1 (2.5)0.41Local swe","journal":"JTO Clinical and Research Reports","year":2021,"id":228354,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.943,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":768688,"name":"Cristina Mullenix","orcid":null,"position":1,"is_corresponding":false},{"id":318558,"name":"Éva Szabó","orcid":"0000-0003-3891-0942","position":2,"is_corresponding":false},{"id":109203,"name":"Seth M. 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