癌症患者死于 COVID-19 的风险增加，并且对 SARS-CoV2 疫苗的免疫反应降低，因此需要定期加强免疫。我们对 2020 年 11 月 3 日至 2020 年 11 月 3 日期间接受积极癌症治疗的 982 名癌症患者进行了全面的图表审查、患者态度调查、SARS-CoV-2 抗体血清学和 T 细胞受体 (TCR) β 测序以了解细胞反应以及 2023 年 3 月 31 日。我们发现 92·3% 的患者接受了初级疫苗，70·8% 接受了单价加强疫苗，但只有 30·1% 接受了二价加强疫苗。 50 岁以下、非裔美国人或西班牙裔患者的加强剂摄入量较低。几乎所有患者在 2 次加强疫苗接种后都发生了血清转化（>99%），并且细胞反应得到改善，这表明重复加强疫苗接种可以克服疫苗接种反应不佳的问题。接受加强疫苗接种与较低的全因死亡率风险相关（HR=0·61，P=0·024）。高危癌症患者的加强疫苗接种率仍然较低，需要鼓励采取加强疫苗接种的策略。在接受各种抗癌治疗的患者中，COVID-19 加强疫苗接种可提高抗体水平并维持针对 SARS-CoV-2 的 T 细胞反应。 -导致患者死亡很大一部分患者仍未得到加强，需要采取策略鼓励患者及时接种疫苗。

Patients with cancer are at increased risk of death from COVID-19 and have reduced immune responses to SARS-CoV2 vaccines, necessitating regular boosters. We performed comprehensive chart reviews, surveys of patients attitudes, serology for SARS-CoV-2 antibodies and T-cell receptor (TCR) β sequencing for cellular responses on a cohort of 982 cancer patients receiving active cancer therapy accrued between November-3-2020 and Mar-31-2023. We found that 92·3% of patients received the primer vaccine, 70·8% received one monovalent booster, but only 30·1% received a bivalent booster. Booster uptake was lower under age 50, and among African American or Hispanic patients. Nearly all patients seroconverted after 2+ booster vaccinations (>99%) and improved cellular responses, demonstrating that repeated boosters could overcome poor response to vaccination. Receipt of booster vaccinations was associated with a lower risk of all-cause mortality (HR=0·61, P=0·024). Booster uptake in high-risk cancer patients remains low and strategies to encourage booster uptake are needed.COVID-19 booster vaccinations increase antibody levels and maintain T-cell responses against SARS-CoV-2 in patients receiving various anti-cancer therapiesBooster vaccinations reduced all-cause mortality in patientsA significant proportion of patients remain unboosted and strategies are needed to encourage patients to be up-to-date with vaccinations.