COVID-19 vaccination, all-cause mortality, and hospitalization for cancer: 30-month cohort study in an Italian province

Anecdotal reports suggested an association between SARS-CoV-2 vaccination and some cancers, but no formal assessment has been published. This population-wide cohort analysis was aimed at evaluating the risk of all-cause death and cancer hospitalization by SARS-CoV-2 immunization status. Using National Health System of-ficial data, the entire population of the Pescara province, Italy was followed from June 2021 (six months after the first vaccination) to December 2023. Cox models were adjusted for age, gender, previous SARS-CoV-2 infec-tion, and selected comorbidities. Of the 296,015 residents aged ≥11 years, 16.6% were unvaccinated, 83.3% re-ceived ≥1 dose, and 62.2% ≥3 doses. Compared with the unvaccinated, those receiving ≥1 dose showed a signif-icantly lower likelihood of all-cause death, and a slightly higher likelihood of hospitalization for cancer (HR: 1.23; 95% CI: 1.11-1.37). The latter association was significant only among the subjects with no previous SARS-CoV-2 infection, and was reversed when the minimum time between vaccination and cancer hospitaliza-tion was set to 12 months. The subjects who received SARS-CoV-2 vaccination showed a substantial reduction in all-cause mortality, and a risk of cancer hospitalization that varied by infection status, cancer site, and the min-imum lag-time after vaccination. Given that it was not possible to quantify the potential impact of the healthy vaccinee bias and unmeasured confounders, these findings are inevitably preliminary.