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Background: Immunotherapy is becoming a common therapy in cancer patients. Cancer patients on systemic therapy are a vulnerable population, making them highly susceptible to illness from any infection. The purpose of this study was to collect and analyze data reported by patients regarding the side effects of COVID-19 vaccines (Pfizer-BioNTech and Moderna) in cancer patients with solid tumors receiving immunotherapy. Due to the lack of studies and inclusion of cancer patients in the clinical trials for the vaccine, it is pivotal to investigate of the effects of the SARS-2-CoV vaccine on patients receiving immunotherapy to begin to bridge the current gap in knowledge. Methods: We performed a twophased retrospective analysis of adult patients (age ≥18 years) who received either Moderna or Pfizer-BioNTech COVID-19 vaccinations and were currently on immunotherapy (December 15th, 2020, through July 31st, 2021). Phase 1 included a tertiary health system (n = 15,910) in Northeast Georgia. Phase 2 involved cross-tabulation with the VAERS CDC database to compare results at a national level (n = 374,667). The primary endpoints were severity of side effects, timing of side effects and the relationship between the vaccines. The method to evaluate outcome was the Pearson-Chi-Squared test. Results: Results showed that patients on immunotherapy were more likely to have at least one side effect in the tertiary health system (OR 6.727 [95% CI, 2.748 -16.465] compared to least two side effects in the national dataset (X2 = 7.032, p < 0.05). This difference was driven by the Moderna vaccine recipients, demonstrating a higher likelihood of experiencing two or more side effects (X2 = 6.159, p < 0.05). Those receiving the Pfizer-BioNTech vaccine did not demonstrate statistically significant side effects. The most common reaction noted was weakness in both datasets, which was more likely to occur after the Moderna vaccine. Gender analysis showed no difference in side effects in those receiving immunotherapy. In terms of timing of side effects, patients on immunotherapy (M = 10.66, SD = 25.1) had a delayed side effect onset of 10 days vs. four days. (M = 4.72, SD = 15.5, p < 0.05). Conclusions: Both local and national datasets demonstrate cancer patients receiving immunotherapy compared to those that were on immunotherapy, were more likely to experience mild vaccine side effects, specifically weakness being the most common. There was no statistically significant increase in more serious adverse reactions. Additionally, side effect onset was delayed in patients on immunotherapy. These findings provide a foundation for understanding mRNA vaccines in patients on immunotherapy, with future research needs involving larger sample sizes.
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Purpose: In this study, the authors explored the situation of the doctoral candidate in the social sciences as they were confronted by crisis and forced to make changes to their dissertation research plans. The authors conceptualized this as a methodological pivot, or an unexpected shift in trajectory, in which candidates engaged and that culminated in new research plans. Design/Methodology/Approach: Using situational analysis, a form of qualitative grounded theory, the authors conducted interviews and collected extant artifacts to understand the situations of the candidate engaged in the pivot. The analysis produced a situational map and a grounded theorizing. The authors also bound the analysis by a specific time period: the COVID-19 pandemic in the USA. Findings: The grounded theorizing evidenced stages of pivoting, reflected as an internal process of grieving. Participants also endured external institutional impediments around programmatic support, funding and policy. Each internal and external situation exerted some degree of pressure on the candidate’s pivot. Technology and its impact on fieldwork, methodological assets and epistemological shifts mediated internal and external situations to produce the pivot. Originality/Value: This work is unique in that it expands on the field of study and practice that has emerged from the complexity of crisis in education, situated predominantly in lower to middle-income countries. In higher income countries, like the USA, educational institutions remain unprepared for crisis. This work underscores this paucity. The authors also build on the literature that addresses the challenges graduate learners face with support and its implications for persistence. © 2021, Emerald Publishing Limited.