Several medical societies and professional oncology organizations have released guidance on whether patients with cancer should receive the vaccine that protects against SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). Both the National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology (ASCO) recommend that patients with cancer seek the vaccine.1,2

Prioritization

The initial supply of COVID-19 vaccines is expected to be limited, so the United States is generally vaccinating individuals based on a prioritization scheme.3 The Centers for Disease Control and Prevention (CDC)’s Advisory Committee on Immunization Practices (ACIP) has recommended that states prioritize health care personnel who may come in direct contact with patients or infectious material and people living in assisted living or skilled nursing facilities first. The CDC also supports the early prioritization of patients with serious health conditions (including cancer) and individuals aged 65 years or older for vaccination. However, the prespecified group prioritization for vaccination varies by state, so it is important to check how early your state is prioritizing patients with cancer.

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The NCCN has recommended that states prioritize patients with cancer in early vaccination groups,1 but because the vaccine supply is limited at this time, the NCCN recognizes that there are subgroups within the population of patients with cancer that should be prioritized ahead of others. For example, if not all patients with cancer can be vaccinated, patients with other comorbidities, patients aged 65 years or older, those currently undergoing active treatment, and individuals with social or demographic risk factors may be prioritized ahead of those who have completed treatment or those who have no other medical conditions.

Individuals who live in the same home as a patient with cancer, such as a partner or caregiver, are also recommended to receive the vaccine as soon as it is available to them.1 Some states may prioritize these individuals in an early vaccination group due to their caregiver status.

Timing of Vaccination

Although it is recommended that all patients with cancer receive the COVID-19 vaccine, there are some individuals who may need to wait to ensure that their immune system responds to the vaccine. The NCCN advises patients who have undergone an allogeneic or autologous transplant or who have received a type of cellular therapy, such as chimeric antigen receptor T (CAR-T) cell therapy, to wait a minimum of 3 months to receive the vaccine.1

Further, patients who received intensive cytotoxic chemotherapy and experienced a resulting decrease in absolute neutrophil count should wait until the neutrophil count recovers to receive the vaccine. It is also advised that patients who underwent a major surgery wait a few days to be vaccinated. All other patients with cancer, regardless of their type of treatment, should receive the vaccine as soon as it is made available to them, according to the NCCN.

Is the Vaccine Safe?

Clinical trials have shown that the COVID-19 vaccines that currently have Emergency Use Authorization (EUA) are safe and effective in the general population.1 The COVID-19 vaccine has not yet been studied in patients with cancer specifically; however, its safety and efficacy in this population is expected to be similar to that in the general population. In addition, because it is not a live vaccine (the mRNA vaccines do not contain a virus) there is no immediate safety risk for those who are immunosuppressed.

After Vaccination

After you receive the COVID-19 vaccine, it is important to continue to take preventative precautions, especially if your treatment causes immune suppression.1 Patients with immunosuppression may take longer to develop full immunity to the virus.

References

  1. Preliminary Recommendations of the NCCN COVID-19 Vaccination Advisory Committee, version 1.0. National Comprehensive Cancer Network. Published January 22, 2021. Accessed February 22, 2021. https://www.nccn.org/covid-19/pdf/COVID-19_Vaccination_Guidance_V1.0.pdf
  2. COVID-19 Vaccine & Patients with Cancer. American Society of Clinical Oncology. Updated February 11, 2021. Accessed February 22, 2021. . https://www.asco.org/asco-coronavirus-resources/covid-19-patient-care-information/covid-19-vaccine-patients-cancer
  3. Dooling K. COVID-19 vaccine prioritization: Work Group considerations. Presented at: the Advisory Committee on Immunization Practices COVID-19 Vaccines Work Group; August 26, 2020. Accessed February 22, 2021. https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2020-08/COVID-08-Dooling.pdf

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COVID19 General Oncology