Which Cancer Patients Need a COVID Booster Shot Most?

September 7, 2021

An alliance of leading U.S. cancer centers has updated guidance about COVID-19 vaccine boosters for cancer patients and the people around them.

The National Comprehensive Cancer Network's new recommendations are intended for health care providers.

"COVID-19 can be very dangerous, especially for people living with cancer, which is why we're so grateful for safe and effective vaccines that are saving lives," chief executive officer Dr. Robert Carlson said in a network news release.

The guidance, from the NCCN's Vaccination Advisory Committee, says several groups should be considered eligible immediately for a third dose of the Pfizer-BioNTech or Moderna mRNA COVID vaccine:

Patients with either new or recurring solid tumors receiving treatment within a year of their initial vaccine dose, regardless of their type of cancer therapy.
Patients with active blood cancers whether or not they are now receiving treatment.
Any cancer patient who received a stem cell transplant (SCT) or engineered cellular therapy (CAR T-cells), especially within the past two years.
Recipients of allogeneic SCT on immunosuppressive therapy or with a history of graft-versus-host disease regardless when they got their transplant.
Any cancer patients who also have an additional immunosuppressive condition -- such as HIV -- or are receiving immune-suppressing treatment unrelated to their cancer therapy.

The updated guidance is based on the latest information from the U.S. Food and Drug Administration and U.S. Centers for Disease Control and Prevention.

It highlights CDC recommendations for people to wait at least four weeks between second and third doses. Patients who develop COVID-19 despite having two doses should wait for their third dose until they have confirmed they are no longer infected.

People who live with immunocompromised people should also get a third dose once it is available to them, the committee advised.

The advisory said it's best for that third dose to be the same type of vaccine as the first two doses, but a different mRNA vaccine is also acceptable. In other words, someone who had the Pfizer vaccine could get a Moderna booster, and vice versa.

If possible, immunocompromised people should to try to receive their third dose in a health care setting instead of a pharmacy or public vaccination clinic to limit their risk of exposure to the general population.

"When it comes to people's safety, we have to take every precaution," said Dr. Steve Pergam, co-leader of the advisory committee.

"That means even after a third dose of vaccine, we still recommend immunocompromised people -- such as those undergoing cancer treatment -- continue to be cautious, wear masks and avoid large group gatherings, particularly around those who are unvaccinated," Pergam said in the release.

The recommendation did not address the single-shot Johnson & Johnson vaccine, which is not an mRNA vaccine.

More information

The American Cancer Society has more on COVID-19.

SOURCE: National Comprehensive Cancer Network, news release, Aug. 30, 2021

Cancer: Misc.Centers for Disease Control Food &, Drug Administration Immune Disorders Immunization Safety &, Public Health Vaccines