COVID-19 Vaccine Recommendations for People with Cancer
- Almost everyone who has cancer should get the vaccine as soon as it’s available to them.
- People who have had stem cell transplant or CAR-T cell therapy should wait 3 months.
- Caregivers, household members, and close contacts of people with cancer should get the vaccine as soon as possible, too.
Read More"These preliminary recommendations by a trusted source, NCCN, provide critical guidance on vaccination for our cancer patients who face the concurrent risks of COVID-19 vulnerability and cancer." Dr. Alexandra Thomas
NCCN is a nonprofit alliance of top cancer centers. The group created a COVID-19 Vaccine Committee that includes hematology and oncology experts with particular expertise in infectious diseases, vaccine development and delivery, medical ethics, and health information technology.
"It was critical that the NCCN come up with guidelines for this because this is a burning question for every patient, survivor and their loved ones,” Nikhil Khushalani, MD, tells SurvivorNet. He is Vice Chair of the Department of Cutaneous Oncology at Moffitt Cancer Center in Tampa, FL.
What the Guidelines Say
The guidelines are based on current knowledge about the COVID-19 vaccines as well as guidelines for the flu shot during active cancer treatment.
"We haven't excluded any cancer patients from vaccination but rather made suggestions around timing. Not every patient on active therapy may have a similar immune response to those not on active therapy,” Khushalani explains.
NCCN's COVID-19 Vaccine Committee recommends the following:
- That people who have cancer be included in CDC priority group 1B or 1C for vulnerable people.
- Everyone with cancer should get the vaccine as soon as it becomes available to them in their state with the understanding that there is limited information about the safety and efficacy of the vaccine in people who have cancer.
- Because the vaccine may not be as effective in people who are immunocompromised due to their treatment, people who have received bone marrow transplant (also called stem cell transplant) or engineered cellular therapy, such as CAR-T cells, should wait until three months after these treatments to get the vaccine.
- Caregivers, household members and other close contacts of people with active cancer should also get the vaccine as soon as they are eligible.
"Right now, there is urgent need and limited data," Steve Pergam, MD, MPH, said in a press release. An associate professor at Fred Hutchinson Cancer Research Center and Infection Prevention Director at Seattle Cancer Care Alliance, Pergam co-led the NCCN COVID-19 Vaccine Committee. "Our number one goal is helping to get the vaccine to as many people as we can. That means following existing national and regional directions for prioritizing people who are more likely to face death or severe illness from COVID-19. The evidence we have shows that people receiving active cancer treatment are at greater risk for worse outcomes from COVID-19, particularly if they are older and have additional [health conditions], like immunosuppression."
The new guidelines acknowledge that while the vaccines have been shown to be safe in general populations, we still don't know how effective they will be at preventing infection with COVID-19 in people with cancer. "Recognizing that there is currently limited information, for our patients the benefits of vaccination generally outweigh the risks," Thomas says.
The panel will continue to meet regularly to adjust and refine its recommendations for cancer patients as new information becomes available. The current recommendations align with what many cancer and infectious disease experts have already recommended.
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"The COVID-19 vaccine guidelines is very encouraging and in keeping with the guidance of our center [Hopkins Medicine]," Carol Ann Huff, MD, tells SurvivorNet. Huff is a hematologist-oncologist at Hopkins Medicine and served on NCCN's COVID-19 vaccine committee. "The release of these guidelines is intended to assist oncology care providers and patients and encourage them to be vaccinated."
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