National Comprehensive Cancer Network issues guidance on third dose of COVID-19 vaccine
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National Comprehensive Cancer Network updated its guidance on COVID-19 vaccination for patients with cancer following FDA authorization of a third mRNA vaccine dose for certain immunocompromised individuals.
The NCCN COVID-19 Vaccination Advisory Committee recommendations — available online at nccn.org/covid-19 — state that based on the latest FDA and CDC decisions, the following groups should be deemed eligible for a third vaccine dose:
- patients with new or recurring solid tumors who have received treatment within 1 year of their vaccine dose, regardless of cancer therapy type;
- patients with active hematologic malignancies, regardless of whether they currently are undergoing cancer therapy;
- individuals who underwent stem cell transplantation or engineered cellular therapy, such as chimeric antigen receptor T-cell therapy, particularly during the past 2 years;
- allogeneic stem cell transplant or immunotherapy recipients who have a history of graft-versus-host disease, regardless of when they received transplant; and
- individuals with an additional immunosuppressive condition, such as HIV, or receiving treatment with immunosuppressive drugs unrelated to their cancer therapy.
The guidance further states that, in accordance with CDC recommendations, individuals should wait at least 2 to 4 weeks between the second and third dose, and that those who develop COVID-19 despite vaccination should not receive a third dose until they have documented clearance of the virus.
The third vaccine dose preferably should be administered to immunocompromised people in a health care delivery setting as opposed to a public vaccination clinic or a pharmacy in order to minimize exposure risk, according to the guidance.
The committee recommended those living in the same household as immunocompromised individuals also receive a third vaccine dose.
“When it comes to people’s safety, we have to take every precaution,” Steven Pergam, MD, MPH, vaccination advisory committee co-leader, associate professor in the vaccine and infectious disease division at Fred Hutchinson Cancer Research Center, and infection prevention director at Seattle Cancer Care Alliance, said in an NCCN-issued press release. “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. All of us should do our part to reduce the spread of COVID-19 and get vaccinated to protect those around us from preventable suffering.”
Cancer care providers throughout the world have used the NCCN recommendations to make management decisions amid the COVID-19 pandemic.
“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,” Robert W. Carlson, MD, CEO of NCCN, said in the press release. “We want our patients to live the longest and best lives possible, which means following the science on vaccination and mask-wearing.”
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