National Organization Recommends COVID-19 Vaccine for Patients With Cancer

The National Comprehensive Cancer Network (NCCN) – an alliance of 30 cancer centers across the United States – recommends that all patients with cancer in active treatment get the COVID-19 vaccine.

The NCCN, however, recommends that patients consider their immunosuppression risks when it comes time to receive the vaccine.

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The organization created a committee of hematology and oncology experts who specialize in infectious disease, vaccine development and delivers, medical ethics and health information technology to come up with the recommendations.

The NCCN recommends that patients:

• With hematopoietic cell transplantation or cellular therapy (such as CAR-T cell therapy) wait at least three months after hematopoietic cell transplantation/cellular therapy for COVID-19 vaccination.
• With hematologic malignancies receiving intensive cytotoxic chemotherapy delay vaccination until their neutrophil count recovers.
• With hematologic malignances with marrow failure from disease and/or therapy and are expected to have limited recovery; or on long-term maintenance receive the vaccine when available.
• With solid tumors receiving cytotoxic chemotherapy, targeted therapy, immunotherapy, or radiation receive the vaccine when available.
• With solid tumors undergoing major surgery separate date of surgery from vaccination by at least a few days.

“One of our primary goals is reducing morbidity and mortality,” said Dr. Sirisha Narayana, an associate professor of medicine at University of California, San Francisco. “We also have to take social determinants of health into account and make special efforts for people in high-risk communities.”

Currently, patients with cancer are prioritized for the vaccination in the high-risk category (CDC group 1b/c). The NCCN also states that caregivers and people living with those who have cancer receive the vaccine when available.

“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 comorbidities, like immunosuppression,” said Dr. Steve Pergam, medical director of infection prevention at Seattle Cancer Care Alliance and co-leader of the NCCN COVID-19 Vaccine Committee.

Pegram also explained that the guidelines were crafted with the limited data that is available and this will likely be an evolving document.

“The medical community is rising to one of the biggest challenges we have ever faced,” said the NCCN’s CEO Dr. Robert W. Carlson. “The COVID-19 vaccines exemplify the heights of scientific achievement. Now we have to distribute them quickly, equitably, safely and efficiently using clearly defined and transparent principles.”

A version of this story appeared on Oncology Nursing News® as “COVID-19 Vaccine for Patients With Cancer: NCCN Guidance.”