As Covid-19 cases spike, guidelines for people with cancer receive significant upgrades

Photo illustration from Beth Israel Deaconess Medical Center

The National Comprehensive Cancer Network has published significant updates to the expert consensus recommendations on vaccination and pre-exposure measures of Covid-19 in people with cancer. The updated guidance includes information on the preventive use of human monoclonal antibodies in addition to the following principles:

• Patients with cancer should get fully immunized, including third doses and/or any approved boosters.
• There is a strong preference for mRNA vaccines, such as the Pfizer or Moderna vaccines.
• Vaccination should be delayed for at least three months following certain cancer treatments. Vaccine delays in patients with cancer should also include those recommended for the general public.
• Full vaccination is also recommended for caregivers, household/close contacts, and the general public.
• The committee strongly supports full vaccination mandates for healthcare workers.

“All of us are called to do everything we can to save as many lives as possible during the ongoing pandemic,” said Robert W. Carlson, CEO of the National Comprehensive Cancer Network. “Vaccination is our most effective approach for avoiding serious Covid-19 complications, including hospitalization and death. However, research shows many immuno-compromised people develop inadequate immune responses from vaccines." 

Carlson mentioned additional tools to help people with cancer and others who are immuno-compromised. For example, the Food and Drug Administration has issued an emergency-use authorization for a drug combination for pre-exposure protection from Covid-19 in adults and children, starting at age 12, who have moderate to severe immune compromise and may not be responsive to vaccination.

“The medical and scientific community’s response to the Covid-19 crisis continues to be extremely encouraging, even in the face of setbacks like new variants and surging infection rates,” Carlson said. “Rapid research, thoughtful analyses, and tireless care delivery is allowing us to save so many more people than we could have a year ago. We hope by sharing this simplified guidance highlighting the latest research and approvals, we can help make sure the very latest in evidence-based care reaches as many patients and providers as possible.”