Immunocompromised Americans Can Get Booster Shots
- The CDC is now recommending a booster shot of the COVID vaccine for immunocompromised people including cancer patients.
- The CDC says that booster shots should be administered 28 days or more after the second dose of the Moderna or Pfizer vaccine
- No identification or prescription will be required
- SurvivorNet Medical Advisors say you should consult your oncologist about managing your COVID risk and the decision to get a booster shot
- Immunocompromised individuals are still being advised to wear masks, socially distance, and make sure everyone in their home is vaccinated.
The panel is recommending that patients with cancer speak to their doctor about getting a booster, but are then free to make an appointment at any vaccination site.Read More
Individuals who received the Pfizer vaccine must receive the Pfizer booster unless there is no Pfizer vaccine in stock at the vaccination site, in which case they can mix and match wth Moderna. The same goes for those who initially received the Moderna vaccination as well, should only Pfizer be available to them at the vaccination site.
Also, no identification or prescription will be required at vaccine sites, as per the recommendations of the CDC.
The 11 experts on the panel discussed the proposal for three hours before voting, a little over 12 hours after the Food and Drug Administration approved the boosters late Thursday night.
CDC Director Dr. Rochelle P. Walensky explained the rationale behind the decision in a statement: “Emerging data suggest some people with moderately to severely compromised immune systems do not always build the same level of immunity compared to people who are not immunocompromised. In addition, in small studies, fully vaccinated immunocompromised people have accounted for a large proportion of hospitalized breakthrough cases (40-44%). Immunocompromised people who are infected with SARS CoV-2 are also more likely to transmit the virus to household contacts.”
This decision will quickly go into effect for all individuals aged 12 and up who received the Pfizer vaccine as well as recipients of the Moderna vaccine over the age of 18.
Immunocompromised individuals who were inoculated with the Janssen vaccine from Johnson & Johnson are not eligible for a booster at this time. That vaccine had not been approved when immunocompromised inoculations began earlier this year, so there are fewer people in that population affected.
There are still a number of unanswered questions though, and a vagueness to some of the group’s recommendations.
“I think this is a moving target and guidelines will change soon. We frankly need more specific guidelines on definition of immunocompromised in this setting,” Dr. Elizabeth Comen, a medical oncologist Memorial Sloan Kettering Cancer Center tells Survivor Net.
“The reality is that the data is evolving in real-time, with ongoing assessments of durability of the vaccine over time, and rate of breakthrough infections particularly in the setting of the delta and other variants.”
Dr. Comen said that above all else, people “MUST be vaccinated,” and shared that she would be first in line once she qualified for a booster.
“Till then, my colleagues and I remain vigilant professionally and personally in the setting of aggressive new variants,” she said.
The group based their decision largely on a New England Journal of Medicine study published this week that found the third dose was extremely effective at increasing COVID antibodies in solid organ transplant patients.
Dr. Comen was not alone in her enthusiasm for the booster.
“I plan to get one when I can. I think any patient who is eligible should get one when they can.”
When asked about potential side effects of a third shot, Dr. Yeo says it “should be similar-but less than original vaccine.”
The other main concern was how the booster might effect some of the younger recipients.
“I think that the age down to 12 is actually helpful from an equity and access standpoint, in part because I know we have as clinicians seen immunocompromised children who remain at risk for contracting COVID infection, and you know we’re reopening schools we’re in this, this whole other era where we’re really trying to support the safety of all of our patients as individuals and as well as in for the teen population in particular in schools,” said Dr. Yvonne Maldonado, the American Academy of Pediatrics liaison to the ACIP.
She went on to note that the most common cancers in that group are hematologic, which has proven to be the lest receptive to the vaccine.
In the end, the goal she explained was to “make sure that the people who need protection are protected and then be able to offer that protection.”
This all comes after the FDA approved the boosters late Thursday night.
“The country has entered yet another wave of the COVID-19 pandemic, and the FDA is especially cognizant that immunocompromised people are particularly at risk for severe disease,” said Acting FDA Commissioner Dr. Janet Woodcock in a statement obtained by SurvivorNet.
How Cancer Patients Can Stay Protected From Covid-19
Multiple oncologists tell SurvivorNet that wearing a mask is still the best way for cancer patients to avoid contracting or spreading the virus as the dangerous delta variant spreads.
Dr. Paul G. Richardson, clinical program leader and director of clinical research at the Jerome Lipper Multiple Myeloma Center at Dana-Farber Cancer Institute notes that getting vaccinated is just one of many steps cancer patients should be taking at this time.
“The key is the success of vaccinations, but other strategies in my [multiple myeloma] patients focus on continued precautions, and attention to therapeutics – not least as the variants are such a concern,” says Dr. Richardson.
“We are moving from pandemia to endemia and as such long-term adjustments and continued caution are inevitable in terms of treatments for underlying and supportive care. Fortunately, however, we are moving towards a more manageable paradigm of therapy/care, although the danger of SARS CoV2 remains clear and present,” he says.
That danger seems to be growing with each day as well with the delta variant rising around the country, and studies show that it is the most vulnerable who are contracting this variant of the virus. Some research indicates that some blood cancer patients don’t get the same benefit from the COVID-19 vaccine. This includes people with cancer that affects the blood, bone marrow or lymph nodes, particularly those with chronic lymphocytic leukemia.
That is why the third shot would be such a help to those with cancer, explains one oncologist.
“Some medical centers have looked at giving a booster vaccine dose, a third dose, and they found that some of these [cancer] patients now have a high enough immune response to potentially prevent infection,” explains Dr. John N. Greene, chief of infectious diseases at the Moffitt Cancer Center.
“But we don’t know how long-lasting even those are, but at least the numbers are high enough that it could prevent an infection. So if you would give a booster vaccine or you could get a higher immune response quantitatively, then those patients could actually do fine even if exposed to the delta variant. And that’s been true with other variants as well. They believe that the higher the titers you can maintain, the greater the chance you can prevent infection.”