NCCN recommends fifth COVID shot for cancer patients

USA: The National Comprehensive Cancer Network (NCCN)-an alliance of leading cancer centers-has recommended a fifth dose of the COVID-19 mRNA vaccine for immunocompromised individuals, including those with cancer or a history of cancer.

The update comes from the NCCN Advisory Committee on COVID-19 Vaccination and Pre-exposure Prophylaxis, which first published the vaccination guidelines for patients with cancer in January 2021. Since then, several updates have been issued with the evolution of data on the virus and vaccines. 

The group explained that a fifth shot of an mRNA vaccine represents a second booster because the primary mRNA immunization series for immunocompromised individuals involves three doses of either the Pfizer or Moderna vaccine.

"The primary mRNA vaccination series for immunocompromised people is considered three shots-this essentially includes most patients with active cancer or a recent history of cancer. The primary series remains two shots for people who are not immunocompromised," they wrote. 

"This guidance is intended to let cancer care providers know not only what they can do, but also what they should do, according to experts across the United States," said Brahm Segal, MD, Roswell Park Comprehensive Cancer Center, Co-Leader of the NCCN Advisory Committee on COVID-19 Vaccination and Pre-exposure Prophylaxis.

The committee has also issued an update for recipients of Johnson & Johnson's single-shot COVID-19 vaccine, including a recommendation that patients receive an mRNA vaccine for both the first and second booster doses.

According to the committee, both homologous and heterologous boosters are suitable for the fifth dose, which means the Moderna and Pfizer vaccines can be used interchangeably.

"Bottom line, we want to share COVID-19 recommendations that are simple and useful," said committee co-leader Lindsey R. Baden, MD, Professor of Medicine, Harvard Medical School and an Infectious Diseases specialist at Brigham and Women's Hospital and Dana-Farber Cancer Institute.

"We know a lot more about COVID-19 and the vaccines now, and we can use that knowledge to minimize the confusion and enhance the protection we can offer to our immunocompromised patients."

Reference:

NCCN. Updated Guidance for COVID-19 Vaccination from NCCN Recommends Fifth mRNA Shot (Second Booster Dose) for Immunocompromised People. 27 April 2022.