This page was last updated on 2/14/2022. Please check back frequently for updates.
Should people with cancer be vaccinated against COVID-19?
At this time, patients with cancer may be offered vaccination against COVID-19 as long as components of that vaccine are not contraindicated. Appendix B, Appendix C, and Appendix D of the CDC’s Interim Clinical Considerations provide details on vaccine components and potential contraindications. See the question below “Should people who are immunocompromised received a third dose of the vaccine?” for information regarding people who are immunocompromised.
At this time, there are three COVID-19 vaccines authorized and recommended in the United States: the Pfizer-BioNTech, Moderna, and Johnson & Johnson/Janssen vaccines. These vaccines are described on the US CDC’s vaccine page. Vaccination, including the use of booster doses and the use of different vaccines across doses, should take place according to current US CDC and FDA recommendations.
Should people undergoing active treatment for cancer be vaccinated against COVID-19?
At this time, patients undergoing treatment may be offered vaccination against COVID-19 as long as any components of the vaccine are not contraindicated. Oncologists have experience providing other types of vaccines to patients receiving treatment for cancer, including chemotherapy, immunotherapy, radiation therapy or stem cell transplantation. Strategies such as providing the vaccine in between cycles of therapy and after appropriate waiting periods for patients receiving stem cell transplants and immune globulin treatment can be used to reduce the risks while maintaining the efficacy of vaccination. Limited evidence is available regarding vaccination of patients with cancer receiving active treatment, but ASCO is aware of no study that has shown any safety concern for such patients with vaccination. See the question below “Should people who are immunocompromised received a third dose of the vaccine?” for information regarding people who are immunocompromised.
Should cancer survivors be vaccinated against COVID-19?
Cancer survivors may be offered vaccination against COVID-19 as long as any components of the vaccine are not contraindicated.
Are there people who should not be vaccinated?
At this time, only those with contraindications to a specific vaccine component should not be offered vaccination with that specific product. These contraindications are described in detail in CDC interim clinical guidance.
Should people who are immunocompromised receive an additional dose of the vaccine beyond what is recommended for persons who are not immunocompromised?
The CDC has published guidance recommending an "additional primary" dose of some vaccines for patients who are moderately or severely immunocompromised. That includes patients who have “been receiving active cancer treatment for tumors or cancers of the blood”. This is supplemental to, and would precede, the “booster” dose that is currently recommended for nearly everyone who received primary vaccination, regardless of immune status. These recommendations can change rapidly and should be reviewed regularly. As of February 4, 2022, the CDC guidance would allow for at least some immunocompromised individuals to receive four total doses of vaccine, depending on vaccine used and context.
ASCO recommends that patients with cancer discuss with their physician whether a third dose of vaccine is appropriate. The resources provided by Memorial Sloan Kettering Cancer Center are useful in determining levels of immunocompromise in patients with cancer and to help with prioritization for additional vaccine doses. The NCCN preliminary recommendations also provide some guidance on this topic.
What other concerns are there for people with cancer who are vaccinated?
There is some evidence that vaccination with mRNA vaccines prior to imaging may cause difficulties in the interpretation of the resulting images. A multidisciplinary group has published information on imaging in general in the context of COVID-19 vaccination: Becker et al, Radiology. The Society for Breast Imaging has published guidance on how this concern can be managed, available on their COVID resource page.
The COVID-19 and Cancer Clinical Trials Working Group has published information on vaccination of patients who are seeking to participate in or enrolled in clinical trials (Desai et al, Nat Rev Clin Oncol).
The American Society of Hematology (ASH) has also released relevant information in “Immune Thrombotic Thrombocytopenia: Frequently Asked Questions.”
Dr. Julie Gralow, Chief Medical Officer of ASCO, answers common questions and concerns people with cancer have about the COVID-19 vaccines available in the United States.
CDC Advisory Committee on Immunization Practices
CDC is regularly updating the number of vaccines distributed and administered on their COVID-19 page. ACIP continues to convene emergency meetings as new information, evidence and clinical trial results are available. Materials from previous meetings and suggested dates and agendas for future meetings can be found on the CDC website.
HHS Expands Pool of Professionals Eligible to Administer COVID-19 Vaccines
On January 28, 2021, HHS added additional categories of qualified persons authorized to prescribe, dispense, and administer COVID-19 vaccines authorized by the FDA. This action authorizes any healthcare provider who is licensed or certified in a state to prescribe, dispense, and/or administer COVID-19 vaccines in any other state or US territory. It also authorizes any physician, registered nurse, or practical nurse whose license or certification expired within the past five years to prescribe, dispense and/or administer COVID-19 vaccines in any state or US territory so long as the license or certification was active and in good standing prior to the date it went inactive.
Please see this announcement for additional information, including training requirements and details on liability protections.
Resources from the American Medical Association
The American Medical Association (AMA) has produced several resources with helpful advice for clinicians regarding the COVID-19 vaccines. Please visit the links below for concise information on the vaccines as well as tips for how to discuss them with patients.
- Physician Frequently Asked Questions
- Patient Frequently Asked Questions
- Tips on How to Talk to Patients about the Vaccine (video with transcript)
Resources from CDC
CDC has developed toolkits to assist clinicians providing or advising patients on the COVID-19 vaccine. Please visit the links below for additional resources:
- Clinical Resources on COVID-19 Vaccination
- Vaccination Communication Toolkit
- Vaccine Recipient Education Toolkit
Resources from the Centers for Medicare and Medicaid Services
The Centers for Medicare and Medicaid Services (CMS) COVID-19 page includes valuable information on coverage and reimbursement for vaccine administration. CMS’ Office of Minority Health (CMS OMH) has also developed a COVID-19 Vaccine Resources website of federal resources and organized them for health care professionals, partners, consumers, and for assistance in additional languages.