NCCN Recommends Second Booster for Immunocompromised

The National Comprehensive Cancer Network (NCCN) recommends a fifth COVID-19 mRNA shot for immunocompromised people, according to a recent announcement. The recommendations were from the NCCN Advisory Committee on COVID-19 Vaccination and Pre-Exposure Prophylaxis.

“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, of Roswell Park Comprehensive Cancer Center, and co-leader of the NCCN Advisory Committee on COVID-19 Vaccination and Pre-Exposure Prophylaxis.

The latest update to the group’s recommendations include:

• Clarification that 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.
• Recommendations for two booster doses for people who are immunocompromised (meaning three primary mRNA doses plus two booster doses).
• Detailed information on how the primary series and booster definition and number differs for people who initially received the JNJ-78436735 vaccine.
• Updated dosing recommendations for pre-exposure prevention with tixagevimab plus cilgavimab (also referred to as monoclonal antibodies) for people with cancer; this treatment should not be viewed as a substitution for vaccination.
• Updated data on mixing mRNA vaccine types, which is now considered to have similar effectiveness compared with using the same vaccine type.

In addition, the committee continues to recommend that household members and other close contacts of people with cancer should get vaccinated according to their Centers for Disease Control and Prevention-determined eligibility.

Source: NCCN Press Release, April 2022