NCCN Provides Major Update to COVID-19 Vaccination Recommendations

[bennevisplace]

The National Comprehensive Cancer Network (NCCN) is a not-for-profit alliance of 32 leading cancer centers devoted to patient care, research, and education in the United States of America.

Extracts from insideprecisionmedicine.com...

NCCN released this morning significant revisions from its Advisory Committee on COVID-19 Vaccination and Pre-exposure Prophylaxis to include recommendations on the recently-approved bivalent vaccines as well as how to protect children with cancer. The new, evidence-based, expert consensus-formulated summary on cancer and COVID-19 vaccination and prevention is available on the NCCN website nccn.org/docs/default-sourc...

Included in the recommendations are definition of what it means to be “immunocompromised” and how that can affect both eligibility for vaccine boosters and their scheduling. This guidance is categorized based on a patient’s tumor and/or treatment regimen as well as by the type of vaccine.

New information in the updated guidance includes:

Immunosuppressed people who have previously received a three-dose primary series and boosting through prior recommendations are now eligible to receive one of the bivalent boosters if they are 12-years-old or older for Pfizer, or at least 18-years-old for Moderna. This has been shown to improve immune response against Omicron strains in people with full immune system capacity. The committee supports this recent approval but cautions they are still awaiting data on bivalent booster effectiveness in immunocompromised people.

In addition to the new recommendations, the NCCN has reiterated earlier COVID-19 prevention advice such as:

Not recommending antibody testing, outside of a research study;

Recommending boosters for everyone with a hematologic malignancy regardless of whether they are in active treatment;

Preferring mRNA vaccination in most situations;

Endorsing the option of mix-and-matching the two mRNA vaccines;

Re-vaccinating after a patient undergoes hematopoietic cell transplantation or engineered cellular therapy (e.g. chimeric antigen receptor [CAR] T-cell therapy);

Vaccines are considered safe for people undergoing immunotherapy;

Vaccination status shouldn’t impact participation in clinical trials; and

Using monoclonal antibodies (tixagevimab plus cilgavimab) as prophylaxis (in addition to vaccination) in selected immunocompromised patients at risk for COVID-19 complications

[Justasheet1]

benn,

What was the major update? Seemed status quo

Jeff

[bennevisplace in reply to Justasheet1]

I suspect "Major update" is covered by journalistic licence. According to the article, new information in the updated guidance includes:

Immunosuppressed people who have previously received a three-dose primary series and boosting through prior recommendations are now eligible to receive one of the bivalent boosters if they are 12-years-old or older for Pfizer, or at least 18-years-old for Moderna. This has been shown to improve immune response against Omicron strains in people with full immune system capacity. The committee supports this recent approval but cautions they are still awaiting data on bivalent booster effectiveness in immunocompromised people.

Moderna is the preferred mRNA vaccine for pediatric immunosuppressed patients ages six-months to 17-years.

Preliminary data shows myocarditis cases are very rare, although relatively more frequent in adolescent and young adult males 16-and-older.

The NCCN statement about Evusheld will interest our members in the UK, the only G7 country where it is unavailable: "In addition to vaccines, a combination of monoclonal antibody drugs (Evusheld) can help prevent COVID-19 in certain patients with weakened immune systems".

[Davidcara]

It is nice having the material posted in a concise way by a respected and trustworthy organization. Thanks for posting bennevisplace.

[CLLerinOz Administrator Volunteer]

I've added a link to this to our pinned post about vaccinations. Thanks for alerting us to it.

[SofiaDeo]

I saw my CLL doc yesterday, and he reminded me to get the *new* Covid booster not the older one, and also Evusheld again when my 6 months post initial dose is up, next month.

[AussieNeil Administrator in reply to SofiaDeo]

Finally!! The medicos are keeping up!

[anapurna in reply to AussieNeil]

Can I get Evesheld privately in the UK? Stupid Government hasn’t bought any.

[AussieNeil Administrator in reply to anapurna]

Here's the only discussion I can find, but it's dated: healthunlocked.com/cllsuppo... Might be worth a new post.

[bennevisplace in reply to anapurna]

More recent discussion here healthunlocked.com/cllsuppo...

Although Evusheld is approved by the UK medicines regulator, the immunosuppressed market within the private health sector is so small that I don't think it has enough purchasing power to persuade Astrazeneca to supply it, if that makes sense. So the NHS is the monopoly buyer and the government pulls the strings.

The same situation applies in Ireland apprently, in case you were thinking of making the trip.

[anapurna]

I don’t imagine Therese Coffey has any interest in this. It’s not about the money obviously. Plenty of that can be found for the rich.