NCCN released COVID vaccine guidelines for people with cancer

[Miranda_GO2]

Here is the link to read the NCCN guidelines giving the vaccine to patients with cancer: nccn.org/covid-19/pdf/COVID...

[Kaylee20]

Even after reading the article I am still uncertain about what to do. I am only on Keytruda now every six weeks. I have done so well for last 18 months I just don't want anything to screw it up. I never leave the house unless to treatment. This is a huge decision to made. If I did not have cancer I would not hesitate to have the shot.

[Miranda_GO2 Partner in reply to Kaylee20]

Hi Kaylee, Right now there isn't any evidence that patients shouldn't receive the vaccine but there is still a lot to learn e so I understand your uncertainly while in treatment. There is another conversation thread in this group that includes patients on immunotherapy who have received the vaccine or plan to receive it. After talking to your doctor, maybe talking to others in the same situation might help you to decide what's best for you.

[Kaylee20 in reply to Miranda_GO2]

Hey Miranda. My name is actually Karen but Kaylee is my daughters name and I use it lol. Anyway, I think I spend to much time reading on the Internet about the virus shot. This weekend I read a lot of reports from the UK and if I understood everything correct they are finding people who are on targeted therapy or immunotherapy the shot is not giving them any protection. I will go back today and re-read these articles and write down the websites just in case anyone else from the group wants to read them. I am still leaning to still have the shot when I can even if the shot just gives me even a small amount of protection. I know that getting Covid would really not be good on us lung cancer survivers. I'm more afraid of the Covid than I am of my lung cancer. Karen in Minnesota

[Miranda_GO2 Partner in reply to Kaylee20]

Hi Karen (not Kaylee) from Minnesota,

I am not sure what articles you are reading or if they are supposed, but I will share a statement put out by SITC, see number 1, as they are suggesting the vaccine should be made available for patients on immunotherapy.

SITC Statement on SARS-CoV-2 Vaccination

and Cancer Immunotherapy

The Society for Immunotherapy of Cancer (SITC) commends the global biomedical community for coming together to develop and authorize safe and effective SARS-CoV-2 vaccines at unprecedented speeds. SITC stands with the world in hoping that rapid vaccine deployment will help to end the global pandemic.

Representing leaders in the field of cancer immunotherapy, SITC recognizes that optimal patient care and clinical trials must both continue and coexist with the dire need for global SARS-CoV-2 vaccination. Based on the demonstrated efficacy and safety of the BNT162b2 (Pfizer Inc./BioNTech SE) and mRNA-1273 (Moderna Inc.) vaccines in healthy individuals across study demographics, and subsequent Emergency Use Authorization (EUA) by the U.S. Food and Drug Administration (FDA), SITC recommends the following actions for all relevant stakeholders and patients concerning SARS-CoV-2 vaccination and cancer immunotherapy:

1.All cancer patients receiving approved or investigational immunotherapy as part of their treatment regimen, either as standard of care or as part of clinical trials and without a general contraindication to vaccination, should/could receive an FDA approved and/or authorized SARS-CoV-2 vaccination when made available to them;

2.At this point in time, the only known relevant contraindications based on available data are patient age as described within EUAs and/or history of anaphylaxis to similar/comparable vaccine components;

3.SITC does not recommend experimental and/or non-approved SARS-CoV-2 vaccination for patients being treated with immunotherapy outside of dedicated clinical trial settings at this time;

4.Immunosuppressed patients, e.g., those receiving corticosteroids or TNF blockers to manage immune-related side effects, patients with hematologic malignancies, or patients with B cell deficiency, may not mount a robust immune response against vaccines and/or may need additional booster vaccinations. SITC recognizes that this aspect has not yet been studied in clinical trials;

5.Given limited data, SITC acknowledges that possible interactions between cancer immunotherapies and SARS-CoV-2 vaccines are unknown at this time. As always, SITC believes the best medical judgment of risk/benefit of SARS-CoV-2 vaccination should be considered for each patient individually.

SITC’s current recommendations regarding SARS-COV-2 vaccination in patients being treated with immunotherapy are subject to change as more data are collected in real-world scenarios and in clinical trials. In addition, SITC may provide further recommendations as additional vaccine candidates gain approval and/or authorization.

Given the paucity of data concerning the interactions between immunotherapy treatment and SARS-CoV-2 vaccination, SITC encourages healthcare professionals, industry sponsors, regulators, and academics to rapidly collect and report novel data relevant to unique aspects of cancer immunotherapy treatment.

SITC recognizes that human immune responses are highly regulated and that immune-modifying therapies could positively or negatively impact SARS-CoV-2 vaccination efficacy and safety. As such, SITC believes continued data collection and research will help to address vital knowledge gaps that could clarify optimal protocols for SARS-CoV-2 vaccination in patients with cancer receiving immunotherapy. Critical aspects that must be further characterized include but are not limited to:

1.Optimal sequence of SARS-CoV-2 vaccination and immunotherapy treatment, to preserve the efficacy and safety of both modalities;

2.Determining effective dosage of SARS-CoV-2 vaccine for patients receiving immunotherapy;

3.Monitoring of SARS-CoV-2 antibody and cellular immune response in patients receiving immunotherapy treatments following receipt of SARS-CoV-2 vaccines

4.Impact and reporting of SARS-CoV-2 vaccination upon immune-related adverse events, and regulatory considerations for adverse event attribution in immunotherapy clinical trials;

5.Development of standards for establishing theoretical risk factors that would support a delay in SARS-CoV-2 vaccination while administering cancer immunotherapy

In conclusion, SITC supports SARS-CoV-2 vaccination in cancer patients receiving immunotherapy, and looks forward to collaborating with the global community to address the above scientific questions while simultaneously working to end the COVID-19 pandemic.

[Kaylee20 in reply to Miranda_GO2]

Hey Miranda

I actually did read the article that you posted this weekend. I see that the SITC does recommend the shot for cancer patients receiving immunotherapy. The reason I am on hold about the shot is because of line #4. On line #4 it states that if you are on corticosteroids (which I am on Hydrocortisone twice a day) the virus shot "may not mount a robust immune response against vaccines and may need additional booster vaccination". This is also more or less what the research is starting to show in the UK. My concern is that if research is starting to see that the virus shot is having very little protection for us cancer patients on corticosteroids, then I don't want it maybe. I know after 18 months on Keytruda I am doing so good. No growth of any of my tumors (I have three large in three different lobes and tons of ground glass) and after starting out with Carbo/Alimta/Keytruda the lymph nodes in my chest that were never biopsy like my tumor but felt they were also cancerous doctor's said are no longer a concern. My thoughts are if I take the shot and it does nothing to protect me from Covid am I wrecking the progress I have made on Keytruda? I fear since how Keytruda works is by "training" your immune system to look for PD 1 protein. Well I be untraining my immune system if I introduce the Covid shot? These are all things I am researching now and was this weekend. I also know that if I were to catch the Covid it for sure would not be good with lung cancer. I know in Minnesota I am still not eligible to get shot since I am 62 years young. I will just keep researching and I appreciate your comment back to me. Karen in Minnesota

[Miranda_GO2 Partner in reply to Kaylee20]

So happy to hear your treatments are going so well! I understand your level of caution and hope that more data will be available soon to put your mind to ease. GO2 is part of a research initiative to look at the effectiveness of the vaccine for patients taking immunotherapy. This is part of the SeroNet Initiative (read about that here: go2foundation.org/blog/comp... . As we learn more, I will be sure to share more on HealthUnlocked to keep everyone updated.