ASCO 2024 New Vaccination Guidelines for Cancer Patients

Why are vaccines important for cancer patients? 

Cancer patients are often in a vulnerable immunologic state, due to a variety of factors. When speaking of blood cancers, this is a common issue amongst patients because the immune cells are produced in the bone marrow and circulate in the bloodstream to fight infections or detect abnormal cells. In blood cancers, this balance is often disrupted because the growth of abnormal cancer cells sometimes occupies the bone marrow or the affected cells are immune system cells. 

What factors weaken the immune system of cancer patients?

• Chronic inflammation
• Hematopoietic stem cell transplant
• CAR-T cell therapy 
• B-cell depleting therapy (a process that destroys malignant B-cells) 
• Impaired or diminished function of immune system cells 
• Treatments that debilitate the immune system like corticosteroids
   

Preventing infections in patients with a vulnerable immune system is fundamental. Several prevention strategies exist, like antibiotics or antiviral agents, but one of the most effective tactics since 1796 was vaccination when the smallpox vaccine was developed, and many lives were saved.  

Optimizing vaccination should be considered a key element for cancer patients

Vaccination is an important measure to avoid infection-associated illness or death among patients with a weakened immune system. 

A recent interview by ASCO with Dr. Lisa Law from Kaiser Permanente and Dr. Randy Taplitz from City of Hope Comprehensive Cancer Center, authors on “Vaccination of Adults with Cancer: ASCO Guideline.”

The doctors conducted a systematic review, analyzing over a hundred publications between 2013 and 2023, including randomized controlled trials and non-randomized studies, many of which the more recent studies contained information on COVID-19 vaccines. They did a compilation of recommendations based on evidence to create vaccination guidelines for cancer patients.

For Vaccines, Timing is key

Dr. Taplitz stated that for cancer patients, responding to vaccines can be affected by their immune status and their anticancer therapy, as well as the severity of the underlying cancer.  The purpose of vaccination is to prevent infection or reduce the severity of the infection in case it can’t be prevented.

Dr. Law mentioned the recommended vaccines for cancer patients based on age and risk:

Procedures like CAR-T cell therapy or B-cell depletion therapy help patients with blood cancer but significantly impact their immune systems because they " erase” the body’s immune memory, and revaccination helps the immune system “remember” how to fight against infections that are a threat to non-vaccinated people. 

Dr. Randy Taplitz discussed the recommended timing of revaccination in patients according to the treatment stage, highlighting the important role of vaccines in restoring immunity. 
 

What vaccines should I get if I want to travel? 

Dr. Lisa Law mentions that following the CDC standard recommendations for the destination is sufficient when traveling outside the United States. However, vaccinations should be delayed until 3 months after the last round of chemotherapy. Dr. Law states that it is important to receive advice from your oncologist in all cases of travel to determine the best timing and to ensure you are not traveling to a location with a regional outbreak. 

Should my loved ones vaccinate with me?

According to the updated recommendations, Dr. Randy Taplitz mentions that all household members and close contacts should be updated on their vaccinations. Vaccines like inactivated influenza, MMR (measles, mumps, and rubella), and varicella are safe to administer to close contacts.

What can help improve vaccine research? 

Over time, vaccines have been proven to eradicate life-threatening diseases, and following the vaccination guidelines can protect vulnerable populations. Dr. Randy addresses powerful information regarding gaps in knowledge, such as the lack of perceived benefits from vaccines and unmet needs like vaccine costs and accessibility. He emphasizes the need for further research and dedicated efforts, mentioning that more cancer patient data is needed for developing more precise vaccine guidelines. 

You can also contribute to life-saving research through HealthTree Cure Hub by creating an account and responding to our vaccination survey. Being aware of your health status and vaccination history leads to improved self-advocacy and better disease outcomes!
 

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