Important: COVID-19 Vaccine Booster Update

Texas Oncology agrees with the U.S. Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) recommendation that certain immunocompromised people, including all cancer patients undergoing active treatment, get a vaccine and booster shot. The booster can be Pfizer-BioNTech, Moderna, or Janssen Johnson & Johnson, regardless of the previous vaccine you received. The dosing interval for a different booster is the same as what is authorized for a booster dose used for the primary vaccination (either two months or six months, depending on which primary vaccine was received).

Patients are advised to check with their local pharmacies or local vaccine distribution centers to schedule a vaccine and/or booster shot.

The FDA and CDC summarized its current recommendation in a FDA media release and CDC media release, outlining more details.

The CDC specifically lists cancer patients among those who should get a COVID-19 booster shot:

According to the CDC, people with cancer are especially vulnerable to COVID-19 because they are more at risk of serious, prolonged illness. The CDC cites studies that indicate:

  • Some immunocompromised people do not always build the same level of immunity after vaccination the way non-immunocompromised people do.
  • Fully vaccinated immunocompromised people have accounted for a large proportion of hospitalized “breakthrough cases,” suggesting that immunocompromised people are more likely to transmit the virus to household contacts.
  • Treatments for cancer can hinder the body’s immune system from fighting COVID-19 as effectively as non-immunocompromised people.
  • The CDC also says that having a history of cancer may increase risk.

The Pfizer-BioNTech and Moderna COVID-19 vaccines, which are FDA-authorized, are a new type of vaccine that does not use the live virus that causes COVID-19. Therefore, they can be safely administered to immunocompromised people, including some cancer patients, people with immunocompromising conditions, or people who take medications or therapies that suppress the immune system.

Questions and Answers

I have cancer, and I am vaccinated against COVID-19. What should I do about getting a vaccine booster?

Check with your local pharmacy or local vaccine distribution center to schedule a vaccine booster shot if you currently are undergoing cancer treatment.

Does this mean every cancer patient should get a vaccine booster shot?

The FDA recommends that everyone who has been receiving active cancer treatment for tumors or cancer of the blood get a booster shot.

How do I know if I am immunocompromised, and therefore in need of a vaccine booster?

According to the CDC, cancer patients undergoing active treatment are considered immunocompromised, and therefore should get a COVID-19 vaccine booster dose. If you have questions, you should plan to discuss this with your doctor at your next regularly scheduled clinic visit. As the CDC’s advisory committee on immunization practices continues to meet on this issue, guidance may change over time.

I’m not in treatment currently, but I would like to get a third vaccine shot to be safe. What should I do?

The CDC currently recommends a vaccine booster shot only for people who are moderately to severely immunocompromised, including cancer patients in active treatment. If you meet the FDA criteria below, you are eligible for a booster shot currently.

  • Moderna:
    • A half dose vaccine as booster shot for people who were fully vaccinated at least six months ago
    • Age 65 or older
    • Age 18-64 and live in long-term care facilities, have underlying medical conditions, or live or work in high risk settings
  • Pfizer-BioNTech:
    • Booster shot for people who were fully vaccinated at least six months ago
    • Age 65 or older
    • Age 18-64 and live in long-term care facilities, have underlying medical conditions, or live or work in high risk settings
  • Janssen Johnson & Johnson:
    • Booster shot for people for people who were fully vaccinated at least two months ago
    • Age 18 or older

I am in treatment, but I am receiving radiation therapy only, not chemotherapy. Am I immunocompromised and therefore in need of a third vaccine shot?

Patients who are receiving radiation therapy only, and have had not chemotherapy or other therapies in combination with radiation therapy, typically are not considered immunocompromised.

Do the COVID-19 vaccines work the same for cancer patients as for others?

More research is needed to address this question. There is data that indicates the vaccines may be less effective in some immunocompromised people, including patients receiving chemotherapy for cancer, patients with blood cancers such as chronic lymphocytic leukemia (CLL), people receiving stem cells or organ transplants, and patients using certain medications, including some cancer medications that may reduce the immune response to vaccination.

To be clear, we strongly recommend that our patients and their close contacts get vaccinated against COVID-19. Further, in light of new FDA and CDC guidance, we recommend all cancer patients in active treatment get a vaccine booster shot, which can be Moderna, Pfizer-BioNTech, or Johnson & Johnson, regardless of the previous version of the vaccine received.

Please note that all cancer patients also should continue to take steps to reduce risk of exposure to COVID-19, including wearing a face mask around anyone outside your home, practicing social distancing, and avoiding crowds and poorly ventilated indoor spaces.