vaccines for cancer survivors: who, what, when, and why?
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Vaccines for Cancer Survivors: Who, What, When, and Why?Andrea J. Zimmer, MD, FACPDirector of Oncology Infectious DiseasesDepartment of Internal Medicine
• Institutional research funding from Astellas and Ansun
• I will be discussing EUA vaccines for COVID-19
Disclosures
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Objectives
Summarize
Summarize current vaccine recommendations for the Oncology populations
Identify
Identify cancer patients who are candidates for immunization for prevention of infections.
Recommend
Recommend resources for vaccine guidance
Why Vaccinate?
• Protect individuals against infection
• Decrease rates of infections-some can even be eradicated altogether!
• Herd immunity for immunocompromised patients who cannot be vaccinated
• Reduce severity or complications related to infection
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Helpful Resources
• CDC
• National Foundation for Infectious Diseases
• American Cancer Society
• National Comprehensive Cancer Network (NCCN)
https://www.cdc.gov/vaccines/
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https://www.cdc.gov/vaccines/
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Live Vaccines
Measles/Mumps/Rubella (MMR)
Varicella (VZ)
Rotavirus
Yellow fever
Oral typhoid
Intranasal influenza
Oral polio
Streptococcus pneumoniae
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Pneumococcal Vaccine
https://www.cdc.gov/vaccines/
ZAJ1
Shingles aka Zoster Vaccine
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ZAJ1 Zimmer, Andrea J, 5/27/2021
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Zoster Vaccine Recombinant (ZVR), Adjuvanted (aka Shingrix)• Recombinant=Non-live• Has an adjuvant to promote strong immune
response against VZV• Reduces risk of shingles by >90%
Tetanus/Diphtheria/Pertussis
Recommend Td booster every 10 years for adults
Tdap should replace Td once during adult life
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Human Papilloma Virus (HPV)
• A vaccine that prevents cancers!• Cervical, vulvar, vaginal, and anal cancer• Oropharyngeal, head, and neck cancer
• Recommended in all females and males age 9-12 years • Catch up standardly done until age 26• 2 doses if started before age 15, otherwise 3 doses
• Approved in United States through age 45• Few prior partners or expected new partners• Health care workers
Gardasil 9 Vaccine:Human Papillomavirus (HPV)
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Influenza vaccine
Influenza Vaccine
• Quadrivalent=4 strains
• Standard dose vaccine• High dose
• Ages >65
• Adjuvanted vaccine• Ages >65
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COVID-19 Vaccines (EUA in U.S.)
• mRNA• BNT162b2 Pfizer
•12 years and older•Two doses, 21 days apart
• mRNA-1273 Moderna•18 years and older•Two doses, 28 days apart
• Adenovirus vector• Ad26.COV2.S Janssen• 18 years and older• Single dose
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What We Don’t Know
• Degree and duration of protection in immunocompromised patients
• What post-vaccine antibody testing means
• Timing of booster vaccines
• What vaccine is “best” for each person or circumstance
Side Effects
• Common• Local reaction • Lymph node swelling• Fever• Headache• Fatigue
• Rare• Anaphylaxis, allergic reactions• Blood clots, low platelets
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