FDA Authorizes Additional COVID-19 Vaccine Dose for Cancer Patients

Additional vaccine doses of COVID-19 will soon be available to everyone in the US to provide additional protection against the coronavirus. For now, the focus is on people with a weakened immune system. Research studies show that immunocompromised people who have little or no protection after two doses of mRNA COVID-19 vaccines may have an improved response after an additional dose of the same vaccine.

Based on this research, the Food and Drug Administration (FDA) has revised emergency authorizations for both the Pfizer-BioNTech and Moderna COVID-19 vaccines. This allows certain immunocompromised individuals, including certain cancer patients and survivors, to receive a third dose of vaccine to boost their immune system response to COVID-19. But who actually qualifies for a third dose? And what can you expect if you or a loved one needs one?

To answer frequently asked questions about the third COVID-19 vaccine doses, we spoke with David Tweardy, MD, infectious disease specialist and chief of internal medicine

What is the difference between a third dose and a booster shot of the COVID-19 vaccine?

An additional dose — also called a third dose — follows the initial two-dose vaccine series for people who may not have received a strong enough immune response after receiving the first vaccine series. In other words, these individuals may not have had the same level of protection against COVID-19 as other individuals due to their weakened immune systems, so they need additional protection that can be provided by a third dose.

In contrast, a booster dose is an additional dose given to groups whose immune response has declined over time. Booster COVID-19 vaccine doses will likely be available to everyone in the US in September. But for now, the FDA and the Centers for Disease Control and Prevention (CDC) have approved additional doses of Pfizer and Moderna’s COVID-19 vaccines for severely immunocompromised individuals, and these are the only people to take an additional dose of COVID-19. should be getting a vaccine right now.

Who is eligible for a third dose of the COVID-19 vaccines?

People eligible for an additional COVID-19 vaccine dose include those who have received the Moderna or Pfizer two-dose COVID-19 vaccine series and are moderately or severely immunocompromised, such as those with certain conditions identified by the CDC. have been identified.

Should I get the same type of vaccine for my third dose as for the first two? For example, if I’ve previously received the Pfizer vaccine, should I get the Pfizer vaccine again?

The CDC recommends that a third dose of the same mRNA vaccine be used, if available, for people who have received the Pfizer or Moderna COVID-19 vaccine series. If you’re not sure which mRNA vaccine you received or if you’re unable to get the same vaccine, it’s okay to get either the Pfizer or the Moderna mRNA COVID-19 vaccine.

What if I received the Johnson & Johnson single-dose vaccine? Do I need another dose or can I get the Pfizer or Moderna two-dose series?

There is still insufficient data to determine whether an additional dose of Johnson & Johnson’s Janssen COVID-19 vaccine produces an improved antibody response in immunocompromised people. The FDA’s approval for additional doses only applies to the two mRNA COVID-19 vaccines. The FDA and CDC are working to provide guidance on this matter.

When Should Eligible Cancer Patients Get a Third Dose?

People with moderately to severely compromised immune systems may receive an additional dose at least 28 days after their second dose of the Pfizer or Moderna COVID-19 vaccine.

However, patients currently undergoing chemotherapy, immunotherapy, CAR T cells, stem cell transplants, or participating in clinical trials may need to tailor the timing of their supplemental vaccine dose to their treatment regimen to optimize their vaccine response. Talk to your primary care provider to determine the appropriate timing for your supplemental vaccination dose if you are immunocompromised or on immunosuppressive therapies.

Can pediatric cancer patients get a third dose?

Yes. Adolescents aged 12-17 are eligible for the Pfizer COVID-19 vaccine. Those under the age of 18 are not authorized to receive the Moderna vaccine and children under the age of 12 are not allowed to receive a COVID-19 vaccine at this time.

What are the most common side effects of the third dose?

Responses reported after the third mRNA dose are similar to what humans experienced after receiving the two-dose series. The most commonly reported side effects are fatigue and pain at the injection site. Most symptoms after vaccination are mild to moderate and disappear within 1-2 days.

Do I need to test for antibodies to get an extra vaccine dose?

New. Outside of the context of research studies, the CDC does not recommend antibody testing to determine an immune response to vaccination. In many cases, you can have a negative antibody test result even if you have been fully vaccinated.

What precautions should cancer patients take after receiving a third dose?

People who are immunocompromised may continue to experience a decreased immune response to COVID-19 vaccines even after receiving the third dose. It is important to continue to follow COVID-19 safety measures, including wearing a mask in indoor public areas, keeping distance from others outside your household, and avoiding crowds and poorly ventilated indoor areas. Because the Delta variant is highly contagious, social distancing and wearing a high-quality KF-94 or KN-95 mask can provide better protection.

It is also important to encourage your family, friends and anyone you spend time with to get vaccinated.

Does MD Anderson offer the third dose?

Yes. This week, eligible patients can begin self-scheduling third dose appointments via MyChart; you must bring your proof of previous vaccination and confirm that you meet the criteria for immunocompromised conditions. We cannot accept walk-ins.

Can I get the third dose elsewhere if that’s more convenient?

Yes. People who meet the eligibility criteria for additional COVID-19 doses should consider getting vaccinated wherever they can. Use the National Vaccine Finder to view available appointments in your community. Again, talk to your primary care provider to determine the appropriate timing for your supplemental vaccination dose if you are immunocompromised or on immunosuppressive therapies.

Reference: Commissioner O of the. Coronavirus (COVID-19) update: FDA approves additional vaccine dose for certain immunocompromised individuals. FDA. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-additional-vaccine-dose-certain-immunocompromised Published August 16, 2021. Accessed August 19, 2021 .

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