Who Should be at the Front of the Line?

Ideally, everyone should be able to get vaccinated with one of the Covid-19 vaccines as soon as possible. But the fact is that the rollout of the vaccine distribution calls for prioritizing certain people (thank you, front-line healthcare workers!) and vaccinating the population in phases.

The National Comprehensive Cancer Network has issued guidance on this topic, specifically as it relates to oncology care. As they explain:

“All patients with active cancer, or with active, recent, or planned cancer treatment, should be considered highest priority to receive one of the coronavirus disease 2019 (COVID-19) vaccines.”

This recommendation is based on a committee made up of hematology and oncology experts who specialize in infectious diseases, vaccine development and delivery, medical ethics, and health information technology.

Cancer care providers can now rely on this expert recommendation as they create care plans for their vulnerable oncology patients. As the expert panel recommends:

• Patients with cancer should be prioritized for vaccination (CDC priority group 1b/c) and should be immunized when vaccination is available to them.
• Immunization is recommended for all patients receiving active therapy, with the understanding that there are limited safety and efficacy data in these patients.
• Reasons for delay of vaccines are similar to the general public (e.g., recent exposure to COVID-19), and cancer-specific factors. Vaccination should be delayed for at least 3 months following HCT or engineered cellular therapy (e.g. CAR-T cells) to maximize vaccine efficacy.
• Caregivers and household/close contacts should be immunized when possible.