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As you may have heard, the Centers for Disease Control and Prevention (CDC) has recommended a third dose of the COVID-19 vaccine for people who are immunocompromised. This includes some – but not all – people with cancer.
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Mini Kamboj, chief medical epidemiologist at Memorial Sloan Kettering Cancer Center, has answers to your questions about who is eligible and how you can make an appointment to receive your third injection.
Why do immunocompromised people need a third dose of the COVID-19 vaccine?
For a vaccine to protect you, it must activate your immune system. In some immunocompromised patients this ability is impaired, so a third dose may stimulate the immune response.
According to the CDC, among severely immunocompromised people who had undergone a solid organ transplant and had virtually no protection after receiving two doses of the Pfizer-BioNTech or Moderna vaccine, 30 to 50% developed antibodies protecting them from COVID -19 after receiving an additional dose. .
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Who is eligible for a third dose of a COVID-19 vaccine?
People with moderate to severe immunosuppression may receive an additional dose, usually due to an organ or stem cell transplant, HIV infection, corticosteroid therapy, or certain cancer treatments. that interfere with the body’s ability to fight infections.
It is important to know that not all cancer patients have a weakened immune system. Cancer patients considered to be immunocompromised include:
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Patients currently being treated for blood cancer or within the past six months
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Patients who were within 12 months of treatment with B-cell depleting drugs (for example, rituximab or Rituxan®) at the time of their initial vaccination
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Patients who have had a stem cell transplant or received CAR T therapy within the past two years
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Patients treated for solid tumors with chemotherapy – and some patients on immunotherapy – now or in the past six months
These eligibility criteria cover the most common indications. Your provider may order the third dose of vaccine for other treatments or immunosuppressive conditions if they decide that the extra dose will be of benefit to you.
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Which cancer patients are not eligible for a third dose at this time?
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Patients with solid tumors are not considered to be immunocompromised if their cancer has been treated with hormone therapy, targeted therapy, surgery, radiotherapy or if it is only under observation.
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To ensure the best immune response to the third dose, MSK experts recommend that some patients discuss the optimal timing for the additional dose with their clinical care team. This includes recent treatment involving a stem cell transplant, CAR T treatment, or anti-CD20 monoclonal antibodies.
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When should eligible patients receive a third dose?
If you meet the criteria, you can receive a third dose 28 days or more after completing your first series of vaccines.
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Which vaccines can be used for a third dose?
Only patients who have completed their primary vaccination course with Pfizer-BioNTech or Moderna vaccines can receive the third dose. MSK will offer patients the same brand of vaccine that they were previously receiving. Mixing of vaccines is not allowed at this time.
The CDC has yet to make recommendations for people who have received the Johnson & Johnson vaccine. We are following their advice closely and will communicate any changes.
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How to make an appointment?
To find out if you need to receive a third dose, call your MSK doctor’s office or send a message through the MyMSK patient portal. If you are eligible for an additional vaccine, your doctor will schedule an appointment for you.
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When and where will MSK start giving the third doses?
On Wednesday August 18, MSK will begin donating the additional vaccines to the David H. Koch Center for Cancer Care at Memorial Sloan Kettering Cancer Center, located at 530 East 74th Street.
From Monday 23 August, we will make an appointment at:
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MSK Westchester, located at 500 Westchester Avenue in West Harrison, New York
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MSK Nassau, located at 1101 Hempstead Turnpike in Uniondale, New York
These clinics will be open from 9 a.m. to 5 p.m., Monday to Friday.
Additional dates and locations, including our New Jersey locations, will be added shortly.
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I am an MSK patient who was vaccinated outside of MSK. What should I do?
If you think you meet the criteria to receive a third dose of vaccine, you should call your provider’s office to confirm your eligibility, and a vaccine appointment will be set for you. You should be prepared to share your vaccination record or a photo of it. Please present your card information, rather than the Excelsior pass, which does not contain details of the brand of vaccine you received and on what dates.
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Are pediatric patients with weakened immune systems eligible for the third dose of vaccine?
Yes, the Food and Drug Administration (FDA) has granted emergency use authorization to patients 12 years of age and older to receive the Pfizer-BioNTech vaccine and 18 years of age and older to receive the Moderna vaccine.
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Should I expect side effects?
The side effects of a third COVID-19 vaccine are similar to those experienced after receiving the original vaccines. Israeli scientists recently started giving a third dose of the Pfizer-BioNTech vaccine to people with weakened immune systems. Side effects were reported by 31% of people, the most common being pain at the injection site. Other side effects included fatigue, headache, body aches and fever. These symptoms do not last long, about one to three days.
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Should I get a third dose if I have had a breakthrough infection after being vaccinated previously?
The safety of a third dose in people who have had breakthrough COVID-19 infections is not known, therefore, an additional dose for these patients is not recommended at this time. Some patients in whom the initial vaccine responses are expected to be severely blunted, such as stem cell transplant recipients or CAR-T recipients or those treated with B-cell depleting therapies, may benefit from a third dose after infectious infection. Discuss your situation with your clinical care team.
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After receiving a third dose, what else should I do to protect myself?
Even after the third dose, people with weakened immune systems should take precautions to protect themselves from COVID-19. You should:
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Wear a mask.
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Stay 6 feet from others you don’t live with.
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Avoid crowds and poorly ventilated indoor spaces until advised by your health care provider.
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Encourage your close contacts to get vaccinated.
If you develop symptoms of COVID-19, contact your clinical care team and get tested.
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Should non-immunocompromised people receive a third dose of COVID-19 vaccine?
Not at this time. Vaccines are still very effective against serious illnesses for those whose immune systems are not weakened. In the future, third doses may be recommended for more people, as immune protection tends to weaken over time. Additionally, as new variants of COVID-19 emerge, it may be necessary to design new vaccines to protect against them.
August 16, 2021
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