Vaccination of Adults With Cancer: ASCO Guideline
- Study type
- Clinical guideline
- Study name
- ASCO Vaccination Guideline 2024
- Design
- Clinical practice guideline based on a systematic literature review (including systematic reviews, randomised trials and non-randomised studies), with recommendations formulated by an ASCO expert panel
- Sample size
- 102 publications included in the systematic review
- Source
- JCO · 2024
In plain words
People with cancer may be more vulnerable to infections because of the illness or its treatments. This guideline recommends that your vaccination record is noted from the very first visit and that the vaccines you need are given on time. After a stem cell transplant, CAR-T therapy or treatments that destroy B cells, some vaccines may need to be given again. Vaccinating the people you live with also helps protect you. Always plan the timing and type of vaccines with your treating doctor.
Key points
Key guideline recommendations
- Level of evidence and strength of recommendation in the full guideline
The goal of vaccination is to limit the severity of infection and, where possible, prevent infection. Optimising vaccination status should be considered a key element of the care of patients with cancer.
- Level of evidence and strength of recommendation in the full guideline
This approach includes documenting vaccination status at the patient's first visit, timely administration of recommended vaccines, and appropriate revaccination after haematopoietic stem cell transplantation, CAR-T therapy or B-cell-depleting therapies.
- Level of evidence and strength of recommendation in the full guideline
Active engagement and coordination among health care providers, including primary care physicians, pharmacists and members of the nursing team, are essential.
- Level of evidence and strength of recommendation in the full guideline
Vaccination of household contacts increases the protection of patients with cancer.
- Level of evidence and strength of recommendation in the full guideline
Some vaccination and revaccination schedules in patients with cancer may be affected by underlying immune status and the anticancer treatment received; vaccination strategies may therefore differ from the recommendations for the general healthy adult population.
Study population
Adults with solid tumours or haematological malignancies, and their household contacts.
Endpoints
The systematic review evaluated the efficacy and safety of vaccines used in adults with cancer or their household contacts. The goal of vaccination is to limit the severity of infection and, where possible, prevent infection.
Safety and side effects
The abstract gives no specific figures on vaccine adverse events. Safety details are available in the full guideline.
Clinical significance and place in guidelines
This guideline builds on the 2013 Infectious Diseases Society of America (IDSA) guideline and regards optimising vaccination status as a key part of the care of patients with cancer. This requires coordination between the oncologist, primary care physician, pharmacist and nurse. Because immune status and anticancer treatment may change the vaccination schedule, the schedule may differ from that of the general healthy adult population. Details of the recommendations for each vaccine and each patient group should be checked in the full guideline.
Limitations
Most of the evidence concerned COVID-19 vaccines, and most of the included studies (64 of 102 publications) were non-randomised; only 14 were RCTs. The literature search extended to 16 February 2023 and does not include later evidence. The abstract does not state the level of evidence or strength of each recommendation.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.