Sometimes, all a struggling team needs is an infusion of new players—a shot in the arm, so to speak, to give them the strength, energy and enthusiasm to compete.
That’s the concept behind recommendations for additional COVID-19 vaccine shots for cancer patients, those with weakened immune systems and other Americans who may be at high risk of exposure to the virus. These additional shots, health experts say, are intended to help better immunize people who, because of their weakened immune systems, didn’t get enough protection from the first two vaccine shots, while providing additional safeguards to those whose immunities may be waning months after their double doses.
But there has been some confusion and many questions about these recommendations, including:
- What’s the difference between a third dose and a booster shot?
- Who is eligible to get an additional COVID-19 vaccine shot (whether as a booster or as a third dose)?
- Are family members or caregivers eligible for these additional shots?
- What other boosters or vaccines should cancer patients get?
- What other steps should cancer patients take to protect themselves?
In this article, we’ll try to answer some of those questions and provide additional insight to help cancer patients and their families and caregivers make informed decisions about getting their updated vaccines and protecting themselves against COVID-19.
If you’ve put off cancer screening or treatment because of the pandemic, call us or chat online with a member of our team to schedule an appointment.
What’s the difference between the additional shots and booster shots?
Not much. In fact, it may help to view them as essentially the same shot—they’re just called different names based on the reason they’re given:
- A booster is given when enough time has elapsed since the original dose of the mRNA vaccine—experts are saying no less than six months—that immunity to the virus is more likely to be waning. Only Pfizer has been approved as a booster so far, and the U.S. Centers for Disease Control and Prevention (CDC) recommends it be given to certain Americans at higher risk of exposure, like frontline medical workers.
- What’s being called “the third shot” is given to people, like cancer patients and others with compromised immune systems, who likely did not get enough protection from the first round of shots and could use the extra dose to better guard them against infection. Both Pfizer and Moderna have been approved as third shots, and the CDC recommends they be given 28 days after the second shot. Anyone on active cancer treatment should talk to their doctor about the timing of their shot.
No matter the reason each type of shot is given, the dosages is the same, and they’re both intended to boost the immune system to better prevent infection.
“I think we sometimes get a little fixated on definitions and verbiage,” says Jeffrey Metts, MD, Chief of Staff at Cancer Treatment Centers of America® (CTCA), Atlanta. “A booster is something that stimulates our immune system and gets it back up to a stronger level. It’s not unusual that we get boosters for other sorts of vaccines in our life. The third dose applies to those who may not have gotten an adequate response to the first two.”
Who should get an additional COVID-19 vaccine shot?
Third shots
Research indicates that people with moderate or severe immune deficiencies, such as those with cancer, HIV or specific immunodeficiency syndromes, may not have received the full effect of their initial COVID-19 vaccine doses. According to the CDC, anyone who has a disease whose condition, treatments or associated drugs suppress the immune system should talk to his or her doctor about receiving an additional mRNA-based COVID-19 vaccine shot made by Pfizer or Moderna.
This includes cancer patients who:
- Are currently receiving treatment—especially chemotherapy or chimeric antigen receptor (CAR) T-cell therapy—for solid tumors and blood cancers
- Received a stem cell transplant within the last two years
- Received an organ transplant
- Are taking immune-suppression drugs
- Are taking high-dose steroids
- Patients with human immunodeficiency virus (HIV) that have a high viral load or a low CD4 count or are not currently taking medication to treat their HIV
Cancer treatments may damage immune cells and make it difficult for the body to fight off infection. They also may make vaccines less effective. Patients should consult with their doctor about the timing of their shot so they can get the most from it.
“It’s always a good practice for patients to talk to their care team before getting a booster or a vaccine,” says Suji Mathew, MD, Infectious Disease Physician and Chief of Medicine at (CTCA)® Atlanta. “By doing that, you get a better sense of timing of the booster relative to treatments. And you also won’t conflate side effects of the treatment vs. the vaccine. Both may give you similar side effects.”
Booster shots
The booster-type shots are recommended for Americans 65 and older and adults older than 18 who:
- Live in long-term care facilities or nursing homes
- Have underlying medical conditions such as obesity, chronic lung, kidney or heart disease
- Work in jobs that may increase risk, such as first responders, law enforcement or corrections officers, transit workers, health care providers or factory and food processing workers
These shots are technically regarded as boosters because they are given more than six months after the initial dose. Currently, only those who received the Pfizer vaccine are eligible to receive booster shots. Boosters may soon be available for those who received the Moderna vaccine and the single-shot Johnson & Johnson vaccine.
Are family members or caregivers eligible for these additional shots?
No, unless they meet the CDC’s criteria. Family members or caregivers who do not have underlying medical conditions and have been fully vaccinated should be sufficiently protected from the virus. If you’re unsure if you are eligible, call your doctor.
What other vaccines or boosters should cancer patients get?
Cancer patients are vulnerable to multiple infections, not just COVID-19. For instance, it’s flu season, so cancer patients should talk to their doctors about when to get a flu shot. And, while you’re at it, talk about what other vaccines or boosters may be in order, including those for shingles, tetanus or pneumonia.
Family members and caregivers should also make sure their vaccines are up to date.
What other steps should cancer patients take to protect themselves?
Caregivers and their family members should continue to take steps to reduce of exposure to COVID-19:
- Wear a mask and encourage your family members and caregivers to wear them.
- Avoid large crowds, when possible, and keep space between yourself and others.
- Wash your hands frequently or use hand sanitizer.
- Avoid people who are sick, and stay home if you’re sick.
- Get tested regularly if you can.
If you’ve put off cancer screening or treatment because of the pandemic, call us or chat online with a member of our team to schedule an appointment.
