Cancer patients potentially overlooked in COVID-19 vaccine rollout

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Almost two-thirds of U.S. states failed to prioritize cancer patients for COVID-19 vaccinations despite recommendations from the Centers for Disease Control and Prevention, according to a study presented this week at the annual meeting of the Radiological Society of North America.

Cancer patients are particularly vulnerable to the effects of COVID-19. Both the disease and treatments like chemotherapy and radiation therapy can weaken their immune systems.

Available vaccines are highly effective, but initial supply limitations forced the CDC's Advisory Committee on Immunization Practices to make difficult patient prioritization decisions. People ages 16 to 64 with high-risk conditions were grouped into the final part of the first phase, along with people ages 65 to 74. 

But this group encompassed 129 million people nationally, leading many states to subprioritize.

WHAT'S THE IMPACT?

For the new study, researchers sought to determine the proportion of states that elected to follow CDC recommendations. They identified every state's COVID vaccination webpage through keyword-based internet search and set out to identify information about vaccination for cancer patients.

While 43 states included cancer among criteria for vaccination, only 17 gave patients with cancer the same immunization priority as patients aged 65 to 74, and just eight precisely defined a qualifying cancer diagnosis.

Overall, the data suggests that nearly two-thirds of states did not give equal vaccination priority to patients with cancer.

Forty-two states did not clearly define the criteria for cancer patients to receive priority vaccination. This lack of clarity is problematic, authors said, due to considerable variation within the cancer patient population.

For example, someone who was diagnosed with breast cancer at age 40, and is now 55, may be in remission and wondering if they're eligible; all too often, that isn't clear. By contrast, someone newly diagnosed with relatively low-risk prostate cancer may not be especially immunocompromised if they have yet to begin treatment.

Of the eight states that defined a qualifying cancer diagnosis for vaccine prioritization, six limited it to patients currently receiving treatment.

The study's authors said the shortfall in the number of states that followed the CDC recommendations is partly due to attempts at streamlining vaccination efforts. Essentially, the CDC governing bodies' definition of high-risk medical conditions was too broad.

THE LARGER TREND

Booster shots, which have been approved and encouraged by the U.S. Food and Drug Administration, may represent an opportunity to better mitigate disparities in vaccine access.

Protection against COVID-19 infection following inoculation from the Pfizer/BioNTech vaccine wanes gradually over time, particularly 90 days after receiving the second dose, strengthening the case for the booster shots, according to recent findings published in The BMJ.

The Centers for Disease Control and Prevention Advisory Committee on Immunization Practices has recommended the booster shots for all adults, which means those newly eligible should be able to get a booster vaccine before year-end. The CDC recommends that adults should get a booster at least six months after their last COVID-19 vaccine.

Individuals should contact the vaccination site where they got their original shots, check their local pharmacy for appointments, or contact their local or state health departments to find a location.
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com