6/9/2021
Vaccines for Cancer Survivors: Who, What, When, and Why? Andrea J. Zimmer, MD, FACP Director of Oncology Infectious Diseases Department of Internal Medicine
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Disclosures
• Institutional research funding from Astellas and Ansun
• I will be discussing EUA vaccines for COVID-19
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Objectives
Summarize Identify Recommend
Summarize Identify cancer Recommend current vaccine patients who are resources for recommendations candidates for vaccine guidance for the Oncology immunization for populations prevention of infections.
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Why Vaccinate?
• Protect individuals against infection
• Decrease rates of infections-some can even be eradicated altogether!
• Herd immunity for immunocompromised patients who cannot be vaccinated • Reduce severity or complications related to infection
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Helpful Resources
• CDC
• National Foundation for Infectious Diseases
• American Cancer Society
• National Comprehensive Cancer Network (NCCN)
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https://www.cdc.gov/vaccines/
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https://www.cdc.gov/vaccines/
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Live Vaccines
Measles/Mumps/Rubella (MMR) Varicella (VZ) Rotavirus Yellow fever Oral typhoid Intranasal influenza Oral polio
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Streptococcus pneumoniae
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ZAJ1 Pneumococcal Vaccine
https://www.cdc.gov/vaccines/
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Shingles aka Zoster Vaccine
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ZAJ1 Zimmer, Andrea J, 5/27/2021 6/9/2021
Zoster Vaccine Recombinant (ZVR), Adjuvanted (aka Shingrix) • Recombinant=Non-live • Has an adjuvant to promote strong immune response against VZV • Reduces risk of shingles by >90%
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Tetanus/Diphtheria/Pertussis
Recommend Td booster every 10 years for adults
Tdap should replace Td once during adult life
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Gardasil 9 Vaccine: Human Papillomavirus (HPV) • A vaccine that prevents cancers! • Cervical, vulvar, vaginal, and anal cancer • Oropharyngeal, head, and neck cancer • Recommended in all females and males age 9-12 years • Catch up standardly done until age 26 • 2 doses if started before age 15, otherwise 3 doses • Approved in United States through age 45 • Few prior partners or expected new partners • Health care workers
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Influenza vaccine
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Influenza Vaccine
• Quadrivalent=4 strains
• Standard dose vaccine • High dose • Ages >65 • Adjuvanted vaccine • Ages >65
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COVID-19 Vaccines (EUA in U.S.)
• mRNA • BNT162b2 Pfizer •12 years and older •Two doses, 21 days apart • mRNA-1273 Moderna •18 years and older •Two doses, 28 days apart • Adenovirus vector • Ad26.COV2.S Janssen • 18 years and older • Single dose
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What We Don’t Know
• Degree and duration of protection in immunocompromised patients
• What post-vaccine antibody testing means
• Timing of booster vaccines
• What vaccine is “best” for each person or circumstance
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Side Effects
• Common • Local reaction • Lymph node swelling • Fever • Headache • Fatigue
•Rare • Anaphylaxis, allergic reactions • Blood clots, low platelets
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