Dr. Steve Pergam, associate professor of the Vaccine and Infectious Disease Division at the Fred Hutchinson Cancer Research Center and the Infection Prevention Director at Seattle Cancer Care Alliance, discusses new guidance from the National Comprehensive Cancer Network’s COVID-19 Vaccination Advisory Committee, regarding a third dose of the Pfizer-BioNTech or the Moderna COVID-19 vaccines for patients with cancer.   Transcript Dr. John Sweetenham: Hello, I'm John Sweetenham, associate director of clinical affairs at the UT Southwestern Harold C. Simmons Comprehensive Cancer Center and guest host of the ASCO Daily News Podcast today. The U.S. Food and Drug Administration (FDA) has authorized an additional COVID-19 vaccine dose for people with certain medical conditions who received the Pfizer-BioNTech, or the Moderna COVID-19 vaccines. Following the FDA'S announcement, the National Comprehensive Cancer Network's COVID-19 Vaccine Advisory Committee released new guidelines regarding the third COVID-19 vaccine doses for people with cancer. Joining me to discuss the booster shots is the committee's co-leader, Dr. Steve Pergam. He is associate professor of the Vaccine and Infectious Disease Division at the Fred Hutchinson Cancer Research Center and the Infection Prevention Director at Seattle Cancer Care Alliance. Steve, thanks for coming on the podcast today. Dr. Steve Pergam: Well, thank you so much Dr. Sweetenham. It's an honor to talk to my colleagues from oncology who I work with every day and to speak to patients and others who might be listening, so thanks for having me on. Dr. John Sweetenham: Great, thank you. Before we start, I should mention that my guest and I have no conflicts of interest relating to the topic today, and full disclosures for all guests on the ASCO Daily News Podcast are available on our transcripts at ASCO.org/podcasts. Steve, can you tell us a little about the groups that should be considered eligible for a third dose of the mRNA COVID-19 vaccines right away based on the latest FDA decision? Dr. Steve Pergam: Sure, the guidelines from the Centers for Disease Control and Prevention (CDC) and from the ACIP after the approval by the FDA are quite broad, and they include patients who are immunosuppressed by medications, such as steroids, drugs like tacrolimus, and then patients with cancer as well, many of whom are often considered immune-suppressed. It gets into patients with immunodeficiencies, and it really addresses a large group of people who are considered immunosuppressed. And I think part of the reason the guidance was written that way is defining what is immunocompromised to a level where you're not going to respond well to the vaccine is a little bit complex because immunosuppression is such a broad term. So they've left the guidance pretty broadly worded, and so I think it's important that when we think about what this guidance looks like, it's really about trying to be inclusive and trying to be somewhat specific at the same time, which is a really, really hard balance to go across, if that makes sense. Dr. John Sweetenham: Sure. For those patients who are immunosuppressed in some way, can you say a little about what the data shows regarding the level of protection that these patients may get from a third dose? Dr. Steve Pergam: Sure, so first, it's actually a little bit difficult to speak to patients with cancer directly. There's not very much data if at all regarding third doses for patients with cancer. So much of the data that supports these recommendations is focused on data that we understand that second dose, receiving that first primary dose, followed by a booster, which is what is common and what's recommended for mRNA vaccines, suggests that patients who have cancer may not respond well to that two-dose regimen. And it's varied between different groups. Some groups have much less response. So, a patient receiving rituxan (rituximab), which is the anti-CD20 antibody, clearly do not h