Vaccination of Adults With Cancer: ASCO Guideline Clinical Insights

Abstract

In 2024, ASCO published a guideline on vaccination of adults with cancer. 1 This companion piece addresses some of the key questions that clinicians may have as they implement the guideline recommendations. Vaccination against infection is a key preventative measure in people undergoing cancer treatment. After a cancer diagnosis, taking early steps to ensure that patients are protected against vaccine preventable illnesses is a crucial component of good oncologic care. Guideline recommendations are listed in Figure 1. WHAT SPECIFIC RECOMMENDATIONS CAN I GIVE MY PATIENTS REGARDING IMMUNIZATION AGAINST INFECTION?People undergoing cancer treatment are more vulnerable to severe outcomes from certain vaccine preventable diseases. [2][3][4] Being proactive with immunization against these illnesses is an important step to stay protected from infectious complications and avoid unexpected treatment delays that ultimately affect cancer-related outcomes.Adults undergoing cancer treatment should be encouraged to receive all the recommended vaccines, as shown in Table 1. Hospitalization for pneumonia is among the most common infectious complications of cancer treatment, the seriousness of which is reduced by vaccines. [5][6][7] Therefore, patients should remain current with the pneumococcal and seasonal respiratory vaccines, including influenza, respiratory syncytial virus (RSV), and COVID-19. The risk of herpes zoster is heightened after a cancer diagnosis in adults regardless of age; thus, patients age ≥19 years should receive the recombinant zoster vaccine (RZV) to prevent shingles and its associated complications. Hepatitis B vaccine is recommended for all adults age 19-59 years who have never been immunized. Similarly, tetanus, diphtheria, and acellular pertussis vaccine (Tdap) is a universally recommended vaccine, and patients should be encouraged to stay up-to-date. Finally, the human papillomavirus (HPV) vaccine offers vital protection for adults younger than 45 years.