Children with cancer or other types of hematologic malignancies have a higher risk of severe COVID-19 disease and its complications. Though they may have a lower immune response to the vaccine, it can still prevent or decrease serious complications from the infection. International cancer groups and health centers recommend that all children with cancer, including those receiving hematopoietic cell transplantation (HCT)/cellular therapy, are vaccinated with one of the available COVID-19 vaccines.
Patients with solid tumors in remission, with myeloproliferative neoplasia, with myelodysplastic syndromes without treatment, and patients receiving endocrine treatment or noncytotoxic agents can receive the COVID-19 vaccine at any time.
Patients with lymphoid malignancies who will receive B-cell depleting agents and those with solid tumors who will receive cytotoxic agents should be given the COVID-19 vaccines before anticancer treatment begins, where possible. If treatment has already been started, then vaccination should be timed around expected periods of treatment-induced cytopenia.
Patients who have undergone HCT or chimeric antigen receptor (CAR) T-cell therapy should wait to vaccinate against COVID-19 until 100 days after completing treatment.
Importantly, close contacts and caregivers of those with cancer as well as those who live in the same household should receive a COVID-19 vaccine.