• People over 50 and those who are immunocompromised are now eligible for a second COVID-19 booster shot.
• Individuals with lung cancer should talk with their oncology teams about whether they should time any booster shots around cancer treatments.

The United States Centers for Disease Control and Prevention (CDC) is now recommending a second COVID-19 booster shot for individuals older than 50 and those with certain conditions that cause them to be immunocompromised. The American Cancer Society states, “Many expert medical groups recommend that most people with cancer or a history of cancer should get a COVID-19 vaccine.”

People who have lung cancer are typically considered immunocompromised, which can lead to an increased risk of severe disease and hospitalization with COVID-19. The new public health recommendations come after recent studies showed an immune response to the Moderna and Pfizer vaccines in many immunocompromised people, including individuals with cancer.

The New Recommendations

Health officials at the United States Food and Drug Administration and the CDC have authorized and recommended a second booster shot for people 50 and older and those who are immunocompromised. Although this recommendation affects a similar age group as the initial recommendations for the first booster dose, there are several details to know before you get this fourth dose:

• This additional booster is for people who received their first booster shot or last COVID-19 vaccine at least four months ago.
• The fourth shot will be either the Moderna or Pfizer vaccine, not the Johnson & Johnson vaccine.
• Even if you were previously vaccinated with the Johnson & Johnson vaccine, it is now recommended that this next dose should be a Moderna or Pfizer vaccine only.
• For those who are immunocompromised and received a three-dose primary vaccination followed by an initial booster, this additional vaccine booster would count as your fifth shot.

How Booster Shots Have Affected People With Lung Cancer

If you are on the fence about whether to get vaccinated (or boosted) to protect against COVID-19, you may be wondering what the research says. The Lungevity Foundation noted that “Patients with lung cancer are known to be at increased risk for severe outcomes and death from COVID-19,” urging people with the condition to get vaccinated against the virus.

When it comes to booster shots, one review of previous studies found that people with solid tumors were able to raise their immune response against the COVID-19 omicron variant from 48 percent after their initial vaccinations to nearly 89 percent after their third vaccine doses. Lung cancer is one type of solid tumor cancer.

The American Lung Association recommends receiving a COVID-19 vaccination two to three weeks before beginning lung cancer treatment with chemotherapy or immunotherapy. This gives the immune system time to develop a response to the COVID-19 vaccine and make antibodies against it. These guidelines do not apply to other lung cancer treatments, such as targeted therapies, because the medications work differently than chemotherapy or immunotherapy.

“Got my fourth COVID-19 vaccination yesterday — arm just sore,” wrote one MyLungCancerTeam member. Another wrote, “Both my wife and I got the booster and had no reactions to it.”

Response to the Moderna Vaccine

The CDC’s latest recommendations follow promising new results about the effectiveness of the vaccines in immunocompromised people. A recent study from Moffitt Cancer Center included people diagnosed with solid tumors, as well as individuals with blood cancers. Researchers tested levels of antibodies, the proteins the immune system makes to help destroy a target. In this case, the antibodies were to the SARS-CoV-2 virus that causes COVID-19, made in response to the Moderna COVID-19 vaccine.

On average, antibodies against the coronavirus were identified after the second vaccine dose in about 90 percent of people in the study. About 98 percent of people with solid tumor cancers showed an antibody response.

Response to the Pfizer Vaccine

Although this recent study only included people given the Moderna vaccine for COVID-19, other research has looked at the response of immunocompromised individuals to the Pfizer vaccine. These vaccines are based on the same technique, using a molecule called mRNA to teach cells how to make a protein that will trigger an immune system response and help prevent a SARS-CoV-2 infection.

In one study that included individuals with medical conditions that caused them to be immunocompromised (including lung cancer), immune system response was about 67 percent. However, individuals with solid malignancies made antibodies after vaccination about 83 percent of the time, according to the study results.

Why These Results Matter

Additional doses of mRNA vaccines may be effective at increasing detectable antibodies in a similar way to the first and second doses. Other research indicates that antibody levels are likely to decrease over time, so getting booster doses at recommended intervals is necessary even in vaccinated people who made antibodies after their initial shots.

Simply making antibodies does not always necessarily translate to complete immunity from COVID-19 infection, but the findings from these studies are a good sign that the mRNA vaccines for COVID-19 can trigger strong responses even from compromised immune systems. It’s evidence that vaccines can protect people at higher risk from severe infections.

According to the CDC, getting vaccinated is still the best way to protect yourself and slow the spread of the virus.

Find Your Team

MyLungCancerTeam is the online social support network for those with lung cancer, their caregivers, and their loved ones. Here, you can connect with other people who understand life with lung cancer. Members come together to ask questions, give advice, and share their stories with others who understand.

Are you planning to get another booster vaccine? Do you have concerns about vaccine effectiveness, vaccine response, or time of vaccination? Share your insights in the comments below, or start a conversation by posting on MyLungCancerTeam.