- Severe forms of Covid-19 are more frequent in boys and girls with cancer.
- So far, the only biologic approved by Cofepris for minors is Pfizer’s.
- The IMSS published the general indications to comply with immunization in this population group.
Authorities of the Mexican Institute of Social Security (IMSS) presented parents of children with cancer a series of recommendations for minors to receive the Covid-19 vaccine. In addition, they also indicated that the chemotherapy regimen should be postponed in case of contagion in order to reduce the complications that may arise in these patients.
Since the immunization campaign began in December 2020, emphasis has been placed on the priority that pediatric cancer patients should receive. This is one of the most vulnerable groups and was initially neglected.
In the first instance, it was due to the fact that the possible side effects in minors were not known. Although shortly after the biologic by Pfizer was the first to show that it was safe at a dose other than that designed for the adult population.
But although from 2021 the Federal Commission for the Protection against Sanitary Risks (Cofepris) authorized the emergency use of this vaccine in Mexico, months had to pass before its application in infants began.
At this time it is active vaccination campaign against Covid-19 in children under 12 years of age, but in the case of children with cancer, some special indications must be followed.
During the ninety-seventh meeting of the working group for the care of pediatric patients undergoing cancer treatment at the IMSS, Dr. Enrique López Aguilar, head of the Cancer Care Coordination, stressed that all minors with cancer should be vaccinated, even if they have already contracted the SARS-CoV-2 virus.
Indications for the application of the vaccine against Covid-19 in children with cancer
He reported that in the child population with cancer and Covid-19, chemotherapy treatment should be delayed until a negative PCR result is obtained. By no means should it be administered for mild symptoms.
He added that if the minors had contact with a relative or someone positive for coronavirus, chemotherapy should be deferred for seven days until the PCR is negative. They should also go immediately to their treating doctor in the presence of mild symptoms of respiratory disease.
Dr. Enrique López Aguilar pointed out that it should be considered that Severe forms of Covid-19 are more frequent in boys and girls with cancer.
He explained that in the case of pediatric oncology patients infected with Covid-19, the next dose of vaccine should be delayed three months from the onset of symptoms or from the time they received a positive test result.
López Aguilar added that the children and adolescents aged 5 to 17 years with moderate or severe immunosuppression will need a third dose to complete the main vaccination schedule, in addition to booster doses, if eligible. He also said that minors with weakened immune systems should get a booster dose.
The Oncology Care coordinator explained that it should be considered for immunization that during a hematopoietic stem cell transplant, allogeneic or autologousAt the time of vaccination, at least three months must pass after the intervention.
In the event that they receive hematological neoplasms, where cytotoxic chemotherapy schemes are applied, or undergo a surgical procedure for the extraction of solid tumors, the immunization against Covid-19 has to be delayed until the neutrophil count is recovered.
Cases in which the vaccine is NOT recommended
Dr. Enrique López explained that the parent or guardian must avoid vaccinating the minor if he or she has a fever or respiratory symptoms associated with coronavirus and assess that the dose is contraindicated in people with a history of having had severe allergic reactions to any component of the biological.
Also, he indicated that The vaccine against the SARS-CoV-2 virus is contraindicated if the pediatric cancer patient presented a reaction to L-Asparaginase. It is a drug that is applied in hematological and antineoplastic therapy. However, if they have a history of mild allergies, they can be vaccinated.
He recalled that the Food and Drug Administration (FDA) of the United States authorized the Pfizer-BioNTech Covid-19 vaccine for emergency use in girls and boys five to 11 years of age. Biologic that showed safety and efficacy results of 75 percent after the first dose, and 95 percent seven days after the second.