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Vaccinations for COVID-19 are finally rolling out across the country, an important step in ending the pandemic that has significantly changed all of our lives.
If you’re a cancer patient or survivor, however, you may have questions about what a COVID-19 vaccine might mean for you.
We asked Mary Mably, RPh, BCOP, oncology pharmacist at the UW Carbone Cancer Center, to answer some commonly asked questions.
As a cancer patient undergoing treatment, should I get a COVID-19 vaccine?
The short answer is: yes, probably.
But the long answer is: it’s complicated.
Because cancer is not one disease, and there are many different ways of treating it, it’s near impossible to issue a uniform recommendation. A patient being treated with hormone therapy for breast cancer is very different than a leukemia patient who has recently received a stem cell transplant.
“The risks and benefits for cancer patients, who may be immunocompromised, have to be weighed on a case by case basis,” Mably said. “However, most experts say that vaccination is safe for use in cancer patients.”
Safety is one thing. Effectiveness is another. Since immunocompromised patients were not included in clinical trials of these vaccines, scientists don’t know for sure if cancer patients who get the vaccine receive the same level of protection. Generally, however, getting the vaccine is still recommended since cancer patients are considered a vulnerable population.
“Even if the protection rate for cancer patients may be lower than the general population, there is still thought that it does provide significant protection,” Mably said. “We feel that the small risk of less protection is worth the benefit of preventing a COVID infection.”
Your oncologist can also help determine the appropriate timing of a vaccine during treatment.
Does the type of vaccine matter?
Both the Pfizer and Moderna vaccines, which have been granted emergency use authorization by the FDA, are what’s known as messenger RNA or mRNA vaccines. Unlike more traditional vaccines, this approach does not inject a patient with a live or inactive virus. Rather, these mRNA vaccines teach the body how to produce a protein to fight off the intended target – in this case, the SARS-CoV-2 virus.
However, there are additional COVID-19 vaccines in development, some of which do involve a live or inactive virus. These vaccines, if approved by the FDA, could be ready by the time widespread vaccination begins taking place. The CDC does not recommend that patients undergoing chemotherapy receive a vaccine with a live virus.
“I think the two vaccines that are out now will be our preferred vaccines for cancer patients,” Mably said.
Additionally, because this is the first time the United States has rolled out an mRNA vaccine on a massive scale, there may be some general bumps along the way, but physicians and scientists and responding and reacting quickly to any issues that arise.
“We’re learning more and more as we go,” Mably said.
Can I expect worse side effects because of my cancer?
“For cancer patients, there should be no increased risk of adverse events,” Mably said. “We have seen some adverse events with this vaccine in general, but that happens with every vaccine.”
Commonly reported side effects among vaccine recipients include injection site pain, headache, mild fever, fatigue, chills and muscle pain – the usual suspects. Some severe allergic reactions to the vaccine have been reported, but they are rare.
The CDC has also launched a text message-based system that vaccine recipients can sign up for and report any side effects they may be feeling. Regardless of your cancer status, Mably recommends signing up.
“The CDC is trying to collect the data as quickly as they can, in as large of numbers as they can, so they can get more information,” she said.
As an added benefit, you’ll also be sent a reminder about getting that second dose of vaccine.
What about cancer survivors and caregivers?
For cancer survivors who are not undergoing active treatment, are in remission, or are considered cured, receiving a vaccine shouldn’t be cause for concern.
“I think the further out people get from therapy, as long as they’re not on any immunosuppressant drugs, they would just be considered in the normal patient population,” Mably said. “However, I would err on the side of trying to get the vaccine sooner rather than later for our cancer survivors.”
Mably says she’s also fielded many questions about the safety of cancer caregivers getting a COVID-19 vaccine.
Because the Pfizer and Moderna vaccines are mRNA vaccines and do not contain any virus, they are safe for caregivers and will not cause an unintended transmission.
However, caregivers are still susceptible to getting COVID-19 through other means, just like the rest of us. We also don’t yet know if a vaccinated individual can still carry and transmit the virus to an unvaccinated individual.
So, for the time being, it’s on all of us to keep doing what we’ve been asked to do.
“For everyone who gets this vaccine, it is still important to mask up, physically distance when possible, and wash your hands,” Mably said. “All of those recommendations still are in place.”
When can I get vaccinated?
Distribution of COVID-19 vaccines has gotten off to a slow start. While vaccine availability may remain limited, it’s not too early to start thinking about your plans for getting vaccinated.
There may be opportunities for those with cancer to get vaccinated sooner rather than later. The CDC has included cancer in its list of conditions that put adults at increased risk of severe illness from the virus that causes COVID-19. The actual distribution of vaccine, however, is decided on a state-by-state basis.
When Wisconsin enters Phase 1C of vaccinations, the state anticipates that “persons aged 16–64 with high-risk medical conditions” may start receiving the vaccine. That said, Phase 1C may still be months away, and the conditions could always change depending on the available supply of vaccine.
“I would encourage people to watch for opportunities to be vaccinated, and to discuss it in advance with their providers,” Mably said. “If you still have a cancer provider, certainly that would be the best person to discuss it with, but otherwise, your primary care doctor would also be able to provide guidance.”
