COVID- 19 Vaccine And Cancer Treatment

Guest post from Dr. Shyamali Singhal, MD

Surgical Oncologist

Founder of Hope & Beauty

Can Cancer Patients That Are Undergoing Cancer Treatment Receive The Vaccine Safely?

There are currently three different vaccines: Pfizer-BioNTech, Moderna, and Johnson & Johnson/Janssen, that have received emergency approval from the FDA and are being widely distributed in the country. The Centers for Disease Control and Prevention (CDC), the National Comprehensive Cancer Network (NCCN), and other important oncology-focused organizations all say that cancer patients should be a high priority group to receive the vaccinations.

In December 2020, the American Association for Cancer Research (AACR) issued a plea that people with cancer receive the vaccines as soon as possible. Their review of medical research found that cancer patients were twice as likely to die from COVID-19 as were people without cancer. In Massachusetts, cancer patients are currently fairly far down the list in Phase 2 of distribution, although cancer is at the top of the list for co-morbidities or pre-existing conditions. The COVID-19 pandemic, caused by the SARS-CoV-2 virus, continues to have a serious impact on many people, including cancer patients, their families, and caregivers.

Who Should Not Get The Vaccine?

Many expert medical groups recommend that most patients with cancer or a history of cancer should get a COVID-19 vaccine. Since the situation for every person is different, it is best to discuss the risks and benefits of getting the COVID-19 vaccine with your cancer doctor, who can advise you.

For patients who have just had a stem cell transplant or received CAR T-cell therapy, who are typically receiving immunosuppressive therapy, we recommend that they delay COVID-19 vaccination until at least 3 months after they’ve completed treatment. That’s based on data that vaccines have had limited efficacy during periods when these patients are their most immunosuppressed.

The data are a little less clear for patients who are getting aggressive chemotherapy, but for those who are receiving more intensive treatment regimens—for example, those starting initial therapy for leukemia—we recommend that they delay vaccination until their cell counts recover.

Those are the two main groups that should delay COVID-19 vaccination, at least initially.

The details of where any one group falls on the list change, and it is clear that powerful competing forces are at work as decisions are made. A change in policy, for example, President Biden’s recent directive that educators should all be vaccinated by the end of March, moves one group higher on the list — and pushes another further down. Some hospitals and cancer centers have supplies of vaccines, but not all do. Some patients who are being treated at one of the supplied hospitals have received calls or emails to register for a vaccine, but those invitations are usually limited to people who fall into the other approved groups.

H&B Encourages You To Get You Vaccine When You Can

There are certain complications and difficult logistics of finding and registering for an available vaccine. We hear many stories of very distressed and frustrated people who have been unable to sign up and many other stories about under-served communities that feel ignored or forgotten. There are also many reports of Americans who don’t want the vaccine. Different studies have reported between a quarter and a half of the population want to delay or never receive the vaccine.

And what about those who may be undergoing treatment soon, such as somebody just diagnosed with cancer or whose treatment has been delayed by the pandemic?

We really don’t want to create guidance that will prevent cancer patients from getting vaccinated. If you start trying to nuance it for the “right time,” it may mean that many patients won’t get the vaccine. So, the best approach is to get the vaccine when you can.

Some Caveats To Keep In Mind

Still, there are some caveats. We do recommend delays for patients undergoing stem cell transplants and those getting induction therapy for leukemia. In addition, cancer patients who are about to undergo surgery should probably wait for a week until after surgery to get vaccinated. Because we don’t want any potential side effects from the vaccine—for example, a fever—to potentially delay their surgery.