COVID-19 vaccines and cancer: what you need to know

With the rollout of COVID-19 vaccination well underway in the United States, many people are wondering about the safety and effectiveness of vaccines, especially in cancer survivors, those on cancer treatment, and those on cancer treatment. whose cancer is currently in remission.

What do patients – past or current – need to know about COVID-19 vaccines? And what questions should they ask their doctors? To find out, we asked Thomas Marron, MD, PhD, an immunologist and oncologist who conducts early phase clinical trials at Mount Sinai in New York City.

Daily health: Now that the vaccine rollout has begun, what is the most important piece of advice you can give to people with cancer?

Thomas Brown: There is general consensus among the major cancer organizations – including the American Cancer Society, the American Society of Clinical Oncology, and the National Comprehensive Cancer Network – as well as the Centers for Disease Control and Prevention (CDC) and oncologists that cancer patients should get the COVID-19 vaccine as soon as it is available to them. Data on the severity of COVID-19 disease in cancer patients is still inconclusive, but some data suggests cancer patients have worse outcomes, which would not be surprising, as many of those who undergo treatment are immunocompromised. People with underlying health conditions like cancer fall into CDC priority groups 1b or 1c because of their increased risk. In general, I encourage people with cancer to get vaccinated as soon as they become candidates, which should probably be done in the next few weeks.

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EH: Are there certain types of patients that concern you the most?

TM: When it comes to getting the vaccine quickly, I worry more about my patients over 65, not because of their cancer, but because they are older and have a much higher risk of disease. COVID-19 and its most serious complications due to their age, which correlates with other health issues.

EH: The general rule for people with immune compromising health problems is to avoid vaccines containing live viruses. Is this a source of concern?

TM: We generally do not recommend live vaccines for cancer and other patients with weakened immune systems. This is not a problem with the Pfizer and Moderna vaccines, which do not contain live virus but rather messenger RNA, which is an instruction manual that teaches your cells how to fight COVID-19. However, some of the vaccines on the horizon – for example, Johnson & Johnson’s vaccine candidate – contain live viruses. At this point, I would hesitate to recommend it to cancer patients. The same warning applies to other COVID-19 vaccines not approved by the FDA, as we do not have enough information on potential side effects in cancer patients. The best advice is that every cancer patient should speak to their oncologist or other healthcare professionals before considering getting vaccinated against Johnson & Johnson or other vaccines containing the live COVID-19 virus, when. ‘they will be available.

EH: Are vaccines safe and effective for patients on active treatment, such as chemotherapy or immunotherapy?

TM: Absolutely. We try to avoid giving the vaccine on the same day that we give chemotherapy, mainly because we will often give patients steroids at the same time to reduce nausea or allergic reactions. Studies have shown that steroids can decrease the effectiveness of the vaccine. However, when it comes to immunotherapy drugs in general, they increase or enhance the effects of the vaccine in fighting infection, just as they help strengthen the body’s natural defenses – T cells and antibodies – to fight cancer. Having said that, I have had a few instances where patients have experienced more severe side effects after receiving a vaccination, such as pain at the injection site or fatigue.

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EH: Speaking of side effects from vaccines, are cancer patients more prone to them in general?

TM: For some patients, such as people on active immunotherapy, the vaccine may cause more irritation or pain at the injection site, or fatigue. Other side effects may include feeling generally unwell and sometimes flu-like symptoms such as mild fever. Again, unlike COVID-19 infection and possible complications, these side effects are not life threatening, so in terms of the risk-benefit equation, getting the vaccine is essential.

EH: Do you have any specific or different advice on side effects for patients who have had COVID-19 before?

TM: I had COVID-19 last March and after getting the first dose of the vaccine my arm was really sore for about four days. This seems to be universal among vaccinees, regardless of their cancer status, whether after the first or second dose. Of my patients who have not had COVID-19, most seem to have a stronger reaction after the second dose. It really depends on the individual. My biggest concern is not the side effects; is that some people will be afraid of the vaccines as a whole, while others may decide not to receive a second dose if they have a strong physical reaction to the first. I advise all cancer patients to be prepared, to make sure they have Tylenol and Gatorade and things like that at home, as if they were preparing for the flu. Besides, if they don’t experience any of the side effects of the vaccine, that’s great; they have supplies for future illnesses.

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EH: Are there any unique steps cancer patients might want to consider before or after receiving the COVID-19 vaccine?

TM: We could eventually get to the point, especially in patients who have had chemotherapy or steroids, where we check their immune status and, if antibody levels are relatively low, potentially offer a third booster dose. But it is far in the future. The first step is to have everyone in the country vaccinated.

In the meantime, the # 1 priority, whether or not the person has cancer, is to contact their doctor with any questions if they have any side effects from the vaccine or even if they are taking multiple medications for different conditions and s. ‘worry. on unexpected interactions.

In addition, even after people receive the vaccine, it is important that they continue to apply the precautions that have been in place since last year, such as washing hands, wearing masks and avoiding social gatherings. apart from their pods or immediate family. COVID-19 vaccines are only about 95% effective in preventing people from contracting COVID-19. One of the goals of the vaccine is to reduce the severity of the disease even if someone becomes ill. But it is always better to avoid getting sick.

Now is not the time to let our guard down. We are still far from the finish line of this pandemic. But for now, I can say with certainty that all cancer patients should receive the COVID-19 vaccine.