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Should cancer patients get the COVID-19 vaccine?

Washington University surgeon Ryan Fields, MD, delivers the COVID-19 vaccine to a colleague. Photo by Matt Miller Washington University surgeon Ryan Fields, MD, delivers the COVID-19 vaccine to a colleague. Photo by Matt Miller

The U.S. Food and Drug Administration (FDA) has approved the use of three vaccines to help protect individuals from getting COVID-19, a highly contagious viral infection that is especially dangerous for people with weak or compromised immune systems, including cancer patients. These vaccines have been shown to be safe and effective, according to the federal Centers for Disease Control and Prevention (CDC), and the potential benefits of receiving a COVID-19 vaccine outweigh the known and potential harms of becoming infected with the disease.

While the COVID-19 vaccines are generally recommended for cancer patients, specific types of cancer treatment might affect when the vaccine should be received. This Q&A is intended to provide important information for cancer patients to consider. However, this document does not take the place of your oncologist, who is aware of the specifics of your case and treatment.

We strongly recommend that patients discuss  risks and benefits of the COVID-19 vaccine with  their oncologist.

The information below represents the current opinions of physicians at Washington University School of Medicine in St. Louis, Siteman Cancer Center and BJC HealthCare related to COVID-19 vaccines for cancer patients.

Q: Why should I consider getting the  COVID-19 vaccine?

A:  Cancer patients who get COVID-19 are at higher risk for complications, hospitalizations and even death compared to healthy people who get COVID-19. That’s because cancer patients in active treatment can have a weakened immune system, which makes it harder to fight off diseases such as COVID-19. Based on the opinions of physicians and other experts at Washington University School of Medicine in St. Louis, Siteman Cancer Center and BJC HealthCare, we recommend that cancer patients who have completed their treatment get the vaccine. Cancer patients who have not completed their treatment should discuss risks and benefits with their oncologist. 

 

Q: What if I’m just about to start cancer treatment?

A:  The answer depends on when and how fast your cancer treatment needs to start. Your oncologist will help you make the right decision.

 

Q: Should I get the vaccine if I’m in the middle of my cancer treatments?

A:  It depends on what type of cancer treatment you are receiving, which is why we strongly recommend talking with your oncologist. But, in general, these are our recommendations for patients undergoing:

  • Chemotherapy – We recommend that patients who are completing their chemotherapy in the next two to three months delay getting their COVID-19 vaccination until treatment is completed. For those undergoing chemotherapy for a longer period, it might be beneficial to receive the COVID-19 vaccine in between rounds of chemotherapy. Talk to your oncologist about getting the first or second COVID-19 shot two weeks before a round of chemotherapy.
  • Radiation Therapy – You should be able to receive the COVID-19 vaccine at any time, but we recommend talking with your radiation oncologist first.
  • Bone Marrow/Stem Cell Transplant – We recommend that patients delay the COVID-19 vaccination until one to three months after transplant. We would postpone the COVID-19 vaccine for a longer period of time if you are placed on steroids and experience decreased immune function.
  • Immunotherapy – We recommend that you talk with your oncologist about the timing for receiving the COVID-19 vaccine.
  • Chronic Oral Immunosuppressive Medication – If you are not on active treatment but still take chronic oral immunosuppressive drugs, we recommend that you get the COVID-19 vaccine.

 

Q:  Do the COVID-19 vaccines contain a live virus?  What should I know about live-virus vaccines?

A:  Anyone with a weak immune system should be very cautious about getting any vaccine that contains live virus. These include measles-mumps-rubella (MMR) and varicella (chickenpox) vaccines, as well as the nasal mist version of the flu vaccine. The standard flu shot does not contain live virus. Two of the COVID-19 vaccines, from Pfizer-BioNTech and Moderna, do not contain the live virus, either. The Johnson & Johnson vaccine uses a modified adenovirus that can enter cells but cannot replicate or cause illness and, therefore, is considered safe for people with a weak immune system, including cancer patients. It does not contain live COVID-19 virus.

 

Q: How do I get the vaccine?

A:  BJC HealthCare and Washington University Physicians are working quickly to make the COVID-19 vaccine available to those who are eligible in accordance with federal and state guidelines. You may pre-register for the vaccine at bjc.org/vaccinate. They will contact you when your eligibility window opens, and when vaccine supply and distribution capacity are available. It could be several weeks or longer before you are able to schedule. Counties and other health systems also have websites where you may pre-register.

You may pre-register on multiple sites. We recommend that you accept the first opportunity provided to receive a vaccine – after you and your oncologist have discussed when you should receive it. For more information, visit physicians.wustl.edu/covid-19-vaccines.

 

Q: Should cancer patients who have recovered from COVID-19 receive the vaccine?

A:  The vaccine is recommended for such patients once they have recovered from COVID-19. For those who received convalescent plasma or monoclonal antibodies as part of their COVID-19 treatment, we recommend they wait for three months after receiving convalescent plasma or monoclonal antibodies before they receive the vaccination.

 

Q: Should my family get the COVID-19 vaccine?

A:  Yes. We recommend that family members get the vaccine when it is available to them.  This will better protect you while you are in treatment.

 

Q: If my child is being treated for cancer, can he or she get the COVID-19 vaccine?

A:  At this time, no COVID-19 vaccine is available for anyone younger than 16.

 

Q: Should I wear a mask and socially distance after I receive the COVID-19 vaccine?

A:  Yes. No vaccine is 100 percent effective. Therefore, it is important to minimize your risk of getting COVID-19 as much as possible. We recommend that you and those you are in close contact with wear a mask in public, wash your hands frequently, sanitize touched surfaces and try to maintain a small “bubble” of family members that you see.

 

Additional information for these recommendations comes from the Centers for Disease Control and Prevention (CDC), American Medical Association, American Society of Clinical Oncology (ASCO), American Society of Hematology (ASH) and Infectious Diseases Society of America