COVID-19 Vaccination Guidelines for Cancer Patients
Posted: January 20, 2021
Cancer Care Northwest (CCNW) is following current CDC recommendations for cancer patients considering COVID-19 vaccination with the Moderna or Pfizer vaccine. Both of these are mRNA vaccines that have shown to be safe and effective for the general public; while cancer patients undergoing active treatment were not included in the clinical trials of these vaccinations, there is a large amount of evidence to support their safety in cancer patients. These recommendations are also supported by the American Society of Clinical Oncology (ASCO). The following recommendations specifically for cancer patients are as summarized below:
- Cancer patients CAN get the vaccine as long as the medications they are taking are not contraindicated with the vaccine.
- Cancer patients should discuss the timing of vaccination with their oncologist to ensure the greatest efficacy and least interaction with treatment. It is recommended that vaccinations be given in between treatments when the patient is least immunosuppressed. Basically, if your immune system is very depressed you may not generate a robust response to the vaccine. However, it has been documented that not getting vaccinated while receiving chemotherapy or other cancer treatments and contracting Covid-19 carries significant risk of severe infection from the virus. In summary, a little vaccination protection may be better than none in immunocompromised persons.
- Long-term cancer survivors (persons at 1 year or longer on observation follow-up only) can get the vaccination anytime as recommended and available.
- If you have already had COVID-19, persons can still get vaccine injection after the acute period and symptoms have resolved. However, it is recommended that you wait 90 days post infection to start the two injection vaccine series.
- Persons with known hypersensitivity to vaccinations in general may require additional observation or elect to defer vaccination.
- Caregivers for cancer patients should be encouraged to consider vaccination as a strategy to diminish overall cancer patient risk of getting this virus.
Since active treatment or patients with chronically lowered immune system strength may have variable and still unpredictable responses to these new vaccines, it is critical that caregivers and these persons with lowered immunity carefully adhere to CDC guidelines as it relates to use of masks, social distancing, good handwashing and other practices to prevent infections.
All persons receiving the Covid-19 vaccines are still at risk for developing COVID-19 despite vaccination (at least 5% risk). It may take one to two weeks after the second dose of vaccination before you have established adequate immunity to COVID-19. Until the duration and extent of vaccination protection is well known, we all must continue to wear masks and follow CDC precautions after vaccination until the pandemic subsides.
HOW AND WHERE DO I GET THE COVID-19 VACCINE:
COVID-19 vaccines will be administered according to the Washington State vaccination distribution plan and the Idaho State vaccination distribution timeline. Vaccines will be given at specified locations throughout your state. Please note, CCNW does not administer COVID-19 vaccines at our facilities and you do not need a prescription to receive a vaccine. For more information, including when and where you can get a COVID-19 vaccine, please visit:
CLINICAL RECOMMENDATIONS FOR CANCER PATIENTS:
Your oncologist should work with you to determine when and which drug treatments may need modification or schedule changes to support your vaccination goals.
- Prior to scheduling the vaccine injection, please notify your oncologist for medication reviews.
- Medical Oncology Patients:
- Patients who receive weekly or every 2- or 3-week treatments, ask your oncologist when it would be best to schedule the vaccine
- Patients that take immunotherapy medications, please ask your oncologist if the medication dose should be reduced, held, or scheduled differently to support the Covid-19 vaccine injection(s).
- Radiation Oncology Patients:
- Patients receiving radiation therapy can get the vaccine at any time with the EXCEPTION if you are also getting concurrent chemotherapy or total body irradiation. For those patients getting both chemotherapy and radiation, please follow the aforementioned chemotherapy guidelines. For total body irradiation, please talk with your oncologist to schedule the vaccine when it is optimal to receive it.
- If the patient has had brachytherapy/HDR radiation, follow the chemotherapy guidelines if taking chemotherapy as well. There is no restriction based on brachytherapy alone for vaccination.
- If patient has had a bone marrow transplant, or diagnosis of myelofibrosis or leukemia, coordinate the decision for vaccination with your oncologist. Bone marrow cell transplantation (HCT) may depress immunity and immune reactivity to vaccines; especially within the first 3-6 months after autologous HCT and often longer after allogeneic HCT.
- Persons with autoimmune conditions who have no contraindications to vaccination may receive an mRNA COVID-19 vaccine but may have a lowered response to the vaccine.
- Persons with history of Guillain-Barre syndrome or Bell’s palsy may receive an mRNA vaccine unless they have other contraindications to vaccination.
- If the patient is pregnant (or actively trying to be), please check with patient’s OB/Gyn or Pediatrician prior to taking a vaccine.
- If the patient currently receives antibody treatments (IVIG, RhoGAM) there is no recommended period limiting when they can receive vaccine.
- If the patient has had surgical fillers (facial) or Botox, please talk with your physician prior to getting the vaccine.
Auletta, J., Chemaly, R., Khawaja, F., Papanicolaou, G., Hill, J., Kanter, J., Waghmare, A., Wiestner, A., & Wingard, J. (2020, December 23). ASH-ASTCT COVID-19 and Vaccines: Frequently Asked Questions. American Society of Hematology. https://www.hematology.org/covid-19/ash-astct-covid-19-and-vaccines
Bhimraj*, A., Morgan, R., Hirsch Shumaker, A., Lavergne, V., Baden, L., Chi-Chung Cheng, V., Edwards, K., Gandhi, R., Gallagher, J., Muller, W., O’Horo, J., Shoham, S., Hassan Murad, M., Mustafa, R., Sultan, S., & Falck-Ytter, Y. (2021, January 8). Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19. Infectious Diseases Society of America. https://www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management/
COVID-19 Vaccine & Patients with Cancer. (2020, December 22). American Society of Clinical Oncology. https://www.asco.org/asco-coronavirus-resources/covid-19-patient-care-information/covid-19-vaccine-patients-cancer
Frequently Asked Questions about COVID-19 Vaccination. (2020, December 29). Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html
CCNW Oncology Covid-19 Vaccination Guidelines
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