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Published on May 12, 2021
This is the second in a multipart series exploring important questions about COVID-19 and its unique impact on cancer patients. In this series, Patient Power went to the experts to get the facts about COVID-19 and how it affects prevention, screening, treatment, and research.
Now that you have received a COVID-19 vaccine, you may still have questions. How well will it work if I am on chemotherapy? Will I be as protected as those who don’t have cancer? Are there any particular side effects that may be important for me to know about? We discussed these questions with Shmuel Shoham, MD, an expert in infectious diseases and an Associate Professor of Medicine at Johns Hopkins University School of Medicine in Baltimore, MD.
Recent studies indicate that people with cancer are at a substantially higher risk of serious disease, complications, and death if they get COVID-19. For that reason, it is essential to get a vaccine as soon as possible. And while there is certainly interest in studying how well the vaccines work in people with cancer or those who are on specific treatment plans, it is too early to know all of the answers yet.
What we do know is that vaccines will increase protection from COVID-19, and that is extremely important for people with cancer. Even if an infection occurs in a vaccinated person, it is likely that it won’t be as serious, require hospitalization, or lead to death.
Many people ask if there are blood tests that can be done after a vaccine to determine how well their body has responded. “There are currently some tests looking at immune response used as part of clinical research trials, but these tests are not yet in general use,” Dr. Shoham said. Even though some physicians may use these tests outside of clinical trials, this is not currently recommended, he added. At this point, it is not clear what the test results mean or what actions should be taken.
The Leukemia & Lymphoma Society has a study underway to help answer some of these questions. The study is building a database of COVID-19 vaccine responses in blood cancer patients.
Over time, researchers will be able to determine if antibody testing will be important to assessing immunity and if vaccine boosters will be needed. In the meantime, Dr. Shoham noted that it is best to assume that anyone on active cancer treatment will not have a full response to the COVID-19 vaccine. For that reason, it is important to create a “cloud of vaccination” around people with cancer, ensuring that everyone who lives or comes into close contact with a patient with cancer is vaccinated.
Some people with cancer have asked if it is possible to take medicines, such as monoclonal antibodies or convalescent plasma, to potentially improve immunity. These ideas have some merit, but studies are still ongoing (or being planned) to evaluate these approaches.
What is most important to do right now, besides being sure that you and your close contacts get vaccinated, is to exercise, eat a healthy diet, get enough sleep, and avoid smoking, said Dr. Shoham. Be sure to control any other chronic illnesses, such as hypertension or diabetes, which can put you at an increased risk for COVID-19 infection. Patients and everyone around them should also continue to wear masks, follow social distancing guidelines, and wash hands carefully.
There is no current evidence that people with cancer, or those undergoing cancer treatment, suffer more side effects from the vaccine. However, the Moderna and Pfizer vaccines can cause temporarily enlarged lymph nodes in the armpit in some. For this reason, the Society of Breast Imaging suggests that women should consider scheduling breast screening exams before the first dose of a COVID-19 vaccination or 4-6 weeks following the second dose, as long as this does not delay needed care.
Dr. Shoham pointed out that another consequence of vaccination is a “false sense of security.” He said he has seen patients who have dropped precautions, such as mask-wearing, after receiving only the first dose of the vaccine and it has resulted in a COVID-19 infection.
He also pointed out that while feelings of tiredness and fever are not uncommon a day or two after a COVID-19 vaccination, a person with cancer should definitely let their healthcare team know if this occurs, just to be sure they don’t have an infection.
~Susan Yox, RN, EdD
- Recommendations of the NCCN COVID-19 Vaccination Advisory Committee
- National Cancer Institute. Coronavirus Vaccines and People with Cancer: A Q&A with Dr. Steven Pergam
- ASCO. Common Questions About COVID-19 and Cancer: Answers for Patients and Survivors
- CDC. How to Protect Yourself and Others
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