03/02/2021 By Dr. Dan Platt

The following are key points that cancer patients need to know about COVID and vaccination.

Cancer patients are at greater risk of contracting COVID and are more likely to die from COVID if they become sick.

Cancer and its treatment take a huge toll on the immune system. While it is well-known among patients that chemotherapy can kill off white blood cells and leave people vulnerable to infection, the impact of cancer directly on the immune system is less understood. Simply put, cancer cells survive and thrive by avoiding, hijacking, and manipulating immune cells throughout the body.

Therefore, all patients with cancer, whether they are currently in treatment or not, have compromised immune systems.

COVID preys on this vulnerability. Many studies over the last 12 months have found that patients with cancer are more likely to contract COVID if they are exposed and have worse outcomes (greater need for ICU admission and higher death rate) than those without cancer. Furthermore, a recent study from the University of Pennsylvania found that even those whose cancer is in remission and who are not currently requiring therapy are at greater risk, likely because of the delayed return of immune cells in the post-treatment period.

If you have cancer, or have had cancer, you should get the vaccine ASAP (it does not matter which one!).

Cancer patients are considered a high-priority group for vaccination, and it is imperative that all patients in active treatment get a vaccine as soon as possible.

It is important to understand that vaccination must be delayed in certain groups who may be too immunosuppressed to generate a protective response to a vaccine.

If you are in one of the following treatment groups, you will need to wait 3 months after your last treatment to receive a COVID vaccine:

• Patients who have had a stem cell transplant or organ transplant and are receiving immunosuppressive therapy (cyclosporine, cyclophosphamide, sirolimus, etc.)
• Patients who have received CAR-T therapy
• Patients who have greatly diminished cell counts because of active treatment with intense chemo regimens (3 or more drugs at one time, or induction therapy)

The bottomline

If you have or have had, cancer, get vaccinated as quickly as possible once you are no longer immunocompromised. As more vaccines become available, it is also important to note:

There is not presently enough data to say that one vaccine is better than another for cancer patients.

Until we know more, whichever vaccine you have access to first is the best one for you! The Pfizer and Moderna vaccines require two shots, spaced 21 days apart, while the recently approved Johnson & Johnson vaccine requires only one shot. All these vaccines grant significant protection against COVID and it is important that you not delay a vaccination so that you can receive the “best” one. If, as more data is gathered, it becomes clear that one vaccine is better than the others in preventing COVID infection in cancer patients, you can always be re-vaccinated. For now, it is very clear that some protection is better than none at all, particularly for the cancer community.

Resources:

Deskside with Dr. Dan

“One small way I am personally contributing to education is through sharing my take on academic and industry articles, using my medical background to boil down the jargon and pull out the benefits of the news for you.”

– Dan Platt, M.D.

Chief Medical Officer