Cancer Center Patient FAQ

COVID-19 is a significant threat to the health of everyone, particularly people with cancer. Studies have shown that people with cancer have higher risk than the general population of being hospitalized, developing a critical illness from COVID-19, and of dying from COVID-19. To protect themselves, people with cancer should reduce their risk of exposure to the virus, accept a vaccine when it becomes available, and encourage those they come in contact with to get vaccinated too.

Here are some frequently asked questions related to the safety and efficacy of the COVID-19 vaccine for patients undergoing treatment for cancer.

When will the vaccine be available to oncology patients?

The COVID-19 vaccine is now available to all patients 6 months of age and older.

Is it safe to get a COVID-19 vaccine if I have a weakened immune system?

Yes. It is safe to receive the COVID-19 vaccine if you have a weakened immune system The Centers for Disease Control and Prevention (CDC) recommends COVID-19 vaccination for all people who are moderately or severely immunocompromised.

Will the COVID-19 Vaccine interact with any of my chemotherapy drugs?

There is no evidence that the COVID-19 vaccines interact with chemotherapy agents. However, clinicians should pay careful attention to potential overlapping toxicities and drug-drug interactions between drugs that are used to treat COVID-19 and cancer-directed therapies.

Questions about vaccination safety have been brought up for patients receiving immune checkpoint inhibitor treatment with drugs such as Keytruda, Opdivo, Yervoy, Bavencio, Tecentriq, etc. We know from multiple recent studies that the influenza vaccine is safe for people on immune checkpoint inhibitors and there does not appear to be an increased risk of developing an inflammatory immune reaction.

If you may benefit from an immune checkpoint inhibitor, you should continue it. You should not delay a COVID-19 vaccination because you are taking an immune checkpoint inhibitor. If you are not sure if the treatment you are receiving is an immune checkpoint inhibitor, you can ask your oncologist.

Should I wait to get the vaccine or delay the start of my chemotherapy?

No. Most cancer patients should get vaccinated as soon as possible. However, stem cell transplant or patients in the process of receiving cellular therapy should wait at least 3 months after they finish therapy to get vaccinated.

If I have already started a chemotherapy cycle or other cancer treatment plan, when should I get the COVID-19 vaccine?

We strongly recommend talking with your oncologist or hematologist to decide the best time to start the vaccine series. Most patients with cancer can receive COVID-19 vaccination as soon as possible, regardless of their cancer treatment. Some patients who are vaccinated during stem cell transplant or CAR-T therapy may need to be revaccinated once immune function is restored.

Below are unique COVID-19 vaccination timing considerations for selected patients:

Treatment/cancer type Timing to start series
Hematopoietic cell transplantation (HCT)/cellular therapy At least 3 months after HCT/cellular therapy
Hematologic  malignancies  
Receiving intensive cytotoxic chemotherapy (for example, cytarabine/anthracycline-based induction regimens for acute myeloid leukemia) Delay until absolute neutrophil count (ANC) recovery or, for those not expected to recover, as soon as possible
Solid tumor malignancies  
Major surgery Separate the date of surgery from vaccination by at least a few days

Is it safe to receive the vaccine during radiation therapy or immunotherapy, after surgery, or while I am taking oral medication for cancer?

Yes. There is no data to suggest that any other treatments such as chemotherapy, surgery, targeted therapy, or radiotherapy would make the vaccine less safe for you.

Does the COVID-19 vaccine interfere with mammogram screenings?

Please refer to our Vaccine Safety FAQ page for an answer to this question.

Are there any stages of specific types of cancer when it is not a good choice to have a vaccine?

From a safety standpoint, there are no special concerns regarding any specific types of cancer or the stage (progression) of cancer and timing of the vaccine.

Does cancer or cancer treatment make the COVID-19 vaccine less effective?

The influenza vaccine is slightly less effective in people with solid tumors and even less effective in people with blood cancers such as lymphoma, leukemia, or myeloma. It is not clear whether low effectiveness is due to the cancer treatment or to the underlying disease. The 4 COVID-19 vaccines authorized for emergency use by the FDA have much higher effectiveness rates overall than the influenza vaccine.

Even though effectiveness of the COVID-19 vaccine may be lower in people with hematologic (blood) cancer, it is still expected to offer protection. While the current recommendation for immunocompromised patients is no different than for other patients, the CDC is evaluating data if an additional booster dose is needed.

Immunocompromised patients also qualify for Evusheld®. Evusheld® is a monoclonal antibody administered into the gluteal muscle every 6 months as pre-exposure prophylaxis. Evusheld® provides additional protection in patients who only partially respond to the COVID-19 vaccine. Evusheld® is not a substitute for vaccination. Discuss with your hematologist or oncologist if you qualify for Evusheld®.

Should my family members and caregivers get vaccinated?

You can also be protected from COVID-19 if the people around you are being vaccinated. Please encourage your household contacts (as well as friends and colleagues) to get vaccinated. The more people who get vaccinated, the lower the risk of exposure to the virus becomes for cancer patients and others who are unable to produce an immune response to the vaccine.

Even if you are healthy and do not know anyone with cancer, your vaccination against COVID-19 is a wonderful gift for all the people in your community who cannot respond to the vaccine.

Can my providers at the Cancer Center administer my COVID-19 vaccine?

You can make COVID-19 vaccine appointments or attend vaccine clinics at Dartmouth Hitchcock Medical Center and at Dartmouth Hitchcock Clinics Concord, Manchester, and Nashua.

For current vaccination clinic information, please visit our COVID-19 Vaccine Clinics page.

What is the difference between a third dose and a booster shot? Should I receive one or the other?

An additional dose is administered to patients who are moderately to severely immunocompromised. This additional dose is intended to improve the patient’s initial response to the vaccine.

A COVID-19 booster is given to a patient after they have completed their vaccine series, and protection against the virus has decreased over time. Please note, if you receive the Moderna booster, you will receive half of the original Moderna dose. Learn more about booster shots.