Norris Cotton 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?
- How will we be contacted when we are eligible for the vaccine?
- Is it safe to get a COVID-19 vaccine if I have a weakened immune system?
- Will the COVID-19 Vaccine interact with any of my chemotherapy drugs?
- Should I wait to get the vaccine or delay the start of my chemotherapy?
- If I have already started a chemotherapy cycle or other cancer treatment plan, when should I get the COVID-19 vaccine?
- Is it safe to receive the vaccine during radiation therapy or immunotherapy, after surgery or while I am taking oral medication for cancer?
- Are there any stages of specific types of cancer when it is not a good choice to have a vaccine?
- Does cancer or cancer treatment make the COVID-19 vaccine less effective?
- Should my family members and caregivers get vaccinated?
- Can my providers at the Cancer Center administer my COVID-19 vaccine?
- I have heard health care workers will be among the first to get vaccinated. Does that include my oncology provider?
The CDC, the State of New Hampshire, and the State of Vermont are developing a plan on how to continue prioritization of people for COVID-19 vaccination, given continued limited supplies of the vaccines. The next phase is expected to include people with underlying conditions that put them at higher risk, such as cancer patients who are on treatments that suppress or weaken the immune system.
Dartmouth-Hitchcock, including Norris Cotton Cancer Center (NCCC) staff, have not yet been told by the CDC and the State of New Hampshire how patients will be prioritized and when the vaccine is avaiilable to patients with cancer. Please do not call your cancer doctors as they are not able to provide additional information about your eligibility.
Because cancer patients were not included in Pfizer and Moderna COVID-19 vaccine trials, there is no data yet as to the safety and effectiveness of these vaccines specifically in people with cancer. This does not mean that people with cancer should not get vaccinated. There is a significant amount of information about safety and effectiveness of other vaccines, such as the flu vaccination, in people with cancer that we use to inform recommendations for the COVID-19 vaccine.
There are no concerns about the safety of the vaccine in people with cancer who have weakened immune systems from a variety of cancer treatments.
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.
Given the recently published data and the high risk of complications from COVID-19 in people with cancer, it is not recommended to delay either vaccination or the start of chemotherapy.
If I have already started a chemotherapy cycle or other cancer treatment plan, when should I get the COVID-19 vaccine?
The most effective time to immunize within the chemotherapy cycle is at about day 4 or 5 of the cycle.
If you are having a stem cell transplant or you are receiving CAR T-cell therapy, you should ask your hematologist about the appropriate timing for vaccination.
Is it safe to receive the vaccine during radiation therapy or immunotherapy, after surgery or while I am taking oral medication for cancer?
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.
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.
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 two 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 will still expected to offer protection.
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.
While the COVID-19 vaccine is not yet available to patients, each of the NCCC locations are making plans for vaccinating patients. Specially trained nurses and technicians will give the vaccine and will be observing patients to make sure there are no reactions.
It is safe for NCCC patients to leave the Cancer Center and go to another area of the facility to receive their COVID-19 vaccine.
I have heard health care workers will be among the first to get vaccinated. Does that include my oncology provider?
The vaccine is currently being given to front-line healthcare workers. Providers in the cancer center are included in the first phase of COVID-19 vaccinations, and provider vaccinations are continuing at this time.
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