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What you need to know about the COVID-19 vaccines if you have cancer
Many people with cancer are wondering if it’s safe to get one of the approved COVID-19 vaccines. After all, we know that having an underlying medical condition, such as cancer or heart disease, puts you at greater risk for developing a serious illness from the virus.
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The short answer is that for most adults with cancer or a history of cancer, vaccination against COVID-19 is recommended, but there are factors for people with cancer to consider first.
In this article, oncologist Halle Moore, MD, discusses vaccine safety for those who have (or have had) cancer.
People with cancer are expected to be (if not already) in one of the earlier priority groups able to receive the vaccine, but this may vary depending on where you live and how much supply is available. You could fall into this priority group because of your cancer diagnosis, your age or both.
Currently, there are three COVID-19 vaccines approved under emergency use authorization:
Both the Pfizer and Moderna vaccines use messenger RNA (mRNA), which is a molecule that contains instructions for making coronavirus’s infamous “spike protein.” Once you receive the vaccine, cells in your body are instructed to make copies of the fake spike protein. This reaction triggers an immune system response that acts as a fire drill. Then, if you’re exposed to the real coronavirus in the future, your cells are already well-equipped and trained to fight it.
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Because the mRNA vaccines don’t contain a live or weakened version of the virus, there’s no risk of contracting the virus from these vaccines. The Pfizer-BioNTech and Moderna vaccines are not interchangeable, so you should receive two doses of the same kind.
The Johnson & Johnson vaccine works differently by delivering a piece of DNA from the COVID-19 spike protein into your body via an adenovirus (the kind of virus that typically causes colds). This modified adenovirus carries the DNA segment but won’t replicate inside the body and cause illness. The DNA then causes cells to make harmless versions of the spike protein, which prompts the body to create an immune response to it.
If you have cancer or are receiving cancer treatment, it’s important to speak with your healthcare provider before you get your first dose of either vaccine.
Your type of cancer and type of treatment will be a factor to consider. Your healthcare provider will be able to discuss risks, benefits, timeline and what you should know before receiving your first dose of the vaccine.
Common side effects following vaccination are a sore arm, fatigue and muscle aches. Fever and chills may also occur, especially after the second dose.
Following vaccination, some people might develop enlarged lymph nodes. These most often occur in the underarm or in the neck on the side of the vaccination. Since cancer can also cause lymph node enlargement, it’s important that you realize this is a possible side effect and is usually not a sign that your cancer is growing (although we know it can be scary).
The enlarged lymph nodes may feel tender to the touch and should resolve on their own, but can sometimes last for several weeks. You should contact your healthcare provider if the enlarged lymph nodes do not start to improve within three to four weeks after your second dose.
If a vaccine is available to you, it may be appropriate to delay the start of some non-urgent cancer treatments until vaccination has been completed. Most cancer treatments, however, should not be delayed for vaccinations. Your healthcare provider can advise you regarding timing of vaccination with respect to your cancer treatment. Depending on the types of cancer treatment you may have had or are receiving, there may be other special considerations.
Here, Dr. Moore breaks down what to consider for many types of cancer treatment regarding the vaccine, although it’s advised to always speak with your own oncology team first and foremost:
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It’s important to be aware that some people with cancer tend to have weakened immune systems, which might make the vaccines less effective. Right now, the mRNA vaccines offer 94 and 95% protection from this virus while the Johnson & Johnson vaccine 66% effective in preventing moderate and severe COVID-19 disease 28 days after vaccination and 85% effective in preventing hospitalization. But it’s difficult to tell if everyone who has cancer will have that same level.
It’s crucial that we all continue to follow safety recommendations for a while longer, including handwashing, following social and physical distancing guidelines and to continue wearing a face mask even after you’ve been vaccinated.
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