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What cancer patients need to know about COVID-19 vaccines

COVID-19 vaccine
Several pharmaceutical companies and national health care agencies have reported encouraging news on a vaccine to help prevent the spread of COVID-19.

Cases of COVID-19 are surging across the country, straining hospitals, health care workers and the nation’s resolve. But good news and reasons for optimism hover on the horizon. After months of research and testing, several major pharmaceutical companies and national health care agencies have reported encouraging news on a vaccine to help prevent the spread of the coronavirus that causes the COVID-19 infection.

Three pharmaceutical companies—AstraZeneca, Modern and Pfizer—have announced their vaccines may soon be ready for national distribution in the United States. One vaccine already has been approved for distribution in England. More vaccines are in the research and clinical trial pipeline.

The three leading vaccines have been shown to be 90 to 95 percent effective in preventing COVID-19 infection, with only a few minor side effects reported. Once distributed, COVID-19 vaccines will go a long way in helping to ease the strain on America’s health care system—and protect cancer patients and others with a suppressed immune system. A vaccine may also help reverse the months-long declines in cancer screenings, diagnostic tests and screenings—trends that began when the pandemic hit early this year—as Americans become more confident in their ability to get around without risk of infection.

“If the health care worker is getting the vaccine, it will help cancer patients tremendously,” says Mashiul Chowdhury, MD, Infectious Disease Program Specialist for Cancer Treatment Centers of America® (CTCA). “If health care workers and frontline workers are immune, then the patients will feel more comfortable coming into the hospital. There will be less transmission, there will be few infections among health care workers, and it will be less likely that health care workers will infect patients and vice-versa.”

If you are a cancer patient or caregiver, below are a few things you may want to know about a COVID-19 vaccine before you get in line for your shot.

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Should cancer patients get vaccines?

If you’re a cancer patient, do not get any vaccine before talking to your doctor, especially if you’ve been diagnosed recently or are or have been in active treatment.

Why? Many vaccines work by educating and stimulating the immune system to recognize and attack viruses and other potentially dangerous invaders. To be effective, however, some vaccines may need a healthy immune system capable of launching a robust attack against a virus.

Cancer patients who’ve had a stem cell transplant or are on an active chemotherapy or radiation therapy treatment regimen may have compromised immune system that may make the vaccine less effective.

Traditionally, vaccines have worked by introducing a harmless form of a virus into the body to educate the immune system on what to look for. But some vaccines use live viruses that, if given to a cancer patient with a weakened immune system, may cause serious side effects.

Early information, however, indicates that the three leading COVID-19 vaccines should be safe. “Due to the nature of the vaccines, there should not be complications giving it to cancer patients,” Dr. Chowdhury says.

Learn more about the impact of COVID-19 on cancer patients and caregivers.

How do COVID-19 vaccines work?

Of the three leading COVID-19 vaccines, the AstraZeneca entry is the most traditional. It uses a harmless version of a coronavirus—one that may normally cause a common cold—to train the immune system to recognize the virus that causes COVID-19.

The Moderna and Pfizer vaccines work on a different principle—by using messenger ribonucleic acid (mRNA) to send instructions to cells to produce defenses against the coronavirus that causes the COVID-19 infection. Messenger RNA is one of several forms of RNA, the workforce behind deoxyribonucleic acid (DNA). DNA uses RNA to send instructions to cells to perform different tasks. 

Two of the new COVID-19 vaccines use synthetic mRNA programmed to send instructions to immune cells to target the virus’ spike proteins, those protrusions on the surface of the viral cells that make them look like a crown (thus the name coronavirus). Spike proteins work in several ways that make COVID-19 difficult to treat. These proteins contain sugar molecules that help the virus fight off immune responses. More importantly, they are used to allow the virus to penetrate other cells, allowing the virus to spread.

The new mRNA vaccines are designed to help the immune system recognize the spike proteins on the viral cells and either remove them or render them ineffective, preventing them from infecting other cells. Because these vaccines use mRNA and not a live virus, they may be better suited for cancer patients.

“The synthetic mRNA is introduced into the body and our cells,” Dr. Chowdhury says. “It instructs the body to create the coronavirus antigen, which is not the virus itself, but a fake antigen that prompts the immune system to make antibodies.”

 

What is mRNA?

Since its discovery in 1961, RNA has been thought to have potential for treating many diseases, including cancer. But, in early research, mRNA vaccines proved to be unstable, inefficient and difficult to work with. Today, researchers say many of those issues have been resolved, and “ multiple mRNA vaccine platforms against infectious diseases and several types of cancer have demonstrated encouraging results in both animal models and humans.” 

Several pharmaceutical companies are conducting clinical trials using mRNA vaccines to treat a variety of cancers, including melanoma, esophageal cancer and metastatic disease. “There’s been a lot of talk about mRNA having potential as a cancer treatment,” says Julian Schink, MD, Chief Medical Officer for  CTCA®. “Hopefully, that will be a byproduct of this vaccine research.”

Learn more about RNA’s role in potential cancer treatments.

Don’t let your guard down

Distributing vaccines to more than 300 million Americans will be a Herculean task that may take many months to complete. And, so far, each of the three leading vaccines require two doses—double the effort to inoculate the masses. The vaccines also raise many questions that may not be answered until after they are widely distributed, such as:

  • How long will the vaccine take to create immunity?
  • How long will the immunity last?
  • Is a vaccinated person still able to transmit the virus?
  • How will I know the vaccine works for me?

Because of these unknowns, health experts, including Anthony Fauci, MD, Director of the U.S. National Institute of Allergy and Infectious Diseases, recommend you continue to wear masks and socially distance, even if you’ve been vaccinated.

“I could feel more relaxed, in essentially not having the stringency of it that we have right now, but I think abandoning it completely would not be a good idea,” Dr. Fauci said in a recent interview of social distancing and masking protocols.

This is especially important advice for cancer patients, who need to be in constant alert to avoid exposure to infections. The U.S. Centers for Disease Control and Prevention estimates that about 60,000 cancer patients are hospitalized with infections every year in the United States.

Dr. Chowdhury also offers this advice to help patients prevent infection during cancer treatment:

Be vigilant. Watch out for warning signs of infection, such as a loss of taste or smell, fever, fatigue, cough or diarrhea. Keep cuts, scrapes or surgical scars clean, and be aware of swelling or redness. Report any such signs to your doctor.

Practice good hygiene. Wash your hands often with warm water and soap. Keep your home clean.

Avoid large crowds. Make sure to wear a mask if you are in an enclosed space with other people. And stay away from people you know may be sick.

Eat well and stay hydrated. Follow your care team’s recommended dietary guidelines. Do not share food, drinking glasses or utensils with others. Avoid raw or undercooked foods. Eat and drink only pasteurized juice or dairy products.

Dr. Chowdhury also offers these words of advice and encouragement about the vaccines’ impending release: “We are fortunate that we are getting the vaccine in this short amount of time. But just because the vaccine was produced quickly doesn’t mean it is not safe. I will take this vaccine in a heartbeat. I am a believer in vaccines. Vaccines are among the greatest discoveries in humankind. They have saved millions of lives all over the world. And they continue to do that. Vaccination has been extremely safe. And with this pandemic, we need to move forward. We need to take care of our patients. We need to take care of our families. It is the responsible thing to do when the time comes to get the vaccine.”

Learn more about vaccines that may help treat or prevent cancer.