By: Jennifer Cashwell, MSN, FNP-BC
We receive a lot of very good questions about COVID vaccinations for cancer patients and patients with other hematologic conditions. Here you'll find a collection of commonly asked questions and the answers from our cancer specialists.
Q: The COVID pandemic is getting better . . . do I still need to get vaccinated?
A: Yes! While the pandemic is getting better, it is not gone, and new variants are being discovered. With few exceptions, most people with cancer should get the vaccine as soon as they can. Many people with cancer have a higher risk of serious COVID-19 illness because they are immunocompromised and they are less able to fight illness and infection. Getting vaccinated is your best line of defense to prevent serious illness from COVID-19.
Q: I am being treated with chemotherapy or immunotherapy . . . can I get vaccinated?
A: Yes! The CDC recommends vaccination for almost all patients being treated with traditional chemotherapy and immunotherapy as soon as possible with very few exceptions.
Q: Which patients with cancer should not get the vaccine?
A: Only a few cancer patients should not get the vaccine. Patients undergoing Hematopoietic cell transplantation (stem cell transplant) and patients undergoing CAR T-cell therapy should wait 3 months after transplant to be vaccinated. Patients having major surgery should separate vaccination from surgery by at least a few days up to two weeks. This is so that any side effects from the vaccine (e.g., fever) are not confused with possible complications from surgery.
Q: I have cancer, and I have been fully vaccinated . . . do I still need to wear a mask?
A: Data suggests that immunization may not work as strongly in people with cancer as it does in the general population. So, people with cancer and their close contacts should get vaccinated and continue to follow CDC recommendations to prevent COVID-19, including wearing masks, maintaining social distance, washing hands, avoiding crowds, minimizing travel, etc. Of course, every person’s situation is unique; please ask your provider about which restrictions are appropriate for you.
Q: I have cancer, and I have been fully vaccinated . . . can my family come visit me at my home?
A: Check with your oncologist for specific recommendations. Depending on your immune system, he or she may recommend you continue to wear a mask and social distance while enjoying your loved ones.
Q: I have cancer, and I have been fully vaccinated . . . can I travel on public transportation (bus, train, plane, etc.)?
A: Check with your oncologist for specific recommendations. Most likely, he or she will recommend you continue to wear a mask and social distance if you will be in any crowds.
Q: I have a history of blood clots . . . should I get vaccinated?
A: Yes! We know that infection with COVID-19 increases the risk for blood clots, so you are more likely to develop a blood clot if you are unvaccinated and get sick with COVID-19 than if you get vaccinated. A recent study has shown that you are 10 times more likely to develop a serious blood clot if you get infected with COVID-19 over the risk of clot after vaccination.
Q: I have sickle cell anemia . . . should I get vaccinated?
A: Yes! The Centers for Disease Control and Prevention (CDC) has recommended that people with sickle cell disease receive the vaccine as soon as possible. People with sickle cell anemia who have COVID-19 infection are more likely to be hospitalized and to require intensive level care (ICU) in the hospital. They are also more likely to die from COVID-19 than people without sickle cell anemia. The COVID-19 vaccines are safe for people with sickle cell disease. In fact, all routine vaccinations for adults and children are recommended for people with sickle cell anemia. Use of hydroxyurea, the most common medication used to treat sickle cell anemia, should not interfere with the vaccine’s effectiveness. Please discuss specific recommendations about the vaccine with your provider if you are taking other medications for sickle cell disease, such as voxelotor or crizanlizumab.
Q: I heard that COVID-19 vaccination can interfere with mammograms.
A: It is true that enlarged lymph nodes can occur in a percentage of patients after receiving the Pfizer or Moderna vaccine (about 16%). This is due to the vaccine working normally in the body. It is recommended that imaging studies, including mammogram, CT scan, and PET scan, be delayed at least 4-6 weeks after the second dose of vaccine.
Q: I already had COVID-19 . . . do I still need to get vaccinated?
A: Yes! The approved vaccines are safe to give to people who have already had COVID-19 infection. This is true even if you have tested positive for COVID antibodies. However, check with your provider if you received monoclonal antibodies or convalescent plasma as part of your treatment for COVID-19. In those cases, it may be recommended you wait 90 days after those therapies before getting vaccinated because those treatments could make the vaccine less effective.
As always, if you have any further questions or need additional guidance, please reach out to your Virginia Oncology Associates provider.
