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The question is repeatedly asked in the office or on the phone or it comes via WhatsApp and the answer is always the same: yes, a cancer patient should be vaccinated against COVID-19. That is the message that Gabriel Krygier, Associate Professor of Oncology at the Chair of Clinical Oncology from the Faculty of Medicine of the University of the Republic, wants to make it clear to a population that is at greater risk of suffering complications if it contracts the SARS-CoV-2 virus.
“Everything cancer patient must be vaccinated. There are different priorities: if you have an active disease, if you are in control or if you had the disease a long time ago. But the fundamental concept is that you should get vaccinated and you should consult with your reference oncologist about the best time to do it, “said Krygier.
The Chair of Clinical Oncology, the Uruguayan Society of Medical and Pediatric Oncology and the National Cancer Control Program prepared a guide to recommendations for vaccination against COVID-19.
The document reads that those who should be prioritized are those with an active cancer in treatment or advanced cancer, along with other vulnerable populations with risk factors and greater complications from COVID-19 infection such as advanced age (over 65 years) and patients with comorbidities such as pulmonary, cardiovascular or chronic kidney disease, among others. Patients with lung cancer and hematologic malignancies, particularly transplant patients, should be especially considered.
Krygier indicated that the patient should consult with his doctor the moment what is the most opportune moment for vaccination within the term of his age group and between treatment cycles; neither chemotherapy nor radiation therapy should be stopped. “It has to be when you have the highest defenses because each one has a different drop curve for blood cells banks. In addition, we must bear in mind that the side effects of the vaccine, in general, occur two or three days after receiving it and can be a little higher with the second dose, “he said.
If the patient has not yet started his systemic treatment, the ideal is to get vaccinated before doing so; if possible, the first dose should be given two weeks before. For patients receiving immunotherapy, there is no specific recommended time to receive the first dose.
The data available on vaccines shows that they are safe in the general population; However, it should be taken into account that the clinical studies available for the development of vaccines against COVID 19, did not include cancer patients. Despite this, these patients are not expected to have an increased risk of complications from the vaccine; but it is known that they are at greater risk of suffering severe complications if they suffer from the disease.
“A patient with lung cancer asked me if she should get vaccinated. COVID-19 is a respiratory disease. There is no doubt about this ”, he affirmed.
As in other viral infections, live or attenuated virus vaccines are contraindicated in this type of patient. But inactivated, recombinant, protein subunit and nucleic acid vaccines such as DNA or RNA can be administered safely.
The guide prepared by the Chair of Clinical Oncology, the Society of Medical and Pediatric Oncology of Uruguay and the National Cancer Control Program recalls that serious adverse effects of vaccination they are rare. These include pain at the injection site, fatigue (feeling tired), headache, general aches, and fever.
Breast cancer patients and others who have had lymph nodes surgically removed should be aware of this, as lymphedema could be triggered. Therefore, it is recommended to get vaccinated in the other arm. In the case of bilaterial lymphadennectomy, use another sector of the body.
On the other hand, Krygier reported that the World Health Organization contraindicates the use of the vaccine in the event of a history of severe allergic reaction to any of its components, in people with a history of severe allergy to polyethylene glycol or related molecules. For cancer patients who have had COVID-19, it is advisable to get vaccinated after six months of having had the disease.
The document also indicates that those who are close to patients under cancer care, such as spouse and children, are the most likely to be sources of transmission and should be considered for early vaccination.
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