Cancer patients & Covid-19 vaccination: key concerns addressed
As a cancer patient, it’s perfectly understandable for you to have questions about taking the Covid-19 vaccination when offered it, particularly if you have recently been diagnosed or are undergoing treatment.
In our commitment to care in every sense, we spoke to two experts on the matter to provide reassurance for cancer patients and their families:
- Dr Patricia (Trish) Fisher – Weston Park Cancer Charity Trustee and SYB ICS Cancer Alliance NHS Clinical Director;
- Dr Louise Merriman, GP Lead for SYB Cancer Alliance
Here, Trish and Louise provide advice for both patients and GPs about the safety and accessibility of the Covid-19 vaccines.
What are the key messages for people to remember when it comes to cancer and the Covid-19 vaccination programme?
Trish says: “The take-home message is that the vaccine is very safe for people on both chemotherapy and radiotherapy treatment. We are encouraging everybody to have the vaccine and ideally to have it as soon as they are offered it.
“For the vast majority of people on treatment, there is no issue about the timing of the vaccination. However, I do get asked about timing all the time and there are a couple of caveats.
“The first is that if you are about to start treatment then ideally you should try to have your vaccination before you start, when your immune system is strong, so that you get the best possible response – however I appreciate that’s not always possible.
“Another consideration is for people who are on chemotherapy treatment. Because chemotherapy lowers your white blood cells, again the timing is ideally just before your next dose of chemotherapy – when your blood count is best.
“But, crucially, vaccination at any time is better than no vaccine. So the take home message is please have your vaccine: it’s very safe it’s not a live vaccine. Very few people can’t safely have it.”
How do vaccination clinics decide who can’t safely be vaccinated?
Louise says: “We are deciding on the priority groups according to what we’ve been advised centrally.
“I think it’s absolutely right that we are prioritising the elderly first and foremost, and then people who have other issues which may make them vulnerable.
“Cancer patients having chemotherapy may well have seen their immune system knocked during treatment, so we do need to make sure that they are covered with the vaccine.
“We put cancer patients who are having treatment into the priority four group. I think as a group, cancer patients are perhaps the most difficult: they are trying to deal with the fact that they have cancer; that they are undergoing treatment that might be making them feel poorly; and then they worry that on top of that the vaccination will make him feel poorly.
“But the contraindications in a cancer patient are the same as the rest of the population. We’re not seeing significant side effects from this vaccine.
“People are getting a sore arm, they may feel a little headachey or fluey for 12 hours, for which we advise paracetamol. But it’s no different from the many other vaccines that we use – the best example being the annual flu jab.”
What should people do who clearly fall into a priority category – yet haven’t yet been offered the vaccine? And can GPs help support those who should – though for whatever reason haven’t – had their vaccine?
Trish: “What we had been saying to patients is not to ring their GP surgery due to the volume of calls from people about their vaccine.
“However, I understand that there’s now an alternative way for people to book themselves in if they’ve not heard?”
Louise: “I would hope that the priority groups have been contacted by their surgeries to come forward and have their vaccine. If people feel that they have been overlooked then they should contact their practice, either by telephone or online. Many surgeries are using an online consultation accessed via their practice websites.
“Cancer patients who are not currently receiving active treatment, who are now well, do not fall into priority four and will be being called over the next month along with other patients with underlying health issues that do not fall into the significantly clinically vulnerable (shielding) group.
“However, increasingly, the big centres are now saying ‘feel free to ring us if you are over 70 and you’re vulnerable’.
“It is still difficult for young cancer patients. Some cancer patients are very young and what I have been advising GPs is to go looking for those patients. Find them, give them a ring and get them into vaccination clinics.
“So, there is supposedly this ‘don’t ring your surgery’ policy but I feel that we have to be a bit more relaxed. If someone is worried, that’s what we’re here for in general practice – to answer whatever their worries about their health are.
“And actually, what more reason could you need than a worry about whether you should have the Covid vaccine or not?”
What should I do if I am shielding, or know someone who is?
Louise: “Those who were shielding before will have a shielding code. But for those who have had a new diagnosis or have recently become unwell, practices should ideally have found, or be finding, those patients.
“But I think also if a patient feels that it (shielding) is a new thing for them and that their practice may not be aware of it, then they should contact their practice.
“And I know at Weston Park, Trish, you’ve been encouraging the consultants and specialist nurses to also give us a little bit of a kick in the letter to say ‘this patient really does need to get on and have their vaccine’, and we’re very grateful for that.”
Do the guidelines change for me if and when I have been vaccinated?
Trish: “No. Even when people are vaccinated, they still need to be very careful and to continue to follow the guidance about protecting themselves and others.
“Although the vaccine reduces the risk of being severely ill with Covid, it doesn’t make you completely unable to catch it. Those who get a mild infection can also spread it despite being vaccinated.”
Louise: “We are talking about vulnerable people who need to be careful because if they did catch the virus, they could still become very poorly.
“From very early on in the vaccine trials, we were convinced that it would protect from significant disease, but it does not protect you fully from catching some kind of mild form of it.
“For cancer patients having treatment, even if they got a mild dose of it, they could feel really quite poorly and it could interrupt their treatment for their cancer, for example.
“So, it’s very important that everybody, not just our cancer patients, understands that this doesn’t change any of the rules. We do need to continue socially distancing, you do need to be careful with hand hygiene and you need to continue using masks, unless there’s a contraindication for it.”
If you have a question for the healthcare team at Weston Park Cancer Charity or need to discuss the Covid-19 vaccine in relation to your cancer diagnosis or treatment, please email [email protected] or give us a call on 0114 553 3330.
Our help is free, confidential and open to anyone affected by cancer.