Immunotherapy and the COVID vaccine: Your questions answered

For cancer patients, the risk of serious illness from COVID-19 is often a major concern. Cancer treatment weakens your body’s immune system, increasing your risk of serious infections.

Immunotherapy is a type of cancer treatment that boosts and supports your immune system against cancer. If you or a loved one is being treated with immunotherapy for cancer, you may be concerned about how the COVID vaccine may affect your immune system and your treatment.

This article answers common questions about cancer immunotherapy and COVID vaccines.

People who are immunocompromised due to cancer are at higher risk for poor outcomes from COVID-19. No matter where you are in your treatment plan, vaccination can reduce your risk of severe COVID. Vaccination is also important for people with strong immunity.

National Comprehensive Cancer Network (NCCN) and American Cancer Society It is recommended that people with cancer, including those undergoing treatment, get vaccinated as soon as possible. The NCCN notes several features of immediate relevance:

  • People who receive a stem cell transplant must wait at least 3 months after receiving the vaccine.
  • People receiving CAR T-cell therapy or natural killer (NK) cell therapy should wait at least 3 months after vaccination.
  • People with cancer who have undergone major surgery should wait a few days to 2 weeks after the procedure to receive the vaccine.

Because they weaken the immune system, some cancer treatments may reduce, but not eliminate, the effectiveness of the vaccine. Even if you are receiving one or more of these treatments, you will still get some protection from the vaccine. Treatment includes:

Vaccination, combined with protective measures like wearing a mask and avoiding crowds, can give you more protection against COVID than you would get without them. For this reason, experts strongly recommend vaccination for people with cancer or a history of cancer.

But first, check with your oncologist when you should be vaccinated. If you are currently being treated for cancer, wait until your immune system recovers from treatment. This gives you the best chance of mounting a strong immune response.

Pfizer BioNTech and Moderna mRNA vaccines are suitable for use in people taking immunotherapy drugs. No one vaccine is known to be better than another for this population.

THE 2021 study They found that the modern vaccine was safe for people with solid tumors who were receiving chemotherapy, immunotherapy, or both. Their response to the vaccine was similar to that of people without cancer. The groups also saw similar rates of side effects.

A separate 2021 study found that people with solid tumors who received the Pfizer vaccine had antibody levels similar to those without cancer 6 months after vaccination. In the subgroup of people who received immunotherapy, about 87% had antibodies, compared to 84% of the control group.

If you can’t or don’t want to get either of these vaccines, you can get the Johnson & Johnson (Janssen) vaccine.

Having cancer or taking immunotherapy drugs does not increase the risk of serious side effects such as allergic reactions or myocarditis.

Swelling of the lymph nodes under the arm on one side of the injection site is a possible side effect of vaccination. Although temporary, this may be relevant for people with breast cancer and other cancers.

Tender and swollen lymph nodes caused by vaccination should subside within a few days to a few weeks. Tell your health care provider if the swelling increases or decreases during this period.

To date, researchers I don’t know for sure if immunotherapy drugs have a positive or negative effect on the effectiveness of COVID-19 vaccines.

Scientific articles 2021 the and 2022 suggests that checkpoint inhibitors could theoretically boost your immune response to the COVID-19 vaccine. However, both articles report that no studies have shown such an effect.

Some immunotherapy drugs, such as CAR T-cells, are possible weakens the immune system temporary. This may reduce the effectiveness of the vaccine. Other types of immunotherapy, such as monoclonal antibodies, should not have this effect.

People with weakened immune systems may find it difficult to respond strongly to a vaccine, regardless of the type of cancer treatment. This may be especially true for people with blood cancer. For this reason, dosing protocols immunocompromised people and differs from that applied to the general public who have cancer.

To date, there is no evidence that the COVID vaccine reduces the effectiveness of immunotherapy drugs. But it can happen 17% – 48% According to studies, the risk of side effects due to increased immune response.

THE Case report published in May 2021 suggests the potential for cytokine release syndrome following COVID vaccination in patients receiving certain immunotherapy drugs. The authors of the study say that more information is needed and that people who still have cancer should be vaccinated.

THE 2021 study After receiving the Pfizer vaccine involving 134 people, no side effects of immunotherapy drugs were found. The study authors also emphasized the need for larger studies and more data, but supported vaccination for people receiving immunotherapy.

However, the effects of some immunotherapy treatments on your immune system make the timing of vaccination important. Talk to your oncologist about when to schedule the vaccine.

People taking immunotherapy drugs should receive an additional primary dose of the vaccine if they have active cancer or are immunocompromised. You may fall into one of these categories if you:

  • You are on CAR T-cell therapy.
  • You are taking high-dose steroids to treat side effects of immunotherapy drugs (or for other reasons).
  • You are receiving cancer treatments such as chemotherapy in addition to immunotherapy.
  • You started cancer treatment within 1 year of your first COVID vaccine.
  • You have new cancer or recurrent cancer and are receiving or receiving cancer treatment.
  • You have any type of hematological (blood) cancer.
  • In addition to cancer, you have a weakened immune system, such as HIV.
  • You have had an organ or stem cell transplant.
  • You developed COVID-19 after contracting SARS-CoV-2 and receiving two doses of the vaccine.

Yes. Getting infected with COVID doesn’t guarantee you won’t get it again. In fact, ever-changing variants are constantly emerging, and multiple infections have become commonplace.

If you have cancer treatment that weakens your immune system, it’s important to get vaccinated, even if you have COVID. Talk to your oncologist about when to get vaccinated after getting Covid-19.

If you have cancer, you may have serious complications from COVID-19. Cancer treatments, including some immunotherapy drugs, may affect your vaccination schedule. Talk to your oncologist about when and how many doses to get your vaccine.

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