There has been a lot of interest in the coronavirus vaccines, and it is understandable for you and your loved ones to have questions about it.
The Government has set out an order of priority for getting the vaccine so that those most in need get it first. This includes people with cancer. Adult household contacts of adults (over 16 years of age) with a severely weakened 
can also have the vaccine now.
Specialists say that it is important for people with cancer to have the vaccine and it is safe. Your cancer treatment can also go ahead if you've had the vaccine.
Three vaccines made by, Pfizer-BioNTech, AstraZeneca-Oxford and Moderna have been approved for use in the UK.
What is a vaccine?
A vaccine is a type of medicine that trains the body's to fight a disease it has not come into contact with before. For infectious illnesses, vaccines try to prevent people from becoming ill with a disease, rather than treating it.
COVID-19 vaccines
The Medicines and Healthcare products Regulatory Agency (MHRA) approved three vaccines for use in the UK:
- Pfizer-BioNTech
- AstraZeneca-Oxford
- Moderna
| Vaccine | How it works | Doses | Storage |
|---|---|---|---|
| Pfizer-BioNTech | This vaccine is an mRNA vaccine and doesn't contain a live virus. mRNA vaccines work by carrying a 'genetic message' to your cells and instructing them to make antigens. This prepares the immune system to make antibodies to fight the virus. | 2 doses up to 12 weeks apart | -70°C |
| AstraZeneca-Oxford | This vaccine is made from a harmless virus that usually causes the common cold in chimpanzees. It doesn't cause a cold in humans. Scientists have changed this virus to include the gene for the coronavirus spike protein. Injecting this vaccine prepares the immune system to attack the virus without exposing the body to the full virus. | 2 doses up to 12 weeks apart | 2 to 8°C |
| Moderna | This vaccine is also an mRNA vaccine. | 2 doses 28 days apart | -20°C |
How well do the vaccines work for people with cancer?
The Pfizer-BioNTech and AstraZeneca-Oxford vaccines have not been tested in people having systemic anti cancer therapy (SACT). But specialists agree that the vaccines are safe for most people having SACT (see questions further down on this page). Systemic anti cancer therapy includes treatments such as chemotherapy and can cause a weakened immune system.
A weakened immune system means it might not work as normal and so it can't protect the body against infections.
So, having the vaccines with a weakened immune system may cause the body to not have a full antibody response. As a result, it might not create enough to give protection against the virus.
This means that people who are clinically extremely vulnerable (having a weakened immune system) should continue to follow advice on protecting themselves and reducing their risk of infection after they've had the vaccine.
Severe allergic reaction (anaphylaxis)
People with a history of a severe allergic reaction (anaphylaxis) to a vaccine, medicine or food should not have these vaccines.
Swollen lymph nodes
A side effect of the Moderna and Pfizer-BioNTech vaccines is lymph node swelling. You might have swollen lymph nodes in the armpit of the arm that had the vaccine for up to 2 weeks. Talk to your doctor if it doesn't get better.
Pfizer-BioNTech vaccine results from the SOAP study
The SOAP study has been looking at COVID-19 in people with and without cancer. It has also been looking at how their immune systems deal with it.
Early (interim) results for the SOAP trial were published in January 2021. Those results showed that:
- most people with a solid cancer will be able to fight COVID-19 in the same way as people without cancer. This is because they develop antibodies to COVID-19
- people with certain types of blood cancer varied in how well they were able to respond to the virus. Many of these people took much longer to get rid of it
The SOAP study has also been looking at how having a COVID-19 vaccination affects the immune system. In particular, they were looking at people with cancer. It looked at people having the Pfizer-BioNTech vaccine.
On 10th March 2021, the researchers released some further information. These results have not been peer reviewed. Peer review means that other experts look at the research. These experts are looking for any errors as well as any limitations in the research. This helps to make sure the conclusions from it are accurate.
The results showed that after 3 weeks of having the first dose, antibodies were found in:
- 39 out of every 100 (39%) of people with solid cancers
- 13 out of every 100 (13%) of people with blood cancers
This is compared to 97 out of every 100 (97%) of people without cancer.
The study also showed that having the second dose of the vaccine 3 weeks after the first dose helps the vaccine work better. The number of people having antibodies after 2 weeks was 95 out of every 100 (95%) for people with solid cancers.
In people who did not get a vaccine boost at 3 weeks, and who researchers tested after 5 weeks, antibodies were found in:
- 43 out of every 100 (43%) of people with solid cancers
- 8 out of every 100 (8%) of people with blood cancers
Understandably, the results of this study might worry you. And it is likely to raise a number of questions about the vaccine and what you should do.
At this stage, we don’t have any more information. We also don’t know what it means for the AstraZeneca-Oxford vaccine. You should still have the vaccine and follow the advice on how to protect yourself from the virus.
Talk to your healthcare team if you have any questions. They know your circumstances best.
Coronavirus (COVID-19) vaccine and cancer treatment
Talk to your doctor or specialist nurse for specific advice for your circumstances.
The information below is about the Pfizer-BioNTech and AstraZeneca-Oxford vaccines. It is only a guide.
Specialists say that everyone having SACT should be considered for the vaccine. Your cancer treatment can also go ahead if you've had the vaccine, and there is no need for your treatment to be delayed because of it.
Can I have the vaccine when I’m having immunotherapy?
Immunotherapy can trigger an increased immune response causing side effects. But there is not enough evidence that it might happen with these vaccines. Specialists say that the benefit of having the vaccine should be weighed against the risk of not having it and becoming ill with COVID-19.
People having immunotherapy can have the vaccine at any time in their treatment cycle.
Can I have the vaccine when I’m taking part in a clinical trial?
You can have the vaccine when on a clinical trial for SACT unless the trial criteria say you may not have a vaccine or exclude people who have had the vaccine.
When is the best time to have the vaccine when I’m having treatment?
Whenever possible you will have the vaccine before you start treatment. If you are already having treatment, your doctor will discuss with you when it is best to have the vaccine.
Can I have the vaccine if I have low levels of white blood cells (neutropenia)?
Ideally, you should not have an injection if you are unwell with neutropenia and until your level of white blood cells is back to normal.
People who have chronic neutropenia should have the vaccine.
Can I have the vaccine if I have low platelets or a bleeding disorder?
Your healthcare team will decide when it is safe for you to have the injection. It will depend on your level of platelets and the risk of bleeding.
Can I have the vaccine if I've recently had an autologous (your own) or allogeneic (donor) stem cell transplant?
People who've had a stem cell transplant can have either vaccine. Specialists say that people who have had an autologous or allogeneic stem cell transplant can have the vaccines 3 to 6 months after their transplant.
The vaccines might not give people with Graft versus Host Disease (GvHD) or those receiving high dose steroids protection. This is because they still have weakened immune systems.
Talk to your healthcare team to find out when would be the best time for you to have the vaccine.
Can I have the vaccine if I've had CAR-T therapy?
Talk to your healthcare team to find out whether you can have the vaccine if you've had CAR-T therapy.
I am having radiotherapy, can I have the vaccine?
The vaccine is recommended for people having radiotherapy and you can have it during treatment. This is because it doesn't affect your immune system like chemotherapy and other cancer drug treatment does.
I am going to have surgery, can I have the vaccine?
Having surgery in itself is not a reason not to have the vaccine. Wherever possible people having surgery should have the vaccine 2 weeks before surgery.
I had cancer treatment to my lymph nodes, can I have the vaccine?
People who had surgery to remove their lymph nodes, or who had radiotherapy to their lymph nodes, are at risk of lymphoedema. Injections in an arm on the side of lymph node treatment can trigger lymphoedema. You should ask to have the vaccine on the opposite arm of your cancer treatment. If you had treatment on both sides, you should have the vaccine in your thigh.
More information
You can read more about what the COVID-19 vaccine means for people with cancer on the Cancer Research UK science blog.
Fonte: Cancer Research UK
As informações e sugestões contidas neste blog são meramente informativas e não devem substituir consultas com médicos especialistas.
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