Cancer patients are at a higher risk of severe COVID-19 due to a suppressed immune system, emphasizing the importance of extra protection against the virus, but many are still concerned about whether or not they should get the vaccine. 

Edward Greeno, MD, a professor of medicine at the University of Minnesota Medical School, chief of the M Health Fairview Cancer Care Service Line and member of the Masonic Cancer Center, addresses common questions that people with cancer may have about receiving the COVID-19 vaccine. 

Q: Is it safe to get vaccinated if I have cancer?
Dr. Greeno: While cancer patients were not included in the initial studies of the currently approved vaccinations, the nature of these vaccines does not raise any concerns based on reported science for mRNA vaccines. In addition, no unusual side effects have been reported in cancer patients. If future vaccines using live virus are approved, those might be of concern for people who are immunocompromised.

Q: Which vaccine is recommended if I have cancer or am undergoing cancer treatment?
Dr. Greeno: The best vaccine is whichever one you can get right now. None of the vaccines have been compared directly to each other to allow us to know which is better, but they are all safe for patients with cancer. The mechanism of action of the approved vaccines does not provide any compelling reason to recommend one over the other for cancer patients.

Q: Are there any reactions specific to cancer patients?
Dr. Greeno: Cancer patients appear to have similar reactions as the general population. One of these reactions, swollen lymph nodes under the arm in which the vaccine is given, is normal. However, for those people with a history of breast cancer or undergoing screening mammograms, that enlargement could be misinterpreted as the spread of cancer to the nodes. Additionally, fevers caused by the vaccine may be misinterpreted as infection in patients with compromised immune symptoms. 

These reactions are not a reason to avoid vaccination, but rather to be aware when planning the timing of vaccination. When visiting your provider for treatments, it is also recommended to mention if you have recently received a COVID-19 vaccine.

Q: Do I still need to take extra precautions if I get vaccinated?
Dr. Greeno: While the vaccinations are quite effective in the healthy people studied in the early trials, they are not 100% effective, and we are not yet sure how well they work in patients with compromised immune systems. In addition, the effectiveness refers to the reduction in severe illness by the body building up an antibody resistance, rather than the ability to prevent infection or to avoid spreading the disease.

Q: Is there anything else I should be aware of as a cancer patient in regards to the COVID-19 vaccine?
Dr. Greeno: We will eventually have more complete information to answer the questions above more thoroughly, but the pandemic is still here and we need to act now to end it, rather than wait until we have perfect information. Because people with cancer are at higher risk for complications and are frequently interacting with others in similar circumstances, it is particularly important for this group to get vaccinated quickly while continuing practices to minimize spread of the virus, including wearing a mask, social distancing and limiting exposure to large groups.

Edward Greeno, MD, is a professor of medicine at the University of Minnesota Medical School and chief of the M Health Fairview Cancer Care Service Line. He is also a Masonic Cancer Center member. He has conducted numerous human trials of cancer therapeutics and his clinical interests include GI malignancies and colon cancer.