Cancer doctors consider Covid-19 vaccines for patients

It is a question that has been on the minds of researchers and oncologists long before the launch of the Pfizer and Moderna vaccines began. While there is a consensus that vaccines are safe for most cancer patients, according to the American Cancer Society and others in the medical community, research whether they will be effective for cancer patients it is still a data-free zone.
The American Cancer Society recommends that cancer patients talk to their doctors before receiving any type of vaccine, because all patients and their courses of treatment are different.

There are several factors that may require a cancer patient to delay vaccination, including recent stem cell transplants or other recent use of therapeutic agents known to reduce the vaccine’s effectiveness, according to Dr. Laura Makaroff, senior vice president prevention and early prevention of the American Cancer Society. Detection.

“As far as vaccine safety is concerned, each situation for each cancer patient is a little different. And there is a spectrum of where any patient can be on their cancer journey,” Makaroff told CNN. “The Covid-19 vaccine is definitely safe for people with cancer, but it is important that patients talk to their doctor and their cancer treatment team to determine when the time is right to receive the vaccine.”

“All the guidance we are seeing – the American Cancer Society and other leading cancer groups – is that immunization with Covid-19 is recommended for patients on active therapy, but we really understand that there is limited data on safety and efficacy on these patients,” said Makaroff.

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Even with limited data, many cancer experts, medical groups and doctors are making a great effort to vaccinate most cancer patients – especially those cancer patients most at risk during the pandemic.

“The potential benefits far outweigh the risks,” said Dr. Brian Koffman, medical director of the Chronic Lymphocytic Leukemia Society, a group that represents patients with the most common adult form of leukemia in the western world.

“Despite the lack of safety data specifically in patients with CLL (chronic lymphocytic leukemia), vaccination against SARS-Cov-2 is considered safe.”

Patients with chronic lymphocytic leukemia who develop symptomatic Covid-19 have an 89% risk of hospitalization, Koffman told CNN, based on a study published in the journal Nature.

LLC is characterized by a weakened immune system. Immunocompromization is so severe that patients with CLL are advised to avoid live vaccines, such as measles or yellow fever.

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And a weakened immune system also means that these cancer patients are at an increased risk of death due to Covid-19, according to Dr. Chaitra Ujjani, a doctor at the Seattle Cancer Care Alliance and professor of oncology at the University of Medicine School of Medicine. Washington. The Nature study, conducted by the European Research Initiative on CLL, found that the death rate for CLL patients with symptomatic coronavirus was 31%.

“What people don’t realize is that the weakened immune system in patients with CLL – due to the disease or some of the treatments for the disease – can really affect their response to vaccination,” Ujjani told CNN.

“We recommend Covid-19 vaccines to our patients … but we are not sure how effective it will be,” she added. “Blood cancer patients are normally excluded from clinical trials that evaluate the vaccine’s effectiveness.”

The American Cancer Society suggests that patients talk to their doctors before receiving any type of vaccine.

Cancer-specific vaccine trials in progress

To remedy the lack of data, Ujjani is launching a research study involving 500 patients with CLL across the country – all of whom are already scheduled to receive the vaccine from their doctor or pharmacist – to determine what type of immune response they will have to commercially available vaccines.

The study, which is a collaboration between more than 10 medical institutions, will be the first of its kind and could bring more clarity to cancer patients.
The Seattle Cancer Care Alliance is conducting similar tests for other cancers, including certain cancers of the immune system and blood, said Ujjani.

Advocacy groups for other, more prevalent cancers are also encouraging cancer patients to get vaccinated as soon as possible. The Lung Cancer Action Network recently asked the United States Immunization Practices Advisory Committee to give lung cancer patients quick access to vaccines.

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“As COVID-19 is primarily a respiratory condition, this disease presents a unique challenge for lung cancer patients, who are at an extremely high risk of hospitalization and death because of COVID-19,” the group said in a letter. .

More research is urgently needed

The scientific community agrees that more research is needed to determine the effectiveness of Covid-19 vaccines in cancer patients – and many doctors are working around the clock to get more tests to take off.

“We need this data so that we can better inform patients and prioritize the distribution of vaccines better. If these vulnerable patients form an appropriate immune response, we should certainly vaccinate them as soon as possible,” Dr. Elad Sharon, senior researcher at the National Cancer Institute, told CNN by email.

“But if research efforts show that these patients fail to form a protective response to these vaccines, then what we will need to do is to vaccinate everyone around these patients first, so that our medically vulnerable patients are more protected by the people who live with them and taking care of them. “

Ujjani added: “We are all working hard to answer that question, but it is difficult because we are working around the clock when vaccines have just become available.”

“Many of our patients have suffered in isolation and fear, and are not sure whether they will return to a normal life,” Ujjani told CNN. “Therefore, every oncologist is interested in seeing how their patients will respond to the vaccine.”

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