COVID-19 Vaccines for Cancer Patients and Survivors: Information to Know

Dana-Farber strongly encourages all patients to get vaccinated for COVID-19 to protect themselves from serious infection of the virus.

You should get a COVID-19 vaccination even if you were previously infected with the virus. The vaccine will help trigger a bigger immune response, which better prepares the body to fight off the coronavirus. If you recently had a COVID-19 infection, you are eligible to get the vaccine as soon as you are symptom-free and have completed your required isolation period.

To find COVID-19 vaccination locations, visit vaxfinder.mass.gov. If you live outside of Massachusetts, visit vaccinefinder.org.

COVID-19 vaccines for cancer patients and those out of active treatment

Dana-Farber recommends that both cancer survivors and active patients on therapy get vaccinated for COVID-19. Furthermore, it is also recommended all Dana-Farber transplant and cellular therapy patients strongly consider vaccination once 100 days have elapsed from transplant or cellular therapy.

Dana-Farber will continue to proactively ensure that patients, families and staff remain safe and protected. Learn more about measures the Institute is taking, including face masks, physical distancing, frequent disinfecting, and more.

Remember: Oncologists, nurses, and other professionals at Dana-Farber are sources of support and information for patients who have questions during this time.

[For the latest information about COVID-19 vaccines, visit the U.S. Centers for Disease Control and Prevention website.]

Do I need additional shots/booster shots? How do I know if I’m eligible?

For some moderately or severely immunocompromised people (including most cancer patients), the CDC recommends three doses of the FDA-approved Pfizer-BioNTech or Moderna vaccines as part of the primary vaccination series. The third dose should be at least 28 days after the second dose, and you should try to get the same vaccine that you received for your first two doses.

Individuals who are immunocompromised who received the FDA-approve Johnson & Johnson/Jansen should receive two doses as part of their primary vaccination series. It is recommended that the second dose be a mRNA vaccine, meaning the Moderna or Pfizer-BioNTech shots.

If you have received COVID-19 vaccines that are not available or currently FDA-approved in the US (such as the Astra-Zeneca vaccine), then you should either complete or restart the COVID-19 vaccine series, including a booster, in the US. The mRNA vaccines are preferred for moderately or severely immunocompromised people, as above.

In addition, the CDC recommends mRNA vaccine booster doses for anyone who is moderately to severely immunocompromised who has completed their primary vaccination series.  The first booster (fourth dose) can be given at least three months after the third dose. The second booster (fifth dose) can be given at least four months after the fourth dose.

Learn more here about the timing of that booster.

Is a COVID-19 vaccine safe?

In developing a COVID-19 vaccine, the FDA established a rigorous process to determine the safety and effectiveness of each vaccine candidate. Vaccines that are made available in the United States by approval or emergency use authorization have met this high safety and effectiveness standard.

Furthermore, even after a vaccine is authorized or approved, it is continuously monitored for any adverse events (such as side effects). If something abnormal is detected, experts will quickly study it further to see if it’s a true safety concern. This helps ensure the benefits outweigh any potential risks for individuals who receive the vaccine.

Finally, each batch of every vaccine is tested for quality and safety to ensure that the vaccine works like it is supposed to, and that it is not contaminated with certain ingredients used during production or outside germs.

“The effectiveness of initial COVID-19 vaccines exceeded the expectations of many experts, and all vaccine candidates must meet the gold standard for safety,” explains Dana-Farber President and CEO Laurie H. Glimcher, MD.

Is the vaccine safe for cancer patients?

The National Comprehensive Cancer Network, an alliance of 31 leading cancer centers across the U.S., recommends that all oncology patients currently in treatment receive the COVID-19 vaccine, and that their caregivers and household members should be immunized as well. Based on evidence from flu vaccinations, the data suggest that patients with cancer would be able to mount some level of protective immune response, though a number of factors may affect the level of response. Additional research on effectiveness and safety for these patients is ongoing.

At this point, there is limited information on how immunocompromised patients may respond to the vaccine. Some studies suggest there is a lower immune response to COVID-19 vaccinations in people that are immunocompromised. Several studies have found that patients being treated for chronic lymphocytic leukemia or other types of lymphoma had a significantly lower antibody response after being vaccinated than healthy volunteers did.

This is why the CDC have begun to recommend a third dose for Moderna and Pfizer BioNTech vaccine recipients as part of their primary series, and then a fourth booster shot. The CDC guidance also states that those receiving Johnson & Johnson vaccines should receive a second mRNA vaccine (Moderna or Pfizer BioNTech) as a part of the primary series and boosters.

If you have specific questions regarding any vaccine, specifically in regard to how it pertains to your cancer care, be sure to speak with your care team.

Can I spread COVID-19 to someone else if I’ve received a vaccine?

Yes, you can still spread COVID-19 to someone else if you’ve received the COVID-19 vaccine series. COVID-19 vaccines provide high levels of protection from hospitalization caused by severe symptoms. However, vaccination does not prevent transmission or infection. With newer variants such as Omicron, a primary vaccine series still prevented COVID-19 related hospitalizations but was less effective at preventing infection and hospitalizations as compared to earlier circulating variants. 

How long does it take to become immune following complete vaccination?

It typically takes a few weeks for the body to build immunity following vaccination. Research into vaccines currently available in the U.S. suggests that individuals will begin to build immunity to the virus 10 to 14 days following their first dose, with full immunity typically appearing seven to 14 days following the second in healthy individuals. For moderate to severely immunocompromised hosts, full immunity is likely not achieved until seven to 14 days after the third dose, and some people with compromised immune systems may not be able to achieve full immunity even after vaccination. 

Does the vaccine protect against emerging strains of SARS-CoV-2?

Data collected by the CDC suggests that COVID-19 vaccinations are slightly less effective at protecting against emerging strains but are still highly effective at protecting individuals from severe symptoms. The CDC has found that the Moderna and Pfizer BioNTech vaccines are more effective than the Johnson & Johnson/Jansen shots. Individuals who have had booster shots are also more protected from infection and hospitalization.

The discovery of emerging strains does not change the recommendations for vaccination, and people should not put off receiving the vaccine in the hopes of getting one that is potentially more effective against emerging SARS-CoV-2 variants.