By Lisa Lowry, RN, BSN
During the winter months one of the most common questions that health care professionals answer is whether or not to get vaccinated with the influenza and pneumococcal vaccinations. Even though these are the vaccines people are most familiar with there are also other vaccinations, such as polio, measles-mumps-rubella (MMR), and shingles, that can be used to prevent other infectious diseases. Typically, vaccines are used on the general public to prevent serious infections, and many of them can be given year-round. However, a cancer patient currently receiving treatment should verify all vaccinations with their oncologist prior to receiving them.
Influenza and Pneumococcal Vaccinations
According to Dr. Bhanu Vakkalanka, a medical oncologist at Mid-Illinois Hematology and Oncology Associates, “the use of the influenza and pneumococcal vaccines are important for cancer patients to have to prevent those particular infections during treatment. However, it is recommended that they receive them well ahead of starting treatment. The reason for this is so the body has plenty of time to make the antibodies from the vaccine that will help fight off infection.”
It is possible to get the vaccines in between cycles of chemotherapy as long as the patient’s white blood cell count is stable; however, the oncologist must agree that it is safe for the patient to receive at this time. Dr. Vakkalanka states that, “it is possible that a patient with a weakened immune system may not get the full immune response from the vaccination if given too close to cytotoxic chemotherapy.”
One important fact to know is which flu vaccine you should be getting. Patients going through treatment for cancer should refrain from getting the live attenuated virus vaccine, typically a nasal spray, as it has the potential to actually cause infection in immunocompromised patients. The Centers for Disease Control and Prevention recommends that caregivers, household members, and those who have close contact with immunocompromised patients receive only the inactivated (non-live) vaccine.
The National Comprehensive Cancer Network (NCCN), states that influenza and pneumonia infections in patients who are immunocompromised can lead to hospitalization and delays in potentially life-saving chemotherapy. Each oncologist has their own preferences on whether or not a patient actively receiving chemotherapy should receive a vaccine or hold off. It is very important that this topic is discussed with your oncology physician.
Miscellaneous Vaccinations
There are times when other vaccinations are needed; however, some of these should not be administered to oncology patients and others close to them.
- Smallpox: Patients with a weakened immune system and their household members should not receive the small pox vaccine.
- MMR: Immunocompromised patients should not get the vaccine as it contains a live virus; however, household members can.
- Varicella zoster (shingles): Recommended for adults age 60 and older, not to be used in people with weakened immune systems.
Any person who does receive vaccines with live viruses, such as the ones mentioned above, should avoid close contact with current oncology patients and cancer survivors for at least 2-6 weeks based on NCCN guidelines.
Reasons to Not Be Vaccinated
There are several reasons why a patient should not get certain vaccines. Obviously, if there is an allergy to a component of a certain vaccine such as gelatin, antibiotics, preservatives, or eggs, you may be advised not to get vaccinated. If you are not feeling well or have an ongoing infection, your physician may recommend waiting to get vaccinated.
For patients receiving chemotherapy, taking immunosuppressive drugs, or having a low white blood cell count, your oncologist may recommend waiting to receive certain vaccines.
Ask Your Physician or Oncologist
For anyone who may be thinking about getting a vaccine, whether a cancer survivor, someone currently going through chemotherapy, or a loved one of an oncology patient, it is important to discuss with your primary care physician and your oncologist if now is the right time for a vaccine or if that vaccine is right for you.
Mid-Illinois Hematology and Oncology Associates is located at 407 East Vernon, Suite 104, Normal, IL. For any questions, you can reach the medical oncologists, nursing personnel, and office staff at 309-452-9701.