Due to their reduced immune defence, cancer patients are more likely to catch the disease.
Independently of other risk factors such as obesity, age, diabetes or high blood pressure, cancer patients, especially those with a haematological malignancy or pulmonary tumour, are at increased risk of developing a severe form of COVID-19.
Chemotherapy with the risk of reducing white blood corpuscles (neutropenia and lymphopenia) predisposes patients to infections in general and increases the risk of complications linked to infections. Discuss this with your oncologist.
Hormone therapy can increase the risk of thrombosis that is already higher in the case of COVID-19, and immune therapy can increase the risk of respiratory failure.
Total body irradiation can be accompanied by a reduction in the lymphocyte count and thus predispose to a more severe infection.
Your oncologist will assess the benefits and the risks of the cancer treatment compared to the risks of complications liked to the COVID-19 infection.
In addition to wearing the mask, social distancing and disinfecting the hands, vaccination against COVID-19 for cancer patients and those in close contact with them is an essential element. However, the role of vaccination in cancer patients has not been the subject of a specific scientific study.
Data concerning the immune response (development of antibodies) following the vaccination of cancer patients and the effectiveness of the vaccine among such patients are non-existent. Just 4% of patients who received the Pfizer/BioNTech vaccine as part of the vast phase III study were cancer patients and there was no separate analysis of the effectiveness of the vaccine among these patients. Cancer patients in general respond less well to all kinds of vaccination so it is therefore advisable to vaccinate those in close contact with them as a means of protecting them and to take all precautionary measures even after vaccination (distancing, mask, hand hygiene). Indeed, all vaccinated persons should continue to respect these measures.
Vaccines based on a live virus (measles, rubella, mumps, yellow fever) are contraindicated for patients with a reduced immune defence. However, the anti-COVID vaccines being used at present do not include any that are based on a live SARS-COVID2 virus.
Certain vaccines - AstraZeneca, Johnson & Johnson, Sputnick and Sinovac – contain a deactivated adenovirus used as a vector and that is unable to trigger a disease. The Comirnaty®(Pfizer/BioNtech), Moderna and Curevac vaccines contain just a part of the mRNA of the virus and are unable to cause even the slightest viral infection.
As for the general population, the contraindications of the vaccine among cancer patients are a previous anaphylactic reaction to a vaccine, medicine or food. An anaphylactic reaction includes, within 4 hours of exposure, a skin rash of the hives variety, a laryngeal or face oedema, wheezing, low blood pressure or fainting. Persons who are allergic to polyethylene glycol (PEG) or to polysorbate 80 cannot receive any of the vaccines used at present, namely Pfizer/BioNtech, Moderna, Astra-Zeneca, Johnson & Johnson, Curevac and Novavax, as they all contain one of two components with a similar structure and can therefore, in theory, trigger a cross allergy.
If you are taking anticoagulants, if you have a low platelet count (<50,000) or if you suffer from bleeding you should report this at the time of vaccination.
Ideally, 10 days before any chemotherapy and it is preferable not to start systemic treatment (chemotherapy, immunotherapy, targeted therapy) earlier than 7 days after vaccination. This must be organised together with your oncologist. The exact vaccination plan depends on the type of vaccine: 1 dose only for Johnson & Johnson, 2 doses for the others at variable intervals
In case of radiotherapy treatment: no data are available at present, but there does not seem to be any element to prevent patients undergoing a course of radiotherapy from being vaccinated. It is nevertheless recommended to respect an inter-treatment interval for the vaccine if the radiotherapy is accompanied by the administration of chemotherapy or immunotherapy treatment.
In case of surgery: it will be proposed to respect an interval between the injection and the surgical intervention depending on the post-operative development. In this situation it is also ideal to be vaccinated prior to the surgery.
In case of stem cell transplants: it is recommended to vaccinate 3 to 6 months after the transplant.
In case of treatment with medicines that act against B-lymphocytes (anti-CD19, anti-CD20, CAR-T cells): the vaccine will be administered either before the start of treatment or 3 months after the end of the treatment but this is something to discuss with your doctor.
In case of treatment with oral corticoids: it is your doctor who will decide on vaccination depending on the dose and expected duration of your treatment.
In case of complications: in the case of an infectious complication, of a generally impaired state of health or hospitalisation following an acute complication it is recommended to delay being vaccinated until after the complications are resolved.
In case of hormone therapy: there seems to be nothing to prevent the administration of the vaccine.
In case of cancer remission: there is no reason not to be vaccinated.
In case of an active and continuing infection, or in case of a temperature of above 38°C, the vaccination will be postponed. In case of a prior infection with COVID-19 it is desirable to measure the anti-COVID-19 antibody count in the blood (COVID-19 serology test) and the decision on administering the vaccine will depend on the result.
- At the vaccination centres in your region (Flanders, Brussels-Capital Region, Wallonia) depending on the timetable decided by the government of each region.
- Federal Call-Center : 0800 14 689
- Brussels-Capital Call-Center : 02/2141919
- Flanders Call-Center : 1700
- Wallonia Call-Center : 0800/16061
- At the Jules Bordet Institute only if you are a patient of the Institute and are about to start cancer treatment or if you are currently following a course of cancer treatment. Your medical consultant (oncologist, haematologist, surgeon, radiotherapist, etc.) will check with you to see whether you are eligible for the vaccination according to the procedure established at Bordet and will prescribe vaccination on an optimal date in regard to your treatment.
Within the European Community three vaccines have been authorised to date: Comirnaty® Pfizer-BioNTech, Moderna COVID-19 Vaccine®, COVID-19 vaccine AstraZeneca® and Janssen Covid19 Vaccine®.
In Belgium, 3 vaccines are available: Comirnaty® Pfizer-BioNTech, Moderna COVID-19 Vaccine®, COVID-19 vaccine AstraZeneca®, but at present it is not possible to choose your vaccine. The Comirnaty® and Moderna COVID-19 Vaccine® are messenger RNA vaccines. The COVID-19 vaccine AstraZeneca® uses a non-replicating viral vector.
- Vaccin AstraZeneca
Copyright : Infographie ©LeParisien
- Vaccin Pfizer/BioNTech et Vaccin Moderna
Copyright : Infographie ©LeParisien
The side effects are similar to those observed with many other vaccines:
- At the injection site:
- Slight (51 %), moderate (31 %), severe (1 %) pain
- Slight (3.1 %), moderate (1.2 %), severe (0.3 %) redness
- Slight (3.8 %), moderate (1.7 %), severe (0.2 %) swelling
- General symptoms:
- T°>38° (1st injection : 1.4 %), (2nd injection : 10.9 %)
- Fatigue, headaches, shivers, muscle pain: 0.1 %
These side effects are not the expression of an infection but are a normal reaction to an effective vaccine, that is, the development of your immunity.
At present several million people have been vaccinated worldwide with a follow-up of several months and there are no reports of rare side effects, except for allergic reactions in persons with a history of allergic reactions (1/100,000 persons). This is a side effect that can be encountered with any vaccine.