I have lung cancer. Should I be vaccinated against a COVID-19?
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What is vaccination?
Vaccination consists of stimulating the defenses of an individual’s body (immune system) through exposure to microorganisms, parts of microorganisms or their derivatives. This early exposure, before infection, allows the immune system to be stimulated and “taught” to react against the administered microorganism (s), thus protecting the individual from future infections or serious infections.
Vaccines stimulate the immune system to react and eliminate the microorganism, just like a natural infection. However, vaccines use dead or weakened microorganisms, as well as fragments of viruses or bacteria, to ensure this stimulation of the immune system occurs safely.
In addition to individual protection, vaccination can also confer group immunity, thus decreasing the circulation and transmission of microorganisms between individuals in a population protected by high rates of vaccine coverage.
What is the vaccine against COVID for?
The vaccine against COVID-19 stimulates the body’s defenses that can protect us against SARS-CoV-2 infection or serious complications that may be associated with it.
What types of vaccines against COVID-19 are available?
The main differences between vaccines are the way in which they induce the body to acquire immunity (defenses against a specific aggressor agent). The vaccines currently in use for the prevention of COVID-19 are mRNA – in these cases, after the vaccine is administered, a component of the virus is produced in the individual’s own body, which in turn will stimulate the immune system to develop defenses. Other vaccines under study are the “traditional” mechanism of action in which components of the virus are directly injected, against which the immune system creates defenses. Regarding the vaccine against COVID-19, there is, to date, no evidence to suggest that one mechanism is superior to another. At the moment, the vaccines in use in Portugal are RNA vaccines.
Is the vaccine against COVID effective?
The first vaccine approved by the European Medicines Agency was the Comirnaty Vaccine (from BioNTech/Pfizer). The results of the clinical trial that led to the approval of this vaccine documented 95% efficacy, including in volunteers at higher risk for severe COVID-19 disease (asthma, chronic lung disease, diabetes, high blood pressure or body mass index ≥ 30 kg/m2).
Vaccination against COVID-19 comprises 2 administrations with an interval of 3-4 weeks. An interval of 7 days after the last administration is considered necessary for the development of a robust and effective response.
Is the vaccine against COVID safe?
Clinical trials that documented the effectiveness of vaccines against COVID-19 included thousands of volunteers, without a significant increase in side effects, or in their severity, in patients undergoing vaccination compared to subjects who did not receive the vaccine (placebo).
As with the use of other drugs, the widespread use of the vaccine, with application in millions of people, may show some very rare undetectable effects during clinical trials.
For this reason, the vaccine against COVID-19 is considered safe, while active surveillance is maintained, in parallel with notification and recording of unforeseen adverse effects.
Can I feel any reaction after vaccination against COVID?
As with other vaccines, the vaccine against COVID-19 can have some side effects. In general, when they occur, these effects are mild and of short duration. The most frequently described symptoms were:
- – pain and/or redness at the injection site;
- – fatigue;
- – headache;
- – muscle pain;
- – joint pain;
- – fever;
- – nausea.
If complaints persist for more than 1 week, or fever for more than 2-3 days, you should contact your attending physician.
Can I be infected with COVID from the vaccine?
No. There is no risk of infection with the vaccine.
However, if you contracted the virus in the days before or after the vaccine, the appearance of the first complaints related to COVID-19 may coincide with the period after vaccination.
I already had COVID. Do I still need the vaccine?
Most people who have had COVID-19 are considered to have acquired protection against the virus for 3-6 months. However, as there is still no certainty about the duration of this protection, vaccination against COVID is considered safe and beneficial even in patients with previous infection.
Given the need to prioritize vaccines in the current context, people with previous COVID-19 infection will be vaccinated later.
After the vaccine, do I still need to take precautions?
Sim! Mesmo após a vacinação deve manter todos os comportamentos de redução de risco de infeção, incluindo a utilização de máscara, lavagem frequente das mãos com água e sabão e distanciamento social.
Apesar da elevada eficácia, a vacinação não garante proteção completa contra a infeção. Mais ainda, desconhece-se se a vacinação impede, ou não, a infeção assintomática, podendo tornar-se portador e transmissor do vírus.
Yes! Even after vaccination you must maintain all the precautions recommended to reduce risk of infection, including the use of a mask, frequent hand washing with soap and water and social distance. Despite its high efficacy, vaccination does not guarantee complete protection against infection. Furthermore, it is unknown whether vaccination prevents or not asymptomatic infection, and prevents you from being a carrier and transmitter of the virus.
I was vaccinated against the flu. Do I still need to get the vaccine against COVID?
Yes. Flu and COVID-19 are both respiratory infectious diseases, but are caused by different viruses. Thus, flu vaccination does not prevent COVID-19.
Is the vaccine against COVID effective and safe in patients with lung cancer?
Doentes com cancro constituem um grupo de maior risco para doença COVID grave, com maior risco de morte comparativamente com a população geral. Doentes com cancro do pulmão, estão associados a um risco ainda mais elevado, sobretudo se tiverem doença ativa e avançada. Apesar do maior risco de doença grave e de morte, ainda não há dados robustos sobre se estes doentes têm maior risco de ter infeção (incidência). A percentagem de doentes com cancro incluídos nos ensaios clínicos da vacina é muito pequena. Com base no conhecimento relacionado com outras vacinas com um mecanismo de atuação semelhante à vacina contra a COVID, assume-se que a sua eficácia e segurança sejam semelhantes às dos indivíduos sem cancro.
De uma forma resumida, o benefício da vacinação em doentes com cancro, incluindo doentes com cancro do pulmão, parece claramente superar os riscos e dúvidas ainda existentes.
O momento ideal para a administração da vacina em doentes com cancro deve ser antes do início do tratamento. Contudo, se se encontrar já em tratamento, é adequada a vacinação durante o tratamento no momento a definir com o seu médico assistente.
Cancer patients are a group at higher risk for severe COVID disease, with a higher risk of death compared to the general population. Patients with lung cancer are associated with an even higher risk, especially if they have active and advanced disease. Despite the increased risk of serious illness and death, there is still no robust data on whether these patients are at increased risk of infection (incidence). The percentage of cancer patients included in clinical vaccine trials is very small. Based on the knowledge related to other vaccines with a mechanism of action similar to the vaccine against COVID, it is assumed that its effectiveness and safety are similar to those of individuals without cancer.
In summary, the benefit of vaccination in cancer patients, including patients with lung cancer, clearly seems to outweigh the risks and doubts that still exist.
The ideal time for the vaccine to be administered to cancer patients should be before treatment is started. However, if you are already on treatment, vaccination during treatment is appropriate, and ideal timing should be defined by your attending physician.
When can lung cancer patients be vaccinated?
Vaccination of cancer patients with active disease, including patients with lung cancer is scheduled for Phase 2 of the vaccination plan against COVID, starting April 2021.
However, patients with lung cancer who are ≥50 years old and another disease: heart failure, coronary heart disease, kidney failure, chronic obstructive pulmonary disease or chronic respiratory disease under ventilatory support and / or long-term oxygen therapy, should be invited for vaccination in phase 1, starting February 2021.
Portugal acquired about 22 million doses, under the agreements between six pharmaceutical companies and the European Union. The six companies are Astrazeneca, BioNTech / Pfizer, Moderna, Curevac, Janssen and Sanofi / GSK.
Considering the specifics of each case as well as the patient’s preferences, your attending physician is the best person to guide you.
Bibliography:
- Organização Mundial de Saúde – Vacinas. https://www.who.int/news-room/q-a-detail/vaccines-and-immunization-what-is-vaccination
- SNS – COVID-19. https://www.sns.gov.pt/vacinacaocovid19/
- SNS – Vacina COVID-19. https://www.sns24.gov.pt/tema/doencas-infecciosas/covid-19/vacina-covid-19/ – sec-3
- ESMO statment for vaccination agaisnt COVID-19 in patients with cancer. https://www.esmo.org/covid-19-and-cancer/covid-19-vaccination
- Patient Power. https://patientpower.info/lung-cancer/emerging-research/lung-cancer-patients-and-covid-19-what-we-are-learning
- American Cancer Society. https://www.cancer.org/about-us/what-we-do/coronavirus-covid-19-and-cancer.html