“This was a complete – I won’t say a disaster, but it’s been pretty close,” said Dr. Hanny Al-Samkari, haematologist and clinical investigator at Massachusetts General Hospital and Harvard Medical School. Cancer patients receive “mixed messages,” he said, and the counseling they receive largely depends on their condition. Every day, he receives a deluge of messages from patients asking if they already qualify for the vaccine (in his state, the answer is largely no). One drove four hours to find a vaccination spot. “It’s the Wild West,” he said.
He urged cancer patients to talk to their doctors about adjusting the timing of the vaccine to suit their treatment unless they are in remission, were treated long ago, or are only receiving hormonal treatment for breast or prostate cancer, said Dr. Tomasz. Beer, a professor in Oregon Health and Science University’s School of Medicine and assistant director of the school’s Knight Cancer Institute.
Covid19 Vaccines>
Answers to your vaccine questions
Currently, more than 150 million people – nearly half of the population – are eligible for vaccination. But each state makes the final decision on who goes first. The 21 million health workers and three million residents of long-term care facilities were the first to qualify. In mid-January, federal officials urged all states to qualify anyone 65 and older and adults of any age with medical conditions that put them at high risk of becoming seriously ill or dying from Covid-19. Adults in the general population are at the back of the queue. If federal and state health officials can resolve bottlenecks in vaccine distribution, anyone 16 and older will be eligible as early as this spring or early summer. The vaccine is not approved in children, although studies are ongoing. It can take months for a vaccine to be available to someone under the age of 16. For current information on vaccination policies in your area, visit your state’s health website
You don’t have to pay anything out of pocket to get the vaccine, although you will be asked for insurance information. If you don’t have insurance, you should still get the vaccine for free. Congress passed legislation this spring that prohibits insurers from applying any cost sharing, such as a personal contribution or deductible. It was layered on additional protection that prevented pharmacies, doctors, and hospitals from paying bills to patients, including those who are uninsured. Still, health experts are concerned that patients could get caught in loopholes that leave them vulnerable to surprise bills. This could happen to those who have to pay a doctor visit fee in addition to their vaccine, or Americans who have certain types of health coverage that aren’t covered by the new rules. If you get your vaccine from a doctor’s office or an emergency room, talk to them about possible hidden costs. To make sure you don’t get a surprise bill, it’s best to get your vaccine from a health department vaccination site or local pharmacy once the injections are more widely available.
That has yet to be determined. It’s possible that vaccinations against Covid-19 will become an annual event, just like the flu shot. Or it could be that the benefits of the vaccine last for more than a year. We have to wait and see how durable the protection against the vaccines is. To determine this, researchers will follow vaccinated people looking for “breakthrough cases” – those people who fall ill with Covid-19 despite vaccination. This is a sign of weakening protection and gives researchers clues as to how long the vaccine will last. They will also monitor the levels of antibodies and T cells in the blood of vaccinated people to determine if and when a booster shot may be needed. It is conceivable that people will need boosters every few months, once a year, or just every few years. It’s just a matter of waiting for the data.
For example, those undergoing chemotherapy have the best chances of building an immune response if the vaccine is given when the white blood cell count is not at the lowest level, said Dr. Bear. Recommendations for patients with leukemia or lymphoma who are in treatment or who have recently undergone a bone marrow transplant are particularly complex and absolutely require consultation and coordination with an oncologist, he emphasized.
While some may be concerned about the risks of running into a crowd at a mass vaccination site, Dr. Al-Samkari urges patients to receive doses where available, as long as they wear masks and keep their distance from other people in line. “Fears are clearly justified,” he said. “But we have to shoot with arms.”
In general, people with cancer should get the vaccine “as soon as they can, wherever they can,” says Dr. Carol Ann Huff, clinical director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins and one of the authors of the Cancer Network’s National Comprehensive Guidelines on Covid-19 vaccines for cancer patients. There are some caveats: Patients undergoing bone marrow transplantation or CAR-T therapy should wait at least three months before getting the vaccine, she said.
But depending on the degree of virus transmission in a patient’s community, it may be safer to wait for the vaccine. When there is a high level of transmission in the community, “the risks may outweigh the benefits of waiting,” said Dr. Bear. Patients with active cancer should check with their oncologist before getting the vaccine, he advised, unless they are in remission, have been treated long ago, or are only receiving hormonal treatment for breast or prostate cancer.
Those participating in cancer clinical trials have more obscure guidelines about vaccination. Allyson Harkey, 46, of Maryland, has stage four kidney cancer and is participating in an immunotherapy trial; She said her doctor isn’t sure she should get the vaccine. The National Comprehensive Cancer Network guidelines broadly recommend that patients receiving immunotherapy should get the vaccine as soon as it becomes available, but they should consult their doctor in advance because there are so many different studies. She feels like she’s in a state of insecurity, waiting for more information – a process made even more frustrating by what she feels like a ticking clock. ‘My prognosis is not great. I probably have a few more years, ”she said. “It’s really hard to spend this time knowing I don’t have much time left alone in my house.”