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Cancer/Covid-19 report: vaccination, risks, what advice?

Cancer/Covid-19 report: vaccination, risks, what advice?

People with cancer are at higher risk for severe Covid-19 disease and should be prioritized for vaccination.

Which? What is known about the side effects of vaccines in cancer patients? What tips are there for protecting yourself against coronavirus in all circumstances?

Cancer/Covid-19 report: vaccination, risks, what advice?

Current scientific data show that cancer patients and immunocompromised individuals have been strongly targeted by Covid-19. Particularly for people with lung cancer, a condition often associated with respiratory disorders, with a risk compounded by Covid-19 infection.

 As of January 18, 2021, people with cancer and hematological malignancies undergoing chemotherapy have priority for vaccination regardless of age.

 Patients to be vaccinated in priority

As of January 18, 2021, people with cancer and hematologic malignancies undergoing chemotherapy treatment are on the Covid vaccination priority list, regardless of age.

« The decision to vaccinate you will be made with your medical team, depending on your current treatments, your general condition, and the nature of the vaccine. You can ask the medical team that follows you for your treatment or your attending physician about this vaccination », says the National Cancer Institute.

For patients with hematologic malignancies, the following are considered ultra-priority

  üPatients are actively treated for acute myeloid or lymphoid hemopathy, regardless of age, as long as        their care program does not usually involve prolonged hospitalization.

ü  Patients treated for multiple myeloma, T-cell lymphoma, diffuse large cell B-cell lymphoma,                  follicular lymphoma, and chronic lymphocytic leukemia should be vaccinated immediately.

In particular, for patients receiving anti-CD20, considering the particular immunogenicity of mRNA vaccines and the diminished but not zero capacity to mount an immune response in these patients, the application of the precautionary principle prevails.
The vaccination is, however, subject to reservations formulated in the opinion.

For patients with solid cancers, the following are considered ultra-priority

  ü  Patients whose neoplasia treatments, whatever the modalities and sequences, are undertaken for curative purposes, excluding basal cell skin tumors.

  ü  patients undergoing active treatment, without curative intent, with first- or second-line chemotherapy.

  ü  Patients receiving radiation therapy for a primary intra-thoracic tumor that includes a large lung volume, radiation therapy that includes a large number of thoracic and/or abdominal-pelvic lymph nodes and/or a large volume of hematopoietic tissue.

There are no greater side effects of the vaccine than for other people, for patients undergoing chemotherapy.
In the shared decision process leading to vaccination, the doctor-patient relationship remains essential.

Contra-indications to vaccination

  ü  Pfizer vaccine has no contraindications for immunocompromised individuals.

   ü  There are no contraindications to vaccination of patients undergoing chemotherapy and the oncologist positions the vaccination at the right time, according to their health status.

ü  The side effects of the vaccine are rare, such as headaches, fever, or local effects at the injection site,      but these are transient.

The injection of the third dose of the vaccine

On June 18, 2021, the Health Department clarified the list of people who can receive a third dose of the vaccine:

  ü  Receiving lymphopenic chemotherapy.

  ü  Receiving an organ or hematopoietic stem cell transplant.

  ü  Chronic dialysis patients after advice from their attending physician who will decide on the need for appropriate examinations for chronic lymphocytic leukemia patients.

  ü  Treated with strong immunosuppressive drugs, such as antimetabolites (Cellcept, myfortic,                      mycophenolate mofetil, immoral, azathioprine) and AntiCD20 (rituximab: Mabthera, Rixathon,            Truxima) and not falling into the above-mentioned categories or carrying a primary immune deficiency.

People with cancer are vulnerable Covid

Cancer patients are 4 to 5 times more at risk of developing a severe form of Covid-19 if they are infected with the virus.
« Their weakened immune systems from certain treatments, including chemotherapy, make them more fragile », explains the National Cancer Institute.
On the other hand, having cancer does not lead to « a higher risk of transmission of SARS-CoV-2 to other citizens », reminds the Scientific Council in an Opinion of April 20, 2020.

 If you are only taking hormone therapy, « this does not automatically make you a person at risk of severe COVID-19 by the Haut Conseil of Public Health», explains Inca.

Precautions for people with cancer

The recommendations published by the Gustave Roussy Institute and the High Council for Public Health (HCSP):

  ü  Respect the 2 meters recommended distance from your neighbors or friends who would come to visit you if they remove their masks.

   ü  Wash your hands after handling a mask, before preparing, serving, and eating food, and before leaving the house; wash your hands after blowing your nose, coughing or sneezing, visiting someone, going outside, taking public transportation, or using the bathroom.

üContinue to watch for symptoms of respiratory infection (coughing, difficulty breathing...),

   üAvoid contact with vulnerable people (pregnant women, chronically ill people, elderly people...) and public transportation.

Medical consultations and guidance at the hospital

In the case of cancer, teleconsultations are to be preferred as well as prescription refills by the pharmacist.
Do not hesitate to contact your surgeon, your radiotherapist, or your oncologist to schedule non-urgent operations and consultations without waiting.

During the epidemic, in healthcare establishments, visits to cancer patients by outsiders are severely limited or even forbidden, for a very short period and with the wearing of a mask, gloves, and hand washing.

For chemotherapy or radiotherapy sessions, or for surgery, it is not possible to be accompanied inside the establishment.

 In case of symptoms

Symptoms of COVID-19 in a person with cancer are generally the same as in the general population.

If infectious symptoms (fever) or respiratory difficulties (cough, difficulty breathing):

  ü  Do not go directly to the doctor, nor to the hospital emergency room, but contact your doctor or the       SAMU as soon as possible, indicating your pathology.

  ü  Avoid contact with other people and keep your mask on

If you are infected with COVID-19, your doctor may need to temporarily suspend your treatment.

Cancer treatments can lower your immune system and make you feel weak. If you have any concerns, do not hesitate to speak with your oncologist or hematologist and your primary care physician.

 

In the end, the Cancer Info service, offered by the National Cancer Institute (NCI) is available to answer all questions of cancer patients and their families by visiting the following link:


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