Amid a surge in COVID-19 infections, vaccination is beginning around the nation of the first FDA-authorized COVID-19 vaccine.
Kelvin Lee, MD, Former Chair of Immunology at Roswell Park and a member of the New York State COVID-19 Clinical Advisory Task Force, answered some key questions relating to cancer care below.
As with the entire COVID-19 pandemic, information about the COVID-19 vaccine is evolving. Watch our COVID-19 vaccine page for additional FAQs as information becomes available.
Q: It has been reported that the vaccines will be distributed first to high-risk groups. Do cancer patients and survivors fall into that group?
A: Cancer patients do. Probably anyone with cancer is at higher risk than the general population for suffering severe consequences from a COVID-19 infection, regardless of the type of treatment they are undergoing. That’s also the case for people with a lot of other preexisting conditions — high blood pressure, heart disease, diabetes — and people in nursing homes and other settings where the consequences of getting COVID-19 are particularly bad. For cancer survivors, it’s less clear.
The first groups to get the vaccine are healthcare workers in emergency rooms, ICUs and similar settings, because they’re in harm’s way and are the most likely to be exposed to the virus. Vaccination is beginning for healthcare workers in high-risk settings and will expand as supply grows.
Q: Will the vaccine have negative effects on my cancer treatment?
A: It’s unlikely to affect your cancer treatment, but very little is known right now about the interactions of the vaccine with cancer therapy or with cancer patients. Your cancer treatments would probably have a negative effect on the vaccine, because the vaccine works with your immune system, and most cancer treatments suppress your immune response. It may be that the vaccine won’t work very well in people who are in active treatment.
But even if the cancer treatment decreases the effectiveness of the vaccine by as much as 50%, it’s still worth getting, because if you have at least 50% protection, that is a good thing.
Q: Will Roswell Park patients get the vaccine at Roswell Park?
A: We are following Food & Drug Administration (FDA), Centers for Disease Control and Prevention and New York State Department of Health guidelines on who can be vaccinated safely, and when. The first groups approved to get the vaccine at Roswell Park are our medical staff who have a high risk of exposure to the virus.
As we continue vaccinating our staff, extensive planning for the vaccination of our patients is also underway. We expect doses to become more rapidly available as additional vaccines go before the FDA and other regulatory agencies for authorization, and we hope to have more information to share in the coming weeks.
We will send our patients information about how to receive the vaccine as soon as it becomes available. Please do not contact your doctor at this time to schedule a vaccine appointment.
Q: How long will the vaccine protect me? Will I need a booster shot later?
A: Both the Moderna vaccine and the Pfizer vaccine are two-shot vaccinations. You’ll get the vaccine and then you’ll get a booster later.
Nobody knows how long the protection will last. The pharmaceutical companies’ analysis shows the vaccines are effective after two months, but will that protection last six months, a year, 10 years? Nobody knows yet, because nobody has been vaccinated that long.
There’s also the question of whether the different types of vaccines that are being developed will offer different lengths of protection. That’s clear in the regular vaccines we give kids. The measles vaccine gives you lifelong protection, while the immune protection from the first chickenpox vaccine disappeared after a number of years.
Q: If it turns out that immune protection lasts only two months, is it even worth it for anybody get it?
A: Even if it’s effective for only two months, there are groups of people who would benefit from that — first responders, people working in the emergency room, people working in the COVID sections of hospitals, because they’re at high risk of infection.
But how long the protection lasts is going to be a big question in vaccinating the entire population.
Q: Should I worry about the safety of the vaccine?
A: The number of patients who have been vaccinated with both the Pfizer vaccine and the Moderna vaccine is in the tens of thousands, so we have a pretty good idea regarding safety — and the initial data from these clinical trials suggest the vaccines are safe. Safety will be very closely scrutinized by the regulatory agencies and panels that will be approving the vaccine for use, so I am confident that an approved vaccine will have an acceptable safety profile. When hundreds of thousands of people have been vaccinated in these clinical trials, we’ll have an even better idea of what the safety signature looks like for the vast majority of people.
There’s certainly the possibility that for small subgroups of the population who are underrepresented in the clinical trials, there may be unexpected side effects that aren’t seen in the larger population. So that needs to be worked out, but for the most part, we have a pretty good idea of the safety.
Q: But isn’t the FDA likely to rush the approval process? Are they skipping steps?
A: The regulatory scientists at the Food & Drug Administration are some of the finest scientists and professionals around. They’ve been doing this a very long time. Their interest is in the health of our citizens, and I encourage people to take what they say to heart. Their review of the safety and efficacy of the vaccine is going to be as high-quality as we can possibly get in these rapidly changing times.
Q: Doesn’t it usually take a lot longer to develop a vaccine? How were these vaccines produced so quickly?
The Pfizer and Moderna vaccines were developed quickly because they used brand-new mRNA technology, which uses instructions for building proteins that can be used to prevent or treat a disease. The same technology was used to develop at least one of the vaccines for the Ebola virus.
The traditional way of making a vaccine was to inoculate chicken eggs with a virus, grow the virus, purify the virus, inactivate the virus, and then make a vaccine out of it. That process is extraordinarily complicated, and that’s why vaccine development took as long as it did.
If the situation weren’t as urgent as it is, Pfizer and Moderna probably would have taken the standard route. But the advantage of this technology is that it’s incredibly fast — faster by magnitudes than any previous technology we used for developing vaccines.
Q: Once I get vaccinated, can I stop wearing a mask and social distancing?
A: Until the virus is gone, you should not. We don’t know what’s going to happen. And what if half the population doesn’t want to get vaccinated? We cannot let our guard down.
The safest thing to do is to get vaccinated and continue our current safety measures until we get the pandemic under control. Then we can consider lightening things up a little, but until people stop dying, we need to do everything we can to stop this pandemic.
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