COVID-19 vaccines are very safe.

The way the vaccines work means that there is a chance that your immune system will learn to protect you, to some degree, from serious symptoms of COVID-19.

Some medications and treatments for cancer may affect how well your immune system responds to the COVID-19 vaccine. Timing your vaccine around your treatment may help the vaccine work best.

Before getting your vaccine, please do the following:

• Read the COVID-19 vaccine information for your condition(s).
  
• Solid cancer (PDF)
• Blood or bone marrow cancer, have had stem cell or bone marrow transplant or CAR-T cell therapy in the last 6 months (PDF)
• People taking immunosuppressive drugs (PDF)
• Time your vaccine appointment around your medication and treatments (if needed).
• Contact your nurse, pharmacist, doctor or nurse practitioner if you have any questions or need any help planning your medication.
• In the 2-3 days before your vaccine, monitor yourself: are any of your symptoms new or getting worse? If you aren’t feeling well, rebook your appointment for another day. You will not lose your place in line. Make sure you are feeling your usual self on the day of your vaccine appointment.

Some medications and treatments for cancer affect how well your immune system responds to the COVID-19 vaccine. Timing your vaccine around your treatment may help the vaccine work best.

NEW information is below for patients about to start or planning to start B-cell depleting therapies

• Recommendations for people with blood or bone marrow cancers (PDF)
• Recommendations for people with solid cancers (PDF)

Not all people with cancer need to time the vaccine around their treatment or medications.

If you are on treatment or your treatment needs to start before you can get the vaccine, do not delay your cancer treatment.

You may need to time your vaccine if any of the following apply to you:

Systemic therapy

• If you are on cyclical therapy, for example chemotherapy given every 3 - 4 weeks, try and book your vaccine one week before your next treatment.
• If you are receiving weekly chemotherapy, the best time to get your vaccine a day or two after your treatment.

Radiation therapy

• If you are receiving radiation therapy to large areas of your body, you may need a blood test before getting your vaccine.
• If you are having radiation close to one of your arms, you should get the vaccine in your other arm. If you have questions, please speak to your radiation oncologist.
• If you are going to start radiation therapy in the next 2-4 weeks, and you are currently eligible to get a vaccine (for example, your age group is eligible), try to get the vaccine as soon as possible (within a few weeks). When you have your cancer centre appointment, please let the staff know the date of your vaccine appointment.

Stem cell, bone marrow transplant or CAR-T therapy

• If you are planned for a stem cell or bone marrow transplant or CAR-T cell therapy, try to book your vaccine at least 2 weeks before you start the chemotherapy that is given before the transplant or CAR-T cells.

Corticosteroids or oral treatments

• If you are taking systemic corticosteroids, such as dexamethasone, try to book your vaccine 28 days after your last dose of corticosteroids.
  
• If there are days in the week or month when you are not on treatment (intravenous or oral treatment, including steroids), try to book your vaccine appointment on your days “off” treatment.

B-cell depleting therapies

• If you have a B-cell lymphoproliferative malignancy and you will be starting or are planning to start:
• a B-cell depleting agent (like Rituximab or obinutuzumab) OR
• a BTK inhibitor (like Ibrutinib, acalbrutinib, zanubrutinib) OR
• Daratumumab OR
• CAR-T
  

OR

• If you have non-malignant conditions but will be starting or planning to start B-cell depleting therapies like Rituximab, alemtuzumab, ocrelizumab or and other CD20 +

Your doctor should have provided your contact information to the provincial immunization program. The provincial immunization program’s call centre will reach out to you to schedule your second dose.

If you are still not sure when to get your vaccine, please contact the care team who is managing your condition.

If you don’t see your medication listed, or if you take medications for another condition and you aren’t sure if you need to consider timing, you can also look at the COVID-19 vaccine planning considerations on the BCCDC website for that condition (if available).

Studies are being done looking at vaccines in patients with cancer and results are starting to be presented. Our experts are keeping a close eye on the evidence that is coming out.

It is possible that cancer patients might have worse symptoms from COVID-19. This is because some treatments affect how well their immune system works.