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COVID-19 and Cancer - Information for Patients

Page updated: September 14, 2021


The COVID-19 pandemic changes often. We will update this page when we get new information. The best source of up-to-date information on COVID-19 in British Columbia is the BC Centre for Disease Control website

COVID-19 vaccine information

  • Those who have been treated for and/or are receiving active treatment (chemotherapy, targeted therapies, immunotherapy) for lymphoma or a malignant hematological disorders (such as leukemia or myeloma) since January 2021.
  • Those who have received any anti-CD20 agents (such as rituximab, obinutuzumab, ofatumumab, ibritumomab or tositumomab) since January 2020.
  • Those have received a bone marrow or stem cell transplant since September 2019 or are still taking immunosuppressant medications related to transplant. 
  • You will be contacted by the provincial Get Vaccinated system about how and when to receive a third dose. After receiving an email or text, you can visit any vaccine clinic for a drop-in appointment four weeks after your second dose.
  • Starting October 6, you can also book an appointment online or by phone.
  • If you are in the first group of severely immune-compromised people with cancer and have not been contacted by September 17, get in touch with your health care provider.
  • You should be offered the third dose at a minimum of 28 days (four weeks) after your second dose.
  • This follows the vaccine guidelines outlined by the Ministry of Health and Provincial Health Officer.
  • Even with a third dose, it is important that those who are severely immune-compromised take precautions to protect themselves against COVID-19.
  • The BC Immunization Committee will be reviewing the available data on other populations who would benefit from a third dose. Guidance is expected soon.

If you have not yet done so, please sign up on the Get Vaccinated websitewww.gov.bc.ca/getvaccinated. Everyone in B.C. is eligible for both doses of the COVID vaccine and can receive both doses at the 21 day (Moderna) or 28 day interval (Pfizer) between doses. 


If you have questions or aren't sure if you are registered, you can phone the provincial vaccine call centre at: 1-833-838-2323.

Yes. All of the COVID-19 vaccines available in Canada are safe for their recommended use. 


Doctors and researchers have looked at the evidence. They agree that unless you have a very serious allergy to any of the vaccine ingredients, you should strongly consider getting a COVID-19 vaccine.  People with cancer have a higher chance of severe symptoms if they get COVID-19. 


Please review special vaccine considerations and FAQs for people with cancer. 


If you have: 

Please visit the BC Center for Disease Control COVID-19 Vaccine webpage for more information.

People with cancer weren’t included in the initial clinical trials of the COVID-19 vaccines but there is now some experience that shows that COVID-19 vaccines are very safe. Researchers still do not know exactly how much protection they will give people with cancer compared to those who do not have cancer.  


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


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. 

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

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). 

Before getting your vaccine, please do the following: 

  • Read the COVID-19 vaccine information for your condition(s). 
  • 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.  

  • Bring your BC Services Card or CareCard to your appointment along with your CEV letter from the B.C. Provincial Government. 

  • If you need to, you can bring one support person with you. You can bring any mobility equipment you need.
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. 
 
If you are interested in participating in COVID-19 research, visit: immunizebc.ca/participate-covid-19-research

Information about COVID-19 vaccines for British Columbians, including CEV populations, can be found on the Government of B.C. website.


Here you will find information about what to expect at a vaccine appointment, invitations for your second dose, availability and choice, and information on the AstraZenica/COVISHIELD vaccines. 


Other COVID-19 vaccine Frequently Asked Questions, can be found on the ImmunizeBC website

Clinically Extremely Vulnerable (CEV) information

B.C. announced its plan to vaccinate those who are at higher risk of serious illness from COVID-19 if they were to get the virus on March 23, 2021. This group, which has been called those who are “clinically extremely vulnerable (CEV),” has been identified through a thorough review of the scientific evidence from around the world combined with expert clinical opinion from here in B.C. 


Those who are being actively treated for cancer or who are on particular immunosuppressant medications, or have a blood cancer are in the CEV group. 


If you have not been contacted by the provincial immunization program, please visit gov.bc.ca/getvaccinated or call: 1-833-838-2323 and provide your Personal Health Number. The registration system or phone agent will confirm if you are eligible. 


If the registration system doesn't confirm your eligibility and you believe you should be included on the clinically extremely vulnerable list, contact the care team who is currently managing your condition with you. 

‎People currently receiving cancer treatment and some people who have just finished treatment are considered “clinically extremely vulnerable” as they are at higher risk of getting very sick if they got COVID-19. 


This group includes: 


  • People receiving systemic therapy for cancer now or within the past 12 months. This includes chemotherapy, molecular therapy, immunotherapy, monoclonal antibodies, hormonal therapy for cancer
  • People receiving radiation therapy for cancer now or in the past 6 months
  • People receiving or who have previously received targeted cancer treatments that can affect the immune system such as CAR-T cell treatments in the past 6 months
  • Anyone with blood or bone marrow cancer (such as leukemia, lymphoma, myeloma, myelodysplastic disorders)
  • People who have had a bone marrow or stem cell transplant in the past 6 months, or are still taking immunosuppressant medicine related to your transplant

If you believe you are in the CEV group but you have not been contacted by the provincial immunization program, please visit gov.bc.ca/getvaccinated or call: 1-833-838-2323 and provide your Personal Health Number. The registration system or phone agent will confirm if you are eligible.  


If you are still unsure, please speak with your care team. 

Coming to your appointment: what you need to know

‎If you are feeling well, please go to your appointment. 


If you have cold or flu-like symptoms, such as cough, fever or shortness of breath, call your cancer centre. Your appointment may need to be rescheduled.


If you are self-isolating after travelling, please do not come to the cancer centre. Call the centre and speak to staff about any appointments you have. 

We may offer you a virtual appointment. Please follow instructions from your health care team.  

Despite easing of restrictions under the Phase 3 restart plan, essential visitor policies remain in place in hospital and clinical settings. 


If you are a new patient and visiting a BC Cancer centre for the first time, you can bring one adult with you.

 

If you are having treatment or a follow-up appointment at a BC Cancer centre, you cannot bring someone with you. Please come by yourself.

 

If you need a support person at all of your appointments and treatments, please talk to your BC Cancer health care team.  

 

Thank you for helping us keep our patients and staff safe.

Right now, you do not have to pay for parking at BC Cancer Centres.  

If you are having a virtual appointment (also called a virtual health visit), please read our handout: 

How to prepare for your Virtual Health Visit

Despite easing of restrictions under the Phase 3 restart plan, essential visitor policies remain in place in hospital and clinical settings. 


All patients and visitors must wear a medical mask in all areas of BC Cancer centres. 


We will give you a medical mask when you arrive. If you are wearing a non-medical mask (like a cotton mask), you will have to take it off and wear the medical mask.

Cancer treatments and care

To speak with one of our counsellors, please see our Patient & Family Counselling page for phone numbers and information.

 

We are offering many of our programs through Zoom.  Please visit our Support Programs page for more information. 

 

If you are experiencing anxiety, worry or stress for any reason we have online tools to help you. 


BC Cancer pharmacies may be able to mail your prescriptions to you. Please call your BC Cancer pharmacy to order your refills.

 

You do not need to get extra refills during the COVID-19 pandemic. If you order more than you need ("stockpiling"), other people may not get the medication they need. 


Your BC Cancer pharmacist will tell you how much medication you need. 


If you are feeling unwell and need a refill on your medication, please do not visit the pharmacy. Call the pharmacy and they will make sure you get your medication safely.

All in-person systemic therapy (chemotherapy) teaching sessions are cancelled during the COVID-19 pandemic.


Right now, sessions are only available online:

Watch the Introduction to Systemic Therapy video here.


All new systemic therapy patients should watch this video. It is very important to watch the entire video so that you are prepared for your treatment.

‎Visit the Request Patient Records page for information. Follow the steps on that page.

This document will help you start thinking about advance care planning.

 

Visit our Advance Care Planning page for more information.

 

Please speak to your family doctor, nurse practitioner or BC Cancer health care team about advance care planning.

If you have concerns at any time during your care, please speak with your oncologist. 

 

If you still have concerns after this, we support you in contacting the Provincial Health Services Authority (PHSA) Patient Care Quality Office. You can speak to someone about your care experience.

 

Please visit the PHSA Patient Care Quality Office webpage for more information. 

Cancer screening programs

‎‎Many cancer screening services are being temporarily suspended at this time to assist in efforts to minimize COVID-19 transmission in healthy people and to allow the health system to focus resources on urgent and emergent care.

For more information please visit here

Cancer screening programs have started again.


For more information please visit our Screening Programs page.

COVID-19 and cancer: managing your risk

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.  

You should do your best to avoid getting COVID-19. This includes:


  • Wearing a mask when near other people, especially indoors.
  • Staying 2 metres (6 feet) from other people.
  • Washing your hands often with soap and water (20 to 30 seconds each time).
  • Not touching your face.
  • Covering your mouth and nose when coughing and sneezing.
  • Staying home when sick.

The BC Centre for Disease Control has a full list of things you can do to stay healthy and help stop the spread of COVID-19. ‎

Read their prevention and risk page here.

If you have cold, flu or COVID-19 symptoms, you should get a COVID-19 test.

Symptoms include:

  • Fever or chills
  • New or worsening cough
  • Shortness of breath (new or worsening)
  • Sore throat and painful swallowing
  • Stuffy or runny nose
  • Lose of sense of smell or taste
  • Headache
  • Muscle aches
  • Fatigue (tiredness)
  • Loss or appetite
  • Nausea or vomiting
  • Diarrhea

If you do not have any symptoms, you do not need a test. Your doctor or health care team may also decide if you need a test.

You can use the BC COVID-19 Self-Assessment Tool to help you decide if you need a test. You can do this assessment for yourself or for someone else if they are not able to.


If you have any symptoms, contact your cancer care team. Tell them how you are feeling. Some of your symptoms may be a side effect of treatment. Your oncologist will know more.




SOURCE: COVID-19 and Cancer - Information for Patients ( )
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