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COVID-19 and Cancer - Information for Patients

Page updated: September 29, 2022


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 treatment information

For information about COVID-19 treatments, Government of BC's COVID-19 treatments webpage.

 

You can also read our patient letter, COVID-19 Treatments for People with Cancer.


Translated copies of the patient letter are available in: 

Vaccines remain the best way of protecting yourself against COVID-19. 

If you are immunocompromised or clinically extremely vulnerable you may benefit from COVID-19 treatments.


To be eligible for treatment, you must have mild or moderate symptoms that started in the past 5-7 days and a positive COVID-19 test result.

If you believe you may be eligible for treatment, please go to the Government of BC’s COVID-19 treatments webpage to review the criteria and complete the four-step request process. 

As part of this process, a doctor and pharmacist team will decide if treatment is safe and appropriate for you.

If you are receiving active cancer treatment and have questions about COVID-19 treatment and your cancer care, please contact your care team and read our patient letter, COVID-19 Treatments for People with Cancer.

Translated copies of the patient letter are available in: 

Go to the Government of BC's COVID-19 treatments webpage, review the criteria for treatment and start the 4 step request process or call the Service BC phone line: 1-888-COVID19 (1-888-268-4319).


OR

  • Contact your family doctor or nurse practitioner
  • If you do not have a family doctor or nurse practitioner, contact your local BC Cancer care team:
    • BC Cancer – Abbotsford: 604-851-4710
    • BC Cancer – Kelowna: 250-712-3900
    • BC Cancer – Prince George: 250-645-7300
    • BC Cancer – Surrey: 604-930-2098
    • BC Cancer – Vancouver: 604-877-6000
    • BC Cancer – Victoria: 250-519-5500

You should start the process as soon as possible. Delays may mean you are not able to receive treatment, because treatment must be started within 5-7 days of developing symptoms.


If you are receiving active cancer treatment and have questions about COVID-19 treatment and your cancer care, please contact your care team.

Evusheld is marketed as a preventative therapy for COVID-19 for people 12+ . 


Recent evidence however, indicates that it may not be helpful against the COVID-19 variants currently circulating in our community. The BCCDC has recently updated it’s guideline and this drug is not recommended as a preventative treatment in B.C., including in severely immunocompromised patients. 

COVID-19 vaccines and cancer

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: 

If you have not yet done so, please sign up on the Get Vaccinated website – www.gov.bc.ca/getvaccinated. 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.

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. 

 
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

Fall 2022 booster doses & flu shots

Invitations for the Fall 2022 booster are now being sent. People who are six months past their last dose will receive invitations for their Fall 2022 booster in the coming weeks.


A booster is an additional shot of vaccine that helps maintain protection against severe illness from COVID-19. The booster works even in people who had a good response to the initial doses.

Booster doses are offered to everyone aged 5 and over, six months after completing their last dose.

Anyone who is clinically extremely vulnerable and over the age of 12 will get the Moderna bivalent booster. You do not need an attestation letter. 


Invitations for the Fall 2022 booster are now being sent. People who are six months past their last dose will receive invitations for their fall booster in the coming weeks. 


For more information on the boosters, please visit: https://www2.gov.bc.ca/gov/content/covid-19/vaccine/booster 

For all people who are currently eligible for their Fall 2022 vaccine, they can also get the seasonal flu vaccine at the same time. 

Timing your COVID-19 vaccines

  • You can have the COVID-19 vaccine at the same time as your flu vaccine. 
  • You do not need to wait a certain amount of time before or after your COVID-19 vaccine to get any other type of vaccine, including the flu vaccine. 
  • For more on COVID-19 vaccine and timing with other vaccines, please visit BCCDC.
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). 

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

Please call your cancer centre if you have tested positive for COVID-19 and/or have any of the following symptoms:

·         Fever or chills

·         Cough

·         Difficulty breathing

·         Sore throat

·         Loss of sense of smell or taste

·         Headache

·         Extreme fatigue or tiredness

·         Diarrhea

·         Loss of appetite

·         Nausea or vomiting

·         Body aches

We may reschedule your appointment or offer you a virtual appointment


We are continuing to screen all patients, staff and visitors for respiratory symptoms and request that visitors show proof of vaccination. For more details about visitor guidelines at BC Cancer centres please see our visitor guidelines.

Please call your cancer centre if you:

·         Are required to self-isolate

·         Have a close contact who has COVID-19

We may reschedule your appointment or offer you a virtual appointment

Yes. You are allowed to bring up to two people with you. 


However, there may be times when you cannot bring visitors, depending on your treatment or the size of the clinic. Please check with your cancer care team to confirm. 


General visitor policies remain in place in hospital and clinical settings as outlined by the Ministry of Health.

We are continuing to screen all patients, staff and visitors for respiratory symptoms and request that visitors show proof of vaccination. For more details about visitor guidelines at BC Cancer centres please see our visitor guidelines.

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

Free parking is available for patients who are onsite for cancer treatment, such as care team appointments, chemotherapy, radiation therapy, dental care, laboratory tests, and imaging related to treatment.

 

Paid parking is required for people who do not have a cancer diagnosis, such as those undergoing consultation, screening or evaluation.

For more information and frequently asked questions about parking, visit our Parking for Patients page.

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, 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.


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.

COVID-19 symptoms can range from mild to severe. Sometimes people with COVID-19 have mild illness, but their symptoms may suddenly worsen in a few days. 


Please visit BCCDC's website here to see the list of COVID-19 symptoms.


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.




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