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Frequently Asked Questions about COVID-19 vaccines for people affected by cancer

Cancer Australia has compiled answers to Frequently Asked Questions (FAQs) about COVID-19 vaccines for people affected by cancer based on information and evidence currently available in Australia and internationally.

Updated 15 October 2021

People affected by cancer have many questions about the COVID-19 vaccines, including questions about:

  • Vaccines in general, as well as the COVID-19 vaccines in particular
  • When and where people affected by cancer can receive the COVID-19 vaccines
  • Whether the COVID-19 vaccines are safe and whether they work for people affected by cancer (safety and effectiveness)
  • Risks and side effects of the COVID-19 vaccines for people affected by cancer
  • Whether a person’s cancer care or other health care (such as flu vaccination) will be affected by the COVID-19 vaccines
  • How we will collect information about the use of the COVID-19 vaccines in people with cancer.

Cancer Australia has compiled these Frequently Asked Questions (FAQs) based on input from cancer clinicians and people affected by cancer, including via a roundtable meeting of key cancer control stakeholders, consultation with consumer representatives and organisations, and queries and concerns raised in social media. The answers to these FAQs are based on information and evidence currently available in Australia and internationally. This webpage is regularly updated as new information and evidence emerges.

This information is intended to supplement the broader information provided by the Australian Government for clinicians and the Australian community about COVID-19 vaccines in Australia, available at www.health.gov.au/COVID19-vaccines.

To print these FAQs, click here.

With the assistance of Aboriginal and Torres Strait Islander people and health experts, Cancer Australia has also developed dedicated FAQs about the COVID-19 vaccines for Aboriginal and Torres Strait Islander people with cancer and complementary FAQs for their healthcare team.

With the assistance of NSW Multicultural Health Communication Service translators and checkers, these FAQs have been translated into the ten most commonly spoken languages in Australia other than English: Arabic (العربية); Chinese, Simplified (简体中文); Chinese, Traditional (繁體中文); Greek (Ελληνικά); Hindi (हिन्दी); Italian (Italiano); Korean (한국어); Spanish (Español); Tagalog (Tagalog); Vietnamese (Tiếng Việt). For FAQs in your language, visit www.canceraustralia.gov.au/CALD.


General information about the COVID-19 vaccines

What is a vaccine? How does it work?

Vaccines are a way of producing an immune response in the body without causing illness. Vaccines strengthen a person’s immune system by training it to recognise and fight against specific infections.

Vaccines use weakened (or inactivated) viruses or parts of the virus (such as a protein) to make our bodies think we have already had a particular disease. When a person is vaccinated against a disease, their immune system can quickly recognise and clear out bacteria and viruses that can cause serious illnesses from that disease.

What is a COVID-19 vaccine? How does it work?

The COVID-19 vaccines strengthen a person’s immune system by training it to recognise and fight something that is specific to COVID-19. For most of the COVID-19 vaccines, this specific thing is the coronavirus ‘spike’ protein.

The spike protein is not the virus itself - it is the ‘pointy’ bit of the coronavirus cell which helps the virus enter people’s bodies. The COVID-19 vaccines that are available in Australia train our immune system to recognise this spike protein as foreign and produce long-lasting immune cells and antibodies to fight it.

None of the COVID-19 vaccines approved for use in Australia use the live or whole virus that causes COVID-19.1 The COVID-19 vaccines cannot give you COVID-19.

How are the COVID-19 vaccines tested for safety before they are approved for use in Australia?

Australia has strict requirements for the testing and approval of vaccines. Before a COVID-19 vaccine is approved for use in Australia, it must:

  • pass several different phases of clinical trials to prove the vaccine is safe and effective; and
  • pass the Therapeutic Goods Administration’s (TGA) rigorous assessment and approval processes. This includes assessment of the vaccine’s safety, quality and effectiveness.

For more information, visit How COVID-19 vaccines are tested and approved on the Australian Government Department of Health website.

Which COVID-19 vaccines are available in Australia?

Australia has entered into five separate agreements for the supply of COVID-19 vaccines, if they are proved to be safe and effective.2

  1. Pfizer/BioNTech (also known as Comirnaty). This vaccine has been provisionally approved by the Therapeutic Goods Administration (TGA) for people 12 years and older.3,4
  2. University of Oxford/AstraZeneca (also known as Vaxzevria). This vaccine has been provisionally approved by the TGA for people 18 years and older.
  3. Moderna (also known as Spikevax). This vaccine has been provisionally approved by the TGA for people 12 years and older.6 
  4. Novavax. This vaccine is currently undergoing TGA evaluation.
  5. COVAX Facility. The COVAX Facility is a global effort to support rapid, fair, and equitable access to COVID-19 vaccines. This agreement allows Australia to buy vaccine doses via the COVAX Facility for the Australian population as well as up to 92 lower-income countries as they become available. Before vaccines become available, they must be approved for use in Australia by the TGA.

What is the difference between the COVID-19 vaccines available in Australia? How does each vaccine work?

Three different COVID-19 vaccines have been approved for use in Australia (the Pfizer, AstraZeneca and Moderna vaccines), but many other vaccines are still being tested in clinical trials.

There are several different types of COVID-19 vaccines. All COVID-19 vaccines aim to cause an immune response specific to the COVID-19 coronavirus without causing illness. Most of the vaccines use the coronavirus ‘spike’ protein to cause an immune response.

You might hear some of the scientific terms for the different types of vaccines, including “mRNA vaccines”, “viral vector vaccines”, and “protein-based vaccines”.

  • Messenger RNA vaccines (or mRNA vaccines) use a genetic code called ribonucleic acid (RNA) to spark the production of the coronavirus’ specific spike protein. The Pfizer and Moderna vaccines are mRNA vaccines. The vaccine cannot change your DNA or genes.
  • Viral vector vaccines use a safe, weakened animal virus which contains the genetic code for a protein unique to the coronavirus, usually the spike protein, to prompt an immune response. The AstraZeneca vaccine is a viral vector vaccine.
  • Protein-based vaccines use a non-infectious component of the coronavirus, usually the spike protein (manufactured in a laboratory), to prompt an immune response. The Novavax vaccine is a protein-based vaccine.1

Which COVID-19 vaccine is suitable for which age group?

The Pfizer and Moderna vaccines are available for all people aged 12 years and over, and the AstraZeneca vaccine is available for all people aged 18 years and older. 

For adults aged under 60 years, the Australian Technical Advisory Group on Immunisation (ATAGI) recommends that the Pfizer or Moderna COVID-19 vaccines are preferred over the AstraZeneca vaccine.7-9  

The prioritisation of the Pfizer or Moderna vaccines for adults aged under 60 years is based on a potentially increased risk of a rare but serious side effect involving thrombosis (clotting) with thrombocytopenia (low blood platelet count) following the AstraZeneca vaccine in those under 60 years.

However, people aged between 18-59 years can choose to receive the AstraZeneca vaccine if the person has made an informed decision based on an understanding of the risks and benefits.8,9 

In the context of a COVID-19 outbreak, ATAGI recommends that people under the age of 60 should strongly consider the AstraZeneca vaccine if they are unable to access the Pfizer or Moderna vaccines.8-10

People who have had the first dose of the AstraZeneca vaccine without any serious adverse effects can be given the second dose, including adults under 60 years.8 

The Pfizer or Moderna vaccines are also the recommended COVID-19 vaccines for pregnant women.9

For adults aged 60 years and over, the individual benefits of receiving a COVID-19 vaccine are greater than in younger people. The risks of severe outcomes of COVID-19 infection increase with age and are particularly high in older unvaccinated people. ATAGI continues to advise that the benefit of vaccination with the AstraZeneca vaccine in preventing COVID-19 outweighs the risk of thrombosis (clotting) with thrombocytopenia (low blood platelet count) in this age group.7,8

The Australian Government Department of Health has developed a guide about the benefits and risks of the AstraZeneca vaccine showing the potential benefits and harms associated with the use of the AstraZeneca vaccine by age group.

For more information, visit the following information on the Australian Government Department of Health website:

 

Getting the COVID-19 vaccines - for people with cancer

When and where can people affected by cancer receive their COVID-19 vaccine?

The Australian Government's COVID-19 vaccine national roll-out strategy commenced in February 2021.

Currently, all people in Australia aged 12 years or older are eligible to receive a COVID-19 vaccine now. 

For people affected by cancer, decisions about when and where to receive the COVID-19 vaccine may be made on an individual basis by the person affected by cancer, in consultation with their healthcare team.

Vaccines are available through Commonwealth Vaccine Clinics, participating general practices, Aboriginal Community Controlled Health Services, state and territory-operated vaccination clinics, and community pharmacies. In addition, the Royal Flying Doctor Service is providing vaccinations in some remote communities.

For more information about where the COVID-19 vaccines will be available, visit:

Who will give (administer) the COVID-19 vaccines to people with cancer?

The decision about who will give people with cancer their COVID-19 vaccine may be made on an individual basis, together with their healthcare team.

Only qualified healthcare professionals can administer the COVID-19 vaccines. Additionally, every healthcare professional who administers the COVID-19 vaccines must complete compulsory COVID-19 vaccination training which covers the handling and administration of COVID-19 vaccines.11

For more information about the training required in order to administer the COVID-19 vaccines, visit COVID-19 vaccination training program on the Australian Government Department of Health website.

Will people with cancer receive a different dosage of the COVID-19 vaccine?

People with cancer are offered the same COVID-19 vaccines as the rest of the Australian population.

Most people in Australia require 2 doses of the COVID-19 vaccines.2

  • The 2 doses of the Pfizer vaccine should be given 3 weeks apart. It is particularly important for people with cancer to get the second dose of the vaccine as close to 3 weeks after the first dose as possible to ensure they are adequately protected from COVID-19.12,13
  • The 2 doses of the AstraZeneca vaccine can be safely administered between 4-12 weeks apart. The Australian Technical Advisory Group on Immunisation (ATAGI) recommends 12 weeks between the first and second dose for maximal vaccine efficacy; however, in the context of a COVID-19 outbreak setting, an interval of between 4 and 8 weeks is preferred.10
  • It is recommended that the 2 doses of the Moderna vaccine are given 4-6 weeks apart (in special circumstances the interval may be longer).14

ATAGI now recommends a 3rd primary dose of COVID-19 vaccine in severely immunocompromised people to address the risk of a suboptimal response to the standard 2 dose schedule. The recommended interval for the 3rd dose is 2 to 6 months after the 2nd dose of vaccine. The 3rd dose is intended to maximise the immune response, to as close as possible to the general population.15

This recommendation applies to all people aged 12 years or over with certain conditions, including cancer, or treatments which lead to severe immunocompromise. This includes the following:

  • People with active blood (haematological) cancer
  • People with other (non-haematological) cancers, on current active treatment including chemotherapy, radiotherapy, and/or hormonal therapy, but excluding immunotherapy with immune checkpoint inhibitors
  • People who have had a solid organ transplant with immunosuppressive therapy
  • People who have had a stem cell transplant or chimeric antigen receptor T-cell (CAR-T) therapy within 2 years of transplantation.

For more information on the populations in which a 3rd primary dose of the COVID-19 vaccine is recommended and the type of vaccine recommended, visit:

ATAGI will continue to monitor the evidence around the need for additional "booster" doses of the COVID-19 vaccines in the future.

Why is it important for people with cancer and their carers to receive the vaccine?

People who have been diagnosed with cancer and are undergoing cancer treatments can have weaker immune systems. People with compromised immune systems as a side effect of cancer treatments, or from the cancer itself, may be at increased risk of contracting COVID-19 and increased risk of more severe infection.

In most cases, COVID-19 infection resolves within weeks of symptoms developing; however, some people may experience lingering symptoms that last for months, known as "long COVID-19".16 Emerging evidence from a study currently being conducted in the UK shows that up to 15% of cancer patients who had been infected with COVID-19 experienced lingering symptoms, including respiratory symptoms, chronic fatigue, and cognitive or psychological dysfunction, which could impact on their cancer outcomes.17

Vaccination protects you from having severe illness and needing to go to hospital as a result of getting COVID-19. Those living in the same household as a person with cancer, as well as caregivers or other close contacts of a person with cancer, should also get vaccinated. 

For more information:

Why is it important for people with cancer to receive the full course of the COVID-19 vaccine?

It is important for all people to get the recommended dosage of the COVID-19 vaccine they are offered. However, this may be particularly important for people with cancer.

Results from studies using the Pfizer vaccine found that cancer patients had lower levels of protection from the SARS-CoV-2 virus (the virus that causes COVID-19) following the first dose of the vaccine, compared to people without cancer. However, when cancer patients received their second dose 3 weeks after the first dose, protection against the SARS-CoV-2 virus improved significantly.12, 13, 18, 19

When people who have lower COVID-19 protection come into contact with the virus, they are more vulnerable to COVID-19 and also risk spreading the virus to their close contacts, such as family and carers.

Even after receiving the vaccine, it is still important for people affected by cancer in Australia, and their close contacts, to continue taking other protective measures against COVID-19, including practising good hygiene and maintaining physical distancing.

 

Safety and effectiveness

Were people with cancer included in the initial clinical trials for the COVID-19 vaccines?

People with cancer were not included in the initial clinical trials for the COVID-19 vaccines. This is because clinical trials typically need to see whether the vaccines will work in people with healthy immune systems.20

Is it safe for people with cancer or people who have a weaker immune system (are immunocompromised) to get the COVID-19 vaccines?

Many cancer organisations internationally currently recommend COVID-19 vaccination for people with cancer and those with a weaker immune system (this is also known as being immunocompromised).21-23 This is because:

  • People with cancer are more vulnerable to contracting COVID-19 and are at an increased risk of more severe infection.21, 24-32
  • Similar evidence from use of other vaccines suggests that COVID-19 vaccines may be safe and effective for people with cancer.21, 33-35

Because people with cancer were not included in the initial clinical trials, there is limited evidence about whether the COVID-19 vaccines are safe for people with cancer, or people who are immunocompromised because of cancer or cancer treatments. However, in principle there are no theoretical additional safety concerns for either the Pfizer or Moderna COVID-19 vaccines (a non-live vaccine) or the AstraZeneca COVID-19 vaccine* (a non-replicating viral vector vaccine) in people who are immunocompromised, on the basis of a general understanding of the vaccines.9 Information is being collected from COVID-19 vaccination programs internationally, and so far, there have been no reports of any significant safety issues specific to people with cancer receiving the COVID-19 vaccines in other countries. This will continue to be monitored.

The Australian Technical Advisory Group on Immunisation (ATAGI) recommend people who are immunocompromised should be among the priority groups to receive the COVID-19 vaccines because of their increased risk of severe illness with COVID-19.9

The decision about whether to receive a COVID-19 vaccine should be made on an individual basis by the person affected by cancer, in consultation with their healthcare team.

For more information, visit the following information on the Australian Government Department of Health website:

* With regard to safety concerns about the AstraZeneca vaccine: So far, no specific biological risk factors or pre-existing medical conditions have been found to increase or decrease the risk of thrombosis (clotting) with thrombocytopenia (low blood platelet count) occurring after the AstraZeneca vaccine.7

Do the COVID-19 vaccines work for people affected by cancer (are they effective)?

Emerging evidence from international studies suggests the COVID-19 vaccines have similar effectiveness and safety in people with cancer compared to people without cancer.18, 36, 37 

Although there is limited evidence from the initial clinical trials about whether the COVID-19 vaccines work for people affected by cancer, we do have a lot of similar evidence from use of other vaccines that suggests the COVID-19 vaccines may be effective for people affected by cancer:

  • Evidence from flu vaccinations suggests that people affected by cancer can mount a protective immune response from COVID-19 vaccines (that is, whether their immune system becomes trained to recognise and fight against specific germs). However, the level of immunity may be affected by a range of factors (such as cancer type, therapies, and immune function).21
  • There is evidence from other vaccinations used to prevent infection to support their use for people affected by cancer, even in those undergoing immunosuppressive therapy.21, 33-35

However, the immune response to vaccination may be reduced in people who are immunocompromised, which may result in lower vaccine effectiveness and protection compared to people who are not immunocompromised.9 This is why a 3rd primary dose of COVID-19 vaccine is recommended in severely immunocompromised people.15

In addition, results from studies using the Pfizer vaccine found that cancer patients had lower levels of protection from the SARS-CoV-2 virus (the virus that causes COVID-19) following the first dose of the vaccine, compared to people without cancer. However, when cancer patients received their second dose 3 weeks after the first dose, protection against the SARS-CoV-2 virus improved significantly.12, 13, 18, 19

Even after receiving the vaccine, it is important for people affected by cancer (especially those who are immunocompromised) and any close contacts, to continue taking other protective measures against COVID-19, including  practising good hygiene and maintaining physical distancing. 

What factors should a person affected by cancer consider when deciding about when to get the COVID-19 vaccine?

For people with cancer, the decision about when to receive a COVID-19 vaccine should be made on an individual basis by the person affected by cancer in consultation with their healthcare team. Factors to consider include:

  • The type of cancer the person has/had
  • The type of treatment they are receiving/received
  • The timing of their treatment
  • The type(s) of vaccine(s) available
  • How their immune system is working.20

For example, some cancer treatments (like chemotherapy, radiation therapy, or immunotherapy) can affect the immune system, which might make the vaccine less effective in some people.20

For more information, visit the Australian Technical Advisory Group on Immunisation’s (ATAGI) COVID-19 vaccination decision guide for people with immunocompromise 

 

Risks and side effects

If I have allergies, should I avoid any of the COVID-19 vaccines?

People who have had an allergic reaction or a severe allergic reaction (anaphylaxis) to any ingredients contained in the COVID-19 vaccines should avoid the specific COVID-19 vaccine(s) that contain those ingredients. Talk to your healthcare team if you have had an allergic reaction or anaphylaxis to any medication (including chemotherapy) in the past.

The ingredients for each of the COVID-19 vaccines can be found in the ‘Product details’ section of their ‘Consumer Medicines Information’ leaflet, available on the TGA website:

  • Click here for the Cominarty [Pfizer] Consumer Medicines Information leaflet
  • Click here for the Vaxzeria [AstraZeneca] Consumer Medicines Information leaflet.
  • Click here for the Spikevax [Moderna] Consumer Medicines Information leaflet.

Allergies that may be particularly relevant to people affected by cancer include allergies to polysorbate 80, which is one of the ingredients in the AstraZeneca vaccine, and polyethylene glycol (PEG) which is one of the ingredients in the Pfizer vaccine. These ingredients are also used in cancer treatments, such as chemotherapy medications, docetaxel and paclitaxel. If you have had an allergic reaction or anaphylaxis in response to polysorbate 80 or PEG, speak to your health professional or seek expert advice on COVID-19 vaccination before being vaccinated.38-40

What are the side effects of the COVID-19 vaccines for people affected by cancer?

Currently, there is no evidence to suggest that people affected by cancer will experience different or worse side effects to the COVID-19 vaccines.

In general, common side effects from the COVID-19 vaccines are similar to those of other vaccines, including:

  • Pain, redness and/or swelling where you received the needle
  • Muscle pain/aches
  • Mild fever
  • Headache
  • Tiredness.41

These side effects are usually mild and usually go away within one or two days.

Thrombosis (clotting) and the AstraZeneca vaccine 

On 8 April 2021, the Australian Technical Advisory Group on Immunisation (ATAGI) issued a statement on the AstraZeneca vaccine in response to new vaccine safety concerns.7

ATAGI noted further evidence of a rare but serious side effect involving thrombosis (clotting) with thrombocytopenia (low blood platelet count) after receiving the AstraZeneca vaccine.

ATAGI recommends that the Pfizer or Moderna vaccines are preferred over the AstraZeneca vaccine in adults aged under 60 years. This recommendation is based on the increasing risk of severe outcomes from COVID-19 in older adults (and hence a higher benefit from vaccination) and a potentially increased risk of thrombosis with thrombocytopenia following the AstraZeneca vaccine in those under 60 years. However, people aged between 18-59 years can choose to receive the AstraZeneca vaccine if the person has made an informed decision based on an understanding of the risks and benefits.8,9 In the context of a COVID-19 outbreak where the supply of Pfizer is limited, ATAGI recommends that people under the age of 60 should strongly consider the AstraZeneca COVID-19 Vaccine if they are unable to access Pfizer or Moderna vaccines.8-10

People who have had the first dose of the AstraZeneca vaccine without any serious adverse effects can be given the second dose, including adults under 60 years. 

The Pfizer or Moderna vaccines are also the recommended COVID-19 vaccines for pregnant women.9

For more information, visit the following information on the Australian Government Department of Health website:

The Therapeutic Goods Administration (TGA) is monitoring the ongoing safety of the COVID-19 vaccines, and this webpage will be updated as new information emerges.

What do I do if I have a side effect (adverse event) after receiving the COVID-19 vaccine?

Serious reactions to the COVID-19 vaccines are extremely rare. 

All people who receive the COVID-19 vaccine should wait at least 15 minutes before leaving the vaccination clinic in case a serious reaction occurs. If you have a history of anaphylaxis (a severe allergic reaction) to anything, you should wait at least 30 minutes before leaving.

If you experience a side effect (adverse event) after receiving the vaccine, you should contact a member of your treating healthcare team, or call the National Coronavirus Helpline on 1800 020 080, available 24 hours a day.

Adverse events should be reported to the Therapeutic Goods Administration (TGA). This helps the TGA monitor the ongoing safety of the vaccine, and if any safety risks become evident, the TGA can inform the community and health providers as soon as possible. Adverse events can be reported to the TGA by you or a health professional, and can be done via an online form, by email, or by phone.

For more information, visit Report a problem or side effect on the TGA website.

Are there any potential risks for people who have, or are at risk of, lymphoedema (swelling)?

Lymphoedema is swelling of a part of the body and can be a side effect of cancer treatment. Within the areas of the body affected by lymphoedema, the immune cells which fight infection may not work as well. Vaccination into these areas may therefore result in a weaker immune response and less protection from COVID-19. Damage to the skin within an area of lymphoedema can also act as an entry site for infection, so careful skin care and protection is advisable for areas of swelling. As a precaution the COVID-19 vaccine should be given in the untreated limb if possible.42, 43

Are there any potential risks relating to people with bleeding disorders and people who are taking blood thinners?

People with bleeding disorders, those receiving antiplatelet or anticoagulant therapy (blood thinners) and those with low platelet counts may have an increased risk of bleeding or significant bruising at the site where the COVID-19 vaccine was given,44 which can be painful for the person. Talk to your health professional if you are concerned about any medication you are taking, before being vaccinated.

 

Impacts and interactions

Will the COVID-19 vaccines affect or interact with my cancer treatment(s)? 

Currently, there is limited information available from COVID-19 vaccines clinical trials about whether the COVID-19 vaccines will affect or interact with cancer treatments. This is because the initial clinical trials for the COVID-19 vaccines did not include people with cancer.

Recommendations vary and there are a number of factors to consider for every individual, including:

  • The type of cancer you have/had
  • The type of treatment you are receiving/received
  • The timing of the treatment you are receiving/received
  • The type(s) of vaccine(s) available
  • How your immune system is working. 

There are some theoretical risks of immune-related side effects for COVID-19 vaccination for people receiving immunotherapy, including checkpoint inhibitors such as pembrolizumab, nivolumab and ipilimumab. However, international cancer organisations and Australian experts recommend vaccination after weighing the benefit of vaccination against risk.22, 45

Optimal responses to the vaccine are more likely more than 3-6 months after stem cell transplant or CAR-T cell therapy.46

If you are having treatment for cancer, speak to your healthcare team about the best timing for you based on your own situation.

Some organisations have provided recommendations for health professionals about the timing of the COVID-19 vaccines and cancer treatments.39 These are located at COVID-19 vaccines and cancer – health professional guidance on the Cancer Australia website.

Does the COVID-19 vaccine impact screening and diagnostic mammograms?

There have been some reports internationally about people who have received a COVID-19 vaccine having lymph node swelling which is being mistaken for possible breast cancer. This swelling occurs in the lymph glands in the underarm area and is known as lymphadenopathy. Lymphadenopathy is an immune system response to an infection or a vaccine. However, as lymphadenopathy is also a symptom of breast cancer, this may lead to a false positive mammogram result; that is, that the mammogram may look abnormal even though there is no cancer actually present.

The Royal Australian and New Zealand College of Radiologists (RANZCR) does not recommend delays to COVID-19 vaccination nor any breast imaging (screening mammogram or diagnostic imaging for breast cancer symptoms).47 However, women having a mammogram should tell their healthcare professional if they have been recently vaccinated.

For more information, visit:

Can people with cancer get the COVID-19 vaccine at the same time as the influenza (flu) vaccine?

No, it is generally recommended that people do not receive the COVID-19 vaccine at the same time as the flu vaccine (or any other vaccine).

At least 7 days between the COVID-19 vaccine and the flu vaccine (or any other vaccine) is preferred. 

However, a shorter interval (including co-administration) is acceptable in some settings.9, 48

This advice is provided by the Australian Technical Advisory Group on Immunisation (ATAGI). The advice is based on a lack of evidence (not enough data) about how the COVID-19 vaccines and flu vaccines affect each other, or whether it is safe to give the two vaccines at the same time. This is precautionary advice, and may change as further information becomes available.

For more information, visit:

 

Collecting information about the use of the COVID-19 vaccines in people affected by cancer

Is any data being collected about the COVID-19 vaccines for people affected by cancer?

Data about the use of the COVID-19 vaccines can help us better understand the safety and effectiveness of the COVID-19 vaccines for people affected by cancer.

Cancer Australia has established an important clinical study to better understand the safety and efficacy of the COVID-19 vaccines in people with cancer, including in people with solid tumours and blood (haematological) malignancies. Monash Health, Victoria have been engaged to develop and implement an Australian clinical trial based on the US National Cancer Institute (NCI) Serological Sciences Network for COVID-19 (SeroNet) framework, which uses innovative technology to examine the safety and efficacy of COVID-19 vaccines in cancer patients. The study has been called SerOzNET to highlight the unique population it will study. The study is now also recruiting children with cancer aged 12-18 years through the Sydney Children's Hospitals Network.

Rapid implementation of this study will allow timely information to be provided to the Australian cancer community about the safety and efficacy of the COVID-19 vaccines in people with cancer.

For more information about the SerOzNET study, visit www.canceraustralia.gov.au/SerOzNET-Study.

Cancer Australia is also monitoring data on the safety and effectiveness of the COVID-19 vaccines for people affected by cancer from international vaccination programs, and we will provide more information here as it becomes available.

 

References

1 Australian Department of Health. How COVID-19 vaccines work [Internet]. Canberra ACT: Australian Department of Health; 2021 [updated 2021 Jan 29, cited 2021 Feb 04]. Available from:   https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/about-covid-19-vaccines/how-covid-19-vaccines-work.

2 Australian Department of Health. Australia’s vaccine agreements [Internet]. Canberra ACT: Australian Department of Health; 2021[updated 2021 Feb 3, cited 2021 Feb 04]. Available from: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/about-covid-19-vaccines/australias-vaccine-agreements.

3 Therapeutic Goods Administration. TGA provisionally approves Pfizer COVID-19 vaccine [Internet]. Canberra ACT: Therapeutic Goods Administration; 2021 Jan 25 [cited 2021 Feb 04]. Available from: https://www.tga.gov.au/media-release/tga-provisionally-approves-pfizer-covid-19-vaccine.

4 Therapeutic Goods Administration. TGA Provisional Approval of Pfizer-BioNTech COVID-19 vaccine to include 12-15 years age group. Canberra, ACT: Therapeutic Goods Administration; 2021 Jul 23 [cited 2021 Jul 30]. Available from: https://www.tga.gov.au/tga-provisional-approval-pfizer-biontech-covid-19-vaccine-include-12-15-years-age-group.

5 Therapeutic Goods Administration. COVID-19 Vaccine: AstraZeneca ChAdOx1-S. Canberra ACT: Therapeutic Goods Administration; 2021 Feb 16 [cited 2021 Feb 17]. Available from: https://www.tga.gov.au/covid-19-vaccine-astrazeneca-chadox1-s.

6 Therapeutic Goods Administration. COVID-19 vaccine: Spikevax (elasomeran). Canberra, ACT: Therapeutic Goods Administration; 2021 Sep 4 [cited 2021 Sep 6]. Available from: https://www.tga.gov.au/covid-19-vaccine-spikevax-elasomeran.

7 Australian Department of Health. ATAGI statement on revised recommendations on the use of COVID-19 Vaccine AstraZeneca, 17 June 2021 Canberra, ACT: Australian Department of Health; 2021 Jun 17 [cited 2021 June 17]. Available from: https://www.health.gov.au/news/atagi-statement-on-revised-recommendations-on-the-use-of-covid-19-vaccine-astrazeneca-17-june-2021.

Australian Department of Health. About the AstraZeneca COVID-19 vaccine Canberra, ACT: Australian Department of Health; 2021 [updated 2021 Jul 14; cited 2021 Jul 14]. Available from: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/learn-about-covid-19-vaccines/about-the-astrazeneca-covid-19-vaccine.

9 Australian Technical Advisory Group on Immunisation (ATAGI). COVID-19 vaccination – ATAGI clinical guidance on COVID-19 Vaccine in Australia in 2021. Canberra, ACT: ATAGI; 2021 [updated 2021 Jun 10; cited 2021 Jun 16]. Available from: https://www.health.gov.au/resources/publications/covid-19-vaccination-atagi-clinical-guidance-on-covid-19-vaccine-in-australia-in-2021

10 Australian Department of Health. COVID-19 vaccination program Phase 1b Canberra, ACT: Australian Department of Health; 2021 [updated 2021 May 05; cited 2021 May 06]. Available from: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/phase-1b.

11 Australian Department of Health. Mobilising Australia’s COVID-19 vaccine workforce [Internet]. Canberra ACT: Australian Department of Health; 2021 Jan 21 [cited 2021 Feb 04]. Available from: https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/mobilising-australias-covid-19-vaccine-workforce.

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14 Australian Department of Health. COVID-19 vaccination - Information on Spikevax [Moderna] COVID-19 vaccine. Canberra, ACT: Australian Department of Health; 2021 Sep 7 [updated 2021 Sep 23; cited 2021 Sep 30]. Available from: https://www.health.gov.au/resources/publications/covid-19-vaccination-information-on-spikevax-moderna-covid-19-vaccine.

15 Australian Department of Health. ATAGI recommendations on the use of a third primary dose of COVID-19 vaccine in individuals who are severely immunocompromised. Canberra, ACT: Australian Department of Health; 2021 Oct 08 [cited 2021 Oct 08]. Available from: https://www.health.gov.au/resources/publications/atagi-recommendations-on-the-use-of-a-third-primary-dose-of-covid-19-vaccine-in-individuals-who-are-severely-immunocompromised.

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21 European Society for Medical Oncology. COVID-19 vaccination in cancer patients: ESMO statements [Internet]. Lugano: European Society for Medical Oncology; 2020 [cited 2021 Feb 04]. Available from: https://www.esmo.org/covid-19-and-cancer/covid-19-vaccination.

22 National Comprehensive Cancer Network. NCCN COVID-19 Vaccination Guide for People with Cancer. USA: National Comprehensive Cancer Network; 2021 Jun 10 [cited 2021 Jul 12]. Available from: https://www.nccn.org/docs/default-source/covid-19/covid-vaccine-and-cancer-05.pdf?sfvrsn=45cc3047_2.

23 Thirumalairaj R, Parikh PM, Agarwal A, et al. South Asian Declaration-Consensus Guidelines for COVID-19 Vaccination in Cancer Patients. South Asian J Cancer. 2021;10(1):3-8.

24 Liang W, Guan W, Chen R, Wang W, Li J, Xu K, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020 Mar 01;21(3):335-7.

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28 Lai AG, Pasea L, Banerjee A, Denaxas S, Katsoulis M, Chang WH, et al. Estimating excess mortality in people with cancer and multimorbidity in the COVID-19 emergency. medRxiv. 2020; doi:10.1101/2020.05.27.20083287.

29 Moujaess E, Kourie HR, Ghosn M. Cancer patients and research during COVID-19 pandemic: A systematic review of current evidence. Crit Rev Oncol Hematol. 2020 Jun;150:102972.

30 Wang Q, Berger NA, X R. Analyses of Risk, Racial Disparity, and Outcomes Among US Patients With Cancer and COVID-19 Infection. JAMA Oncol. 2020 Dec 10;doi:10.1001/jamaoncol.2020.6178.

31 Rüthrich MM, Giessen-Jung C, Borgmann S, Classen AY, Dolff S, Grüner B, et al. COVID-19 in cancer patients: clinical characteristics and outcome – an analysis of the LEOSS registry. Ann Hematol. 2021;100(2)383-393.

32 Venkatesulu BP, Chandrasekar VT, Girdhar P, Advani P, Sharma A, Elumalai T, et al. A systematic review and meta-analysis of cancer patients affected by a novel coronavirus. medRxiv. 2020 May 29;doi: 10.1101/2020.05.27.20115303.

33 Cordonnier C, Einarsdottir S, Cesaro S, Di Blasi R, Mikulska M, Rieger C, et al. Vaccination of haemopoietic stem cell transplant recipients: guidelines of the 2017 European Conference on Infections in Leukaemia (ECIL 7). Lancet Infect Dis. 2019; 19(6):e200-e212.

34 Mikulska M, Cesaro S, de Lavallade H, Di Blasi R, Einarsdottir S, Gallo G, et al. Vaccination of patients with haematological malignancies who did not have transplantations: guidelines from the 2017 European Conference on Infections in Leukaemia (ECIL 7). Lancet Infect Dis. 2019 Jun; 19(6):e188-e199.

35 Rieger CT, Liss B, Mellinghoff S, Buchheidt D, Cornely OA, Egerer G, et al. Anti-infective vaccination strategies in patients with hematologic malignancies or solid tumors-Guideline of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO). Ann Oncol. 2018 Jun 01; 29(6):1354-1365.

36 Thomas SJ, Perez JL, Lockhart SP, et al. 1558O COVID-19 vaccine in participants (ptcpts) with cancer: Subgroup analysis of efficacy/safety from a global phase III randomized trial of the BNT162b2 (tozinameran) mRNA vaccine. Ann Oncol. 2021;32(suppl_5):S1129-S1163.

37 Oosting S, Van der Veldt AAM, GeurtsvanKessel CH, et al. LBA8 Vaccination against SARS-CoV-2 in patients receiving chemotherapy, immunotherapy, or chemo-immunotherapy for solid tumours. Ann Oncol. 2021;32(supple_5):S1283-S1346. 

38 COVID-19 Vaccine AstraZeneca (ChAdOx-1-S) solution for injection 5mL multidose vial [CMI]. Macquarie Park, NSW: AstraZeneca Pty Ltd; 2021 [cited 2021 Feb 23]. Available from: https://tga-search.clients.funnelback.com/s/search.html?collection=tga-artg&profile=record&meta_i=349072.

39 Medical Oncology Group of Australia. COVID-19 vaccination in patients with solid tumours: Medical Oncology Group of Australia Position Statement: Medical Oncology Group of Australia; 2021 [updated 2021 Apr 26; cited 2021 May 06]. Available from: https://www.moga.org.au/all-position-statements/covid-19-vaccination-in-patients-with-solid-tumours.

40 Australasian Society of Clinical Immunology and Allergy (ASCIA). Allergy, Immunodeficiency, Autoimmunity and COVID-19 Vaccination Position Statement: ASCIA; 2021 Apr 14 [cited 2021 May 06]. Available from: https://www.allergy.org.au/hp/papers/ascia-hp-position-statement-covid-19-vaccination.

41 Australian Department of Health. What happens after I am vaccinated for COVID-19? [Internet]. Canberra ACT: Australian Department of Health; 2021 [updated 2021 Feb 22, cited 2021 Feb 23] Available from: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/learn-about-covid-19-vaccines/what-happens-after-i-am-vaccinated-for-covid-19.

42 British Lymphology Society and The Lymphoedema Support Network. Consensus document on COVID-19 vaccination for patients with lymphoedema [cited 2021 Feb 24]. Available from: https://www.thebls.com/documents-library/consensus-document-on-covid-19-vaccination-for-patients-with-lymphoedema.

43 Cancer Australia. Lymphoedema — what you need to know. Cancer Australia: Surry Hills, NSW; 2012.

44 Haematology Society of Australia and New Zealand. COVID-19 Vaccination in Haematology Patients: An Australia and New Zealand Consensus Position Statement [cited 2021 Feb 24]. Available from: https://www.hsanz.org.au/news/10054698.

45 UK Chemotherapy Board. Clinician Frequently Asked Questions (FAQs) and guidance on COVID19 vaccine for patients receiving Systemic Anti-Cancer Therapy. Accessed 2 Mar 2021. https://4bd2316d-e45d-4e90-96b5-431f1c12dd3e.filesusr.com/ugd/638ee8_bc24796daf974cfa830a432248401191.pdf.

46 Hamad N, Ananda-Rajah M, Gilroy N, et al. Australia and New Zealand Transplant and Cellular Therapies COVID-19 vaccination consensus position statement. Int Med J. 2021;51(8):1321-3.

46 The Royal Australian and New Zealand College of Radiologists. The Royal Australian and New Zealand College of Radiologists' Statement on Vaccine Induced Adenopathy: The Royal Australian and New Zealand College of Radiologists; 2021 March [cited 2021 May 06]. Available from: https://www.ranzcr.com/documents-download/professional-documents/position-papers/5272-position-statement-on-covid-vaccines-and-breast-screening.

48 Australian Department of Health. ATAGI advice on seasonal influenza vaccines in 2021 Canberra, ACT: Australian Department of Health; 2021 [updated 2021 Jun 08; cited 2021 Jun 16]. Available from: https://www.health.gov.au/resources/publications/atagi-advice-on-seasonal-influenza-vaccines-in-2021