Are Covid-19 vaccines safe for cancer patients?
KUALA LUMPUR: With the National Covid-19 Immunisation Programme in full swing now, more individuals are coming forward to register for the vaccination. As of June 5, almost 13 million individuals had registered for the Covid-19 vaccine shots, up from 9.89 million on May 6, according to the Covid-19 Vaccine Supply Access Guarantee Special Committee. Currently, the second phase of the immunisation drive is under way during which senior citizens and people with comorbidities, who include cancer patients, will be inoculated. However, uncertainties over the safety of the vaccines for patients undergoing cancer treatment have led many of them to avoid registering for the vaccination. Their main concern is that the vaccine may interfere with their cancer treatment and increase their risk of developing other health complications. Mahkota Medical Centre consultant radiotherapist and oncologist Dr Chong Kwang Jeat, however, dismissed such fears, stressing that the Covid-19 vaccines are safe and that there is no evidence indicating that the vaccines are not safe for cancer patients. In fact, it is safer for the patients to opt for the vaccine to stay protected against Covid-19 because multiple studies conducted recently by medical professionals in countries such as China, the United States, United Kingdom and Italy have concluded a worse outcome for cancer patients who contract Covid-19 compared to those without underlying diseases. Vaccines are safe  With that being said, the risk of severe Covid-19 requiring intensive care unit (ICU) admission is more likely for cancer patients, Dr Chong told Bernama, adding that on the whole, the risk of death for a cancer patient who contracts Covid-19 is about 15 to 30 percent. He said this worse outcome of Covid-19 is particularly noted in patients with blood cancer who are immunocompromised or with lung cancer or active or advanced cancer currently on treatment and those with other comorbidities such as diabetes, hypertension, heart disease, kidney disease and obesity. Dr Chong said to address vaccine hesitancy among cancer patients, it is important to educate the public about the tremendous benefits and importance of vaccination through mainstream media and social media. There is also an urgent need to build public confidence and awareness through advocacy by public figures and healthcare professionals and curb the dissemination of misleading and irresponsible news and messages about vaccines, especially on social media. The people must know the risk of widespread non-vaccination as it can lead to a potential tsunami of Covid-19 cases that will ravage our healthcare system. We also need to emphasise that getting vaccinated is not only to protect oneself but the people around us and society as a whole. No one is safe until everyone is safe, added Dr Chong. Adhere to treatment  Dr Chong also said that the available data linking the higher risk of Covid-19 to cancer survivors is mixed. This is supported by a recent large British study which showed chemotherapy within the last 12 months was associated with severe disease and death from the virus, especially for those who received treatments that caused suppression of the immune system. However, other studies from the US, Canada, Spain and the UK did not show a detrimental impact of recent chemotherapy, he explained. On whether cancer patients should continue adhering to their treatments during the Covid-19 pandemic in view of the higher risk of them contracting the infectious disease, Dr Chong said as every case is different, the patients should discuss with their treating oncologist to see if their treatment can be modified during the pandemic. The guiding principle is to continue cancer treatment while minimising the risk of patients contracting Covid-19 as neglecting either one could lead to serious consequences, he said. The doctor, he added, may have to modify the cancer treatment if they have to omit or replace immunosuppressive treatment such as chemotherapy with hormonal treatment in some breast cancer cases or reduce the frequency and/or duration of chemotherapy and use oral chemotherapy instead of intravenous injection or infusion which requires more hospital visits. In some patients, the doctor may shorten the duration of radiotherapy, and reduce the frequency of follow-ups for non-urgent cases, he said, adding that for those who are unable to come to the hospital, there is also the option of teleconsultations and the delivery of drugs to their homes. Dr Chong himself started adopting online consultations after the pandemic started last year, with most of these patients being from overseas. Adapting to teleconsultation  Being aware of the limitations of virtual consultations, Dr Chong said he normally would study the notes and reports the patient sends to him earlier before the consultation. During the teleconsultation session, he would discuss with the patient and/or their family member regarding the case and suggest the next move or action to be taken. This facility is particularly useful for my overseas patients who are unable to travel due to travel restrictions and border closures. Teleconsultations also allow us to provide continuity of care to our existing patients who are unable to travel to our hospital. Such virtual meetings are often very warm and joyful... it is like a reunion with old buddies. I am always delighted to see my old patients and know I can still be of service to them. Most patients feel more assured and comforted knowing that their doctor is aware of their progress and well-being, he said. If required, the hospital also delivers the prescribed drugs by courier service to the patients concerned after the teleconsultations. -Bernama