Supporting the

Neuroendocrine Cancer Community

Vaccinations

Oct 7, 2020

Vaccinations

There are two main types of vaccines. These are live vaccines and inactivated (not live) vaccines.

You shouldn’t have immunisations with live vaccines while you are having cancer treatment or for some months afterwards. This is because live vaccines contain a very weak version of the illness they are vaccinating you against. 

Check with your doctor/specialist team how long you shouldn’t have live immunisations for. 

This depends on your type of cancer treatment.

ALWAYS CHECK WITH YOUR DOCTOR / SPECIALIST TEAM BEFORE  ARRANGING VACCINATIONS

  • Flu
  • Pneumonia (Pneumococcal vaccination)
  • Shingles
  • Others e.g. travel

Flu

Who should have the flu vaccination?

Some cancer treatments lower immunity and lower your resistance to flu. These include:

  • chemotherapy
  • radiotherapy
  • some targeted cancer drugs
  • some immunotherapy treatments
  • long term steroids
  • removal of the spleen

After cancer treatment, your resistance to infection might be low for some months or years – so always check with your specialist team in the first instance.

The best time to have the flu vaccine is in the autumn before flu starts spreading. But you can get the vaccine later.

The flu virus changes each year. So, you need to have the vaccine again each year. This is to protect yourself against the most common type of flu predicted for that year.

Cancer specialists generally recommend that you should have the flu vaccine before you start any cancer treatment (particularly that which might affect your immune system). But this isn’t always possible.

For many cancer types, your specialist may advise you to have the vaccine during treatment if you haven’t had one. They will explain when it is best to have this. This might depend on different factors, such as the level of white blood cells in your blood. For example, with chemotherapy, you might have it towards the end of one cycle and just before you start another cycle. The vaccine might not give you as much protection as it would a person whose immunity is not low. But it is still important for most people to have it.

The flu vaccine injection doesn’t contain live flu virus so you won’t develop flu from having it. It is safe to have it while you are having cancer treatment.

But you should check with your doctor if you:

  • are allergic to egg (manufacturers make the vaccines from viruses grown in hen’s eggs)
  • have had a reaction to a vaccine before

People with an egg allergy can have a flu vaccine with a very low egg content. Or you can have a newer type of flu vaccine that is grown in cells and not in eggs. Ask your doctor about this.

Side effects of the flu vaccine

The vaccine doesn’t usually cause many side effects. But with the injection you may have:

  • slight soreness around the injection site
  • a slight fever
  • aching muscles
  • tiredness
  • headache

Contact with other people who have the flu vaccine

  • Adults – It is safe for you to be in contact with people who have had the flu vaccine as an injection.
  • Children – Some pre school and primary school children have the flu vaccine as a nasal spray.  Avoid close contact with children who have had the nasal spray if you have a severely weakened immune system. You should do so for 2 weeks following their vaccination.

The nasal spray contains a live, but weakened form of the flu vaccine. So there is a very small chance that the vaccine virus could be passed on to you and cause flu if you have a severely weakened immune system.

The injection does not contain a live form, so these precautions do not apply to contact with people who have had the injection.

Pneumococcal Vaccine

The pneumococcal vaccine protects against serious and potentially fatal infections – such as certain pneumococcal pneumonia, pneumococcal septicaemia and pneumococcal meningitis. 

It’s also known as the pneumonia vaccine.

Who should have it ?

  • (Babies born on or after 1 January 2020 have 2 doses of pneumococcal vaccine at: 12wks and 1 year
  • Babies born before this date will continue to be offered 3 doses, at 8 and 16 weeks and a booster at 1 year.)
  • People aged 65 and over only need a single pneumococcal vaccination. This vaccine is not given annually like the flu jab.
  • People with a long-term health condition may need just a single one-off pneumococcal vaccination or vaccination every 5 years, depending on their underlying health problem.

There are 2 types of pneumococcal vaccine :

The type of pneumococcal vaccine you’re given depends on your age and health. The most relevant vaccine is :

  • Pneumococcal polysaccharide vaccine (PPV) is given to people aged 65 and over and people at high risk because they have long-term health conditions.

Both the PPV and the PCV are inactivated or “killed” vaccines and do not contain any live organisms. They cannot cause the disease they protect against.

Shingles (and Chicken Pox)

You’re eligible for the shingles vaccine if you are aged 70 or 78 years old.

In addition, anyone who was previously eligible (born on or after 2 September 1942) but missed out on their shingles vaccination remains eligible until their 80th birthday.

When you’re eligible, you can have the shingles vaccination at any time of year.

Zostavax is a live, attenuated varicella-zoster vaccine – therefore not suitable for those with a compromised immune system.

Non-live “Shingles” vaccine : Shingrix is inactivated vaccine – so not live, however, although this is licensed in the UK , it is not widely or NHS available – though some private practices may have it. 

Chickenpox Vaccine

There are 2 chickenpox vaccines currently available.

It is recommended for certain individuals, such as:

  • non-immune healthcare workers
  • people who come into close contact with someone who has a weakened immune system

This is to lower the chances of infecting people at risk. 

For example, if you’re having chemotherapy treatment, it’s advisable that non-immune children close to you are given the chickenpox vaccine.

The vaccine would also be recommended if you were about to start work in a radiotherapy or oncology department and had not had chickenpox before.

Other vaccines – e.g. Travel vaccines

If you’re planning to travel outside the UK, you may need to be vaccinated against some of the serious diseases found in other parts of the world. 

However at this current point in time (during COVID19) people are currently advised not to travel abroad.

Further information : 

NHS : https://www.nhs.uk/conditions/vaccinations/flu-influenza-vaccine/

CRUK : https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/cancer-drugs/flu-vaccine and NHS : https://www.nhs.uk/conditions/vaccinations/flu-influenza-vaccine/

https://www.nhs.uk/conditions/vaccinations/when-is-pneumococcal-vaccine-needed/

NHS : https://www.nhs.uk/conditions/vaccinations/pneumococcal-vaccination/

https://www.nhs.uk/conditions/vaccinations/who-can-have-the-shingles-vaccine/

https://www.nhs.uk/conditions/travel-vaccinations/ 

https://www.nhs.uk/conditions/vaccinations/when-is-chickenpox-vaccine-needed/

COVID19 advice from NHS : https://www.nhs.uk/conditions/coronavirus-covid-19/

and UK Govt :https://www.gov.uk/guidance/travel-advice-novel-coronavirus

The FCDO (Foreign, Commonwealth & Development Office) has a global advisory against ‘all but essential’ travel : travel corridors list :https://www.gov.uk/guidance/coronavirus-covid-19-travel-corridors?priority-taxon=774cee22-d896-44c1-a611-e3109cce8eae#stay-up-to-date 

Source : NHS, CRUK & Gov.UK : links as above + https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/cancer-drugs/%20immunisations-and-cancer-treatment