People with certain types of cancer may be at increased risk for getting the flu, and it can be more severe among those receiving treatments that weaken their immune system. While most cancer patients are encouraged to get the influenza vaccine, not everyone benefits. In this Ask the Expert, infectious disease specialist Mini Kamboj explains when it’s safe to get vaccinated — and when to wait.
- Influenza can be severe in people undergoing cancer treatment.
- The influenza vaccine is the best way to protect yourself against the flu.
- It’s safe for most people undergoing cancer treatment to be vaccinated.
- People who have severe egg allergies may request an egg-free version of the vaccine.
- Those undergoing intensive chemotherapy or bone marrow transplant should wait to be vaccinated.
Fall is upon us, which means vibrant leaves, sweater weather, and football. It also means flu season, which typically starts in December, is around the corner.
It’s hard to ignore ongoing public health messages in the media stressing the importance of getting the influenza vaccine. Commonly known as the flu, influenza is a highly contagious viral infection of the nose, throat, and lungs that can cause serious health complications, and in some cases may be fatal. People with certain types of cancer may be more at risk for getting the flu.
According to the Centers for Disease Control (CDC), the influenza vaccine is the most effective way to protect yourself against the flu. But should people undergoing cancer treatment be vaccinated? We asked Mini Kamboj, Director of MSK’s Infection Control Program, to explain.
Influenza Can Hinder Your Cancer Care
“It is not known whether infections due to the influenza virus occur more frequently in people who are undergoing cancer therapy than in the average person who is otherwise healthy,” explains Dr. Kamboj. “What we do know is that if you’re undergoing treatment, flu-related complications are more common, and can lead to hospitalization and a delay in your cancer care.”
If your immune system is not able to fight off the influenza virus, it increases your risk for developing a bacterial infection such as pneumonia, which requires hospitalization, intravenous antibiotics, and postponement of certain cancer treatments like chemotherapy.
“We want to make sure that your cancer care runs smoothly,” she says.Back to top
Cancer Treatment and Immunity
Even if you’re not actively in treatment, having cancer can diminish your immune system’s ability to fend off illness. For example, blood cancers such as leukemia and lymphoma and cancer in the lymph nodes (where the bulk of disease-fighting blood cells live) can lower immunity.
And if you are receiving cancer treatment, you’re at increased risk for complications from influenza. For example, radiation for lung cancer may raise your chances of developing flu-related respiratory conditions such as pneumonitis. Steroid medications, which are often prescribed for people undergoing radiation therapy, and chemotherapy are also known to weaken your immune defenses.
“For most people, it’s best to protect yourself and get the flu vaccine regardless of the type of cancer treatment you’re receiving,” says Dr. Kamboj.Back to top
Helping Others Stay Well
When you’re receiving cancer treatment, you’re also in close proximity to healthcare workers and other patients who might be more vulnerable to complications from the flu. Experts agree that getting the flu shot not only shores up your immunity but also protects others.
“When we educate patients about getting vaccinated, we highly encourage family members and caregivers to get the vaccine too, especially if there are young children in the household,” notes Dr. Kamboj.
Older people, especially those undergoing cancer treatment, are at higher risk for getting the flu and for developing health complications because of it. A new high-dose influenza vaccine is now available for people age 65 and over. Clinical studies have shown that it provides greater protection against the flu in the elderly population compared to the standard vaccine.Back to top
When to Decline the Vaccine
The CDC recommends that everyone over six months of age get the influenza vaccine. Aside from some soreness at the site of the injection, there are few risks associated with it. However, there are times when it should be declined or postponed.
For example, people who have had severe allergic reactions to eggs, such as anaphylaxis, should request an egg-free version of the vaccine.
“Also, someone undergoing very intensive chemotherapy, such as after a bone marrow transplant, should not get the flu shot,” warns Dr. Kamboj. “The vaccine is not likely to offer any protection in this setting, and if certain blood counts such as platelets are extremely low, bleeding at the site of the injection can occur.”
Vaccination guidelines state that people should wait at least four months after transplant to receive the flu shot.
Once flu season is officially declared, New York State law requires unvaccinated healthcare workers to wear a mask when they are near patients in hospitals and other medical facilities. “Unvaccinated individuals visiting patient-care areas at MSK are also asked to wear a mask to further reduce the risk of transmission among our patients,” notes Dr. Kamboj.Back to top
If You Have Cancer, Get the Inactivated Vaccine
Some people are afraid that the flu vaccine will make them sick with flu-like symptoms such as cough, fever, muscle aches, and fatigue.
“It’s important to understand that there are different types of influenza vaccines,” explains Dr. Kamboj. “The inactivated vaccine that we offer to our patients does not cause the flu.”
Another type of influenza vaccine contains live, weakened strains of the influenza virus. This vaccine can produce a mild or low-grade infection so that the body makes antibodies against the virus. “We do not offer this particular live vaccine to our healthcare workers or to our patients, whose immune systems are down and should not be challenged with an active virus,” says Dr. Kamboj.
It takes about two to four weeks after receiving the influenza vaccination for protection to kick in.Back to top
An Ounce of Prevention
“People should know that the flu shot is not going to protect them against other circulating viruses that cause respiratory illness or the common cold during the fall and winter,” notes Dr. Kamboj. “You might still get the sniffles or even a respiratory condition from these viruses.”
Hand hygiene significantly reduces your risk of getting sick and spreading germs. “Wash your hands several times a day! It’s underrated, but it’s so important,” she stresses. “You don’t even need antibacterial cleanser. Regular soap is just as good and is known to kill both influenza and other cold viruses.”
Alcohol-based hand gels are also convenient when soap and water aren’t accessible.Back to top