Cancer patients too can take COVID-19 vaccine, but under medical supervision, cancer specialists said ahead of the World Cancer Day on February 4.

Though few patients with cancer were included in the vaccine trials, they said that going by various studies, vaccines look safe for cancer patients. At a time when several countries, including India, have started the COVID vaccination drive, cancer patients, one of the vulnerable groups, are waiting to hear if they can also take the jab. Doctors said that this can be done only with safe and effective vaccines along with the coordinated global vaccination programme. Of more than 200 vaccines being developed across the world, three are being indigenously produced in India. Though all these vaccines are aimed at providing immunity against the SARS-CoV2 infection, the presentation of antigens to the host for the development of antibodies relies on various technologies or platforms.

The efficacy of COVID-19 vaccines can also vary in patients with distinct contexts of malignant disease (tumour type, disease extent, intrinsic or therapy-induced immune suppression). According to doctors, benefits of vaccination seem to outweigh the risks. "The efficacy and duration of immunity in patients with cancer are still unknown and unexplored. Given the often-immune compromised status and the frailty of cancer patients, it is suggested to monitor in the context of registries and dedicated clinical trials. Close surveillance and monitoring of patients with cancer is required after COVID-19 vaccination to assess the potential adverse events and measure clinical outcomes like infection, severity and mortality from COVID-19, complications from cancer etc.," Ajay Chanakya Vallabhaneni, Consultant Surgical Oncologist and Robotic Surgeon, KIMS Hospitals, told IANS.

"Patients with cancer are particularly vulnerable to COVID-19 because of the immune compromising nature of cancer treatment. On top of that, progressing cancer itself depletes the immune system and leaves patients susceptible to infection. Admittedly, very few patients with active cancer or in active therapy were included in the trials. But assessment of studies available on vaccines, these look remarkably safe for cancer patients too," said Revanth Gangasani Reddy, Consultant Surgical Oncology, Aware Global Hospitals.

According to A.V.S. Suresh, Senior Consultant Medical Oncologist and Haematologist, Continental Hospitals, although evidence regarding vaccination in patients with cancer is limited, there is enough proof to support anti-infective vaccination in general (excluding live-attenuated vaccines and replication-competent vector vaccines), even in patients with cancer undergoing immunosuppressive therapy. Most traditional vaccines contain dead or disabled viruses, which are incapacitated to cause disease while provoking an immune response against the virus.

"Cancer cells progressing in a human body weakens the immune system and makes the patient vulnerable to infections like the COVID-19 virus. People living with HIV too have low CD4 count and high viral load are at high risk of infection. It is important that people with cancer and HIV are given priority and are vaccinated at the earliest. The government and the healthcare mechanisms should create a system where COVID-19 vaccine is administered on such highly susceptible cases on an urgent basis," said D. Sridhar, Consultant Surgical Oncology, SLG Hospitals.

The doctors are of the view that the timing of vaccination depends on individual therapy scenarios and may ideally occur before systemic therapy starts. But if the patient has already started systemic therapy, it is reasonable to vaccinate him/her during therapy. Physical distancing measures, masks, face shields, sanitisers and other hygiene measures are still required during the pandemic, including for patients with cancer, and should certainly accompany the vaccination strategies.