Vaccines: How to Protect Yourself and Your Community

Patient Expert

Last week my daughter got a letter from the daycare center her toddler attends that a case of chicken pox had been diagnosed. December 8, 2016, NBC News carried a story that the Centers for Disease Control and Prevention (CDC) has reported increased outbreaks of mumps on college campuses, which may put other communities at risk when the students go home for winter break.

As a cancer patient or survivor, you need to be concerned about these incidents, and you need to discuss vaccines with your doctor. Cancer patients’ immunity is compromised by chemotherapy, radiation, and even the stress of the disease. So should you or your family members automatically get vaccinated? It depends on the type of vaccine. Here is some information that can help you decide.

The flu vaccine. According to the CDC, the flu vaccine is recommended for cancer patients because they are more likely to have serious complications from influenza. Family members need to be vaccinated too. Discuss which form of flu vaccine is right for you and your family members with your doctor. The American Cancer Society says that if you are receiving chemotherapy, your doctor may want to time your shot when your immune system is strongest. The high dose flu vaccine and the adjuvanted flu vaccine are specifically designed for people 65 years and older who have lower immune systems.

Not everyone can get a flu shot. The nasal mist form of the vaccine contains a weakened form of the live virus, so your doctor will probably advise against that type of vaccine for you and your family while you are in treatment. Babies under the age of 6 months and people with allergies to some of the vaccine ingredients should not be vaccinated. Keep in mind that these people are sitting near you at church and on the bus. With your doctor’s approval, you need to be vaccinated to help protect them.

Vaccines for pneumonia. Cancer patients are also at increased risk for pneumonia, so talk to your doctor about whether you and your family members should receive one of the pneumococcal vaccines. The CDC website says, “Each year in the United States, pneumococcal disease causes thousands of infections, such as meningitis, bloodstream infections, pneumonia, and ear infections. Pneumococcal vaccines are very good at preventing severe disease, needing treatment in the hospital, and death.”

These vaccines are becoming routine for the elderly and young children, but if you are a cancer patient or survivor between the ages 19 and 64, it may be appropriate for you too. Since these vaccines have become widely available, rates of pneumonoccal disease have dropped significantly.

Other vaccines. Some vaccines such as the MMR (measles, mumps, rubella) and chickenpox vaccines contain a form of live virus. Your doctor will probably advise against you receiving these while in active cancer treatment. Usually it is safe for family members to receive the shots, but discuss your cancer status with all the doctors involved. The form of polio vaccine usually used in the United States does not contain a live vaccine, but some forms do, so be sure to ask to make sure you don’t get a live vaccine.

Community immunity. This concept is sometimes referred to as “herd community.” The idea is that if most of the people in a community are vaccinated, everyone is protected because a particular disease cannot spread easily through a population. It will never be possible to vaccinate everyone. Infants, people with allergies to vaccine ingredients, and people with severely compromised immune systems may not be able to receive vaccines. However, if most of the people they come in contact with have been vaccinated, they are safer. This is why your family members need to be vaccinated if you are not eligible for certain vaccines.

Taylor, a young friend of ours, had a stem cell transplant as part of her cancer treatment. Strong chemotherapy wiped out all of her previous immunity. Every vaccine, every childhood illness that had given her protection against disease, was suddenly gone, leaving her at an increased risk for all types of infections. You can’t tell whether the person next to you in line at the grocery store is vulnerable to a germ you might be carrying because you didn’t discuss a vaccination plan with your doctor. Protect all cancer patients like Taylor; protect yourself. Talk to your doctor about which vaccines you and your family need.

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