Information for People with a History of Blood or Bone Marrow Cancer, and/or Stem Cell or Bone Marrow Transplants

The following information is for people who have:

  • a history of blood or bone marrow cancer; and/or
  • have had a stem cell or bone marrow transplant or CAR T-cell therapy in the last 6 months or who are still taking immunosuppressive drugs.

Why is planning for a COVID-19 vaccine important?

  • Preparing for your vaccine is important because people with blood or bone marrow cancer may need to talk to their health-care providers about timing their vaccine with their treatment or medications.
  • People on regular platelet transfusions or receiving intravenous immunoglobulin (IVIG) definitely need to check with their health-care provider about timing.
  • It is also important that you monitor how you are feeling in the days leading up to your vaccine appointment. If you are feeling unwell, rebook for when you are feeling better.

Should I get the COVID-19 vaccine? Will the vaccine work for me?

  • All of the COVID-19 vaccines available in Canada are safe, and they do not contain any live virus. The vaccines cannot give you COVID-19.
  • Doctors and researchers have looked at the evidence. They agree that unless you have a very serious allergy to any of the vaccine ingredients, you should strongly consider getting the COVID-19 vaccine because you have a higher chance of experiencing severe symptoms if you get COVID-19.
  • People with cancer weren’t included in the clinical trials of the COVID-19 vaccine. While the COVID-19 vaccine is very safe, we do not know exactly how much protection it will give people with cancer compared to those who do not have cancer.
  • However, the way vaccines work means that there is a strong chance that your immune system will learn to protect you, to some degree, from COVID-19.

What about the medications or treatments that I take?

Some medications and treatments affect how well your immune system responds to the COVID-19 vaccine. Timing your vaccine around your treatment may help the vaccine work best.

Not all people with blood or bone marrow cancer need to time the vaccine around their treatment or medications. Please read the section below. If you are still not sure when to get your vaccine, please call the care provider you most recently saw for your cancer treatment or follow-up. This may be your family doctor, nurse practitioner, oncologist, hematologist, or other.

You may book your vaccination appointment without delay if any of the following apply to you:

  • You have finished treatment or are not on treatment (you are just being monitored).
  • You are on daily tablet medication (chemotherapy or other) for your cancer.
  • You are on daily steroid medication (for either your cancer or complications).
  • You had a bone marrow or stem cell transplant more than 3 months ago
  • You had CAR T-cell therapy more than 6 months ago.

You may need to time your vaccine if any of the following apply to you:

  • You are planning to start chemotherapy treatment soon.
  • You are between chemotherapy cycles.
  • You are having a stem cell or bone marrow transplant or CAR T-cell therapy soon.

I am planning to start chemotherapy soon:

  • If you will be starting your first chemotherapy cycle soon, try to book your first vaccine dose about 2 weeks before you start. However, if your chemotherapy needs to start before you can get the vaccine, you should not delay your cancer treatment.
  • Try to book your second vaccine dose between your chemotherapy cycles when your blood counts have recovered. This is usually about 1 week before the next chemotherapy cycle starts.
  • If you are not able to get the first vaccine dose before you start treatment, try to book your vaccine doses between chemotherapy cycles, when your blood counts have recovered. This is usually about 1 week before you start another cycle of chemotherapy.

I am between chemotherapy cycles:

  • If you are between chemotherapy cycles, try to book your vaccine doses between your chemotherapy cycles, when your blood counts have recovered. This is usually about 1 week before you start another cycle of chemotherapy.
  • If there are days in the week or month when you are not on treatment (intravenous or oral treatment, including steroids), try to book your vaccine appointment on your days “off” treatment.

I am having a stem cell or bone marrow transplant OR CAR T-cell therapy soon:

  • If you are planned for a stem cell or bone marrow transplant or CAR T-cell therapy, try to book your vaccine at least 2 weeks before you start the chemotherapy that is given before the transplant or CAR T- cells.
  • If you have already had a transplant , or you did not get one or both vaccine doses before your transplant, you are able to get a COVID-19 vaccine dose starting 3 months after your transplant.

If you don’t see your medication listed, or if you take medications for another condition and you aren’t sure if you need to consider timing, contact your health-care provider.

How else should I plan for my vaccine appointment?

  • Review COVID-19 Immunization Plan for Newfoundland and Labrador
  • It is important that you are feeling as well as possible when you get your vaccine. However, some people with cancer have chronic symptoms, like a cough, tiredness, nausea, vomiting or pain.
  • In the 2-3 days leading up to your vaccine, monitor yourself: are any of your symptoms new or getting worse? If you aren’t feeling like your usual self, rebook your vaccine appointment for another day. Consider reaching out to your health care provider about your worsening symptoms.
  • You can feel safe going to the COVID-19 vaccine clinic, as they are following all COVID-19 safety precautions.

What or who should I bring with me?

  • Please bring your non-expired MCP card to your appointment.
  • You can bring any medical or mobility equipment that you need.
  • If you need to, you can bring a trusted friend, family member or caregiver with you to support you through the process and/or translate for you as needed. Please only bring one person.

What happens after my vaccine?

  • Everyone who gets a COVID-19 vaccine will stay on location to be monitored for 15 minutes after they get their vaccine.
  • You should tell a health-care provider at the vaccination site if you do not feel well.
  • Many people with blood or bone marrow cancer can have low blood counts or are on blood thinners that may make them bruise or bleed easier after an injection. Press firmly on the injection site for 5 minutes after the vaccination to reduce bruising.
  • If you have any new or worsening symptoms once you go home, please call your health care team or 8-1-1. If you have a severe allergic reaction, call 9-1-1 immediately.
  • Everyone will have to continue following COVID-19 public health measures, even after getting their vaccine.

My vaccine planning checklist

  • Read the COVID-19 vaccine information for my condition(s)
  • Time my vaccine appointment around my medication and treatments (if relevant to me)
  • Talk to my doctor if I have any questions or need any help planning my medication
  • Monitor how I’m feeling leading up to my vaccination appointment. Is anything new or getting worse compared to how I usually feel?
  • Make sure I am feeling my usual self on the day of my vaccine appointment
  • Plan to bring the medical and mobility equipment I need with me

April 23, 2021