Boosters? Masks? The Latest Covid Safety Recommendations
- Because people with cancer may be at a higher risk of developing severe Covid-19, it’s important to stay on top of health recommendations.
- People with cancer should consider a second booster shot if they haven’t already.
- There are several drugs available for patients with cancer if they do develop Covid-19, but these drugs cannot be used in every case.
- People with cancer should still follow common sense public safety precautions, like masking up in crowded places and keeping hands clean.
For many people who currently have or previously had cancer, current guidelines can be confusing. Should you be getting each vaccine booster? Are masks still a must in all public places? What about available treatments if you do get Covid-19? We consulted experts to come up answers to these important questions when it comes to cancer and Covid-19.
Are people with cancer more at risk for Covid?Read More
Hematologist/oncologist Dr. Thomas Martin explains why blood cancer patients may be more at risk for severe Covid-19.
There are also certain cancer treatments that may make people more vulnerable to Covid infections, even if they are vaccinated. These include patients who:
- Are taking medicine to suppress the immune system
- Had an organ transplant
- Had a stem-cell transplant within the last two years
- Are taking high-dose corticosteroids or other immune-suppressing drugs
Should those with cancer get vaccinated?
What about boosters?
The Centers for Disease Control and Prevention (CDC) recommends that everyone over 6 months old get the Covid vaccine — and that includes most people with cancer and those who were previously treated for the disease. People with an increased risk of developing severe Covid, including cancer patients, should also get booster shots. While it is recommended that all members of the public get one booster shot, those with an increased risk should get two.
“Whatever you get, either [Pfizer or Moderna], we encourage people to get their two extra boosters,” Dr. John Greene, chair of Moffitt Cancer Center’s Infectious Disease Program, tells SurvivorNet.
You may have heard that some people should get a third booster shot, but Dr. Greene explains that this is not needed in most cases.
“As far as a third booster, that’s very rare and it depends on what their immune system is doing,” he explains. Dr. Greene adds that if a patient is interested in getting another booster shot (with the Pfizer and Moderna shots, that would be five shots in total), they can request that, but it’s not common.
What about virus mutations?
As we all know, there have already been several variants of Covid-19 — and immunocompromised people may be worried how safe they are from new strains, even with the vaccine.
“The new omicron strains are rapidly mutating and becoming less and less covered by the current vaccine, so the companies are vigorously working on trying to get a new vaccine that covers all the new emerging variants,” Dr. Greene explains. “The might be out in six months to a year, but until then, we work with what we have.”
Are there any cancer treatments that should not be mixed with the vaccine or boosters?
There are a few situations where a doctor may recommend that a patient with cancer wait to get a vaccine or booster. One of those situations is when a patient has already had a recent Covid infection.
“Many of our patients are getting infected with the new variant,” Dr. Greene says. “And that immunity will give them protection from reinfection for at least 90 days. So after the 90 days are up, they can get a booster.”
Another situation is when a patient’s immune system has been so severely affected by treatment that it would simply not be beneficial to get them the vaccine “Because their chance of mounting an immune response is zero to 20 percent,” Dr. Greene says. An example Dr. Greene gave was Rituxan (rituximab), which is a monoclonal antibody used to treat some blood cancers. Because this drugs knocks out immune producing cells, it would not make sense to try to mount an immune response to Covid while patients are taking the drug.
Can cancer patients be treated with approved Covid treatments?
If a person with cancer gets sick with a Covid infection, there are a few different treatment approaches doctors can take. Which approach your doctor goes with, and whether Covid treatment is required at all, will depend on several factors.
Drugs that may be used to treat Covid include:
- Remdesivir (Veklury) may be prescribed for people who are hospitalized and need supplemental oxygen or have a higher risk of serious illness
- Paxlovid combines two types of medicine, nirmatrelvir (which blocks an enzyme Covid uses) and ritonavir (an antiviral drug), and can be used to treat mild to moderate Covid in people who are at higher risk of serious illness
- Molnupiravir can be used to treat mild to moderate Covid in adults who may be at higher risk and may not be able to take other treatments
- Baricitnib (Olumiant), a rheumatoid arthritis drug, may be used in some cases to reduce inflammation and have antiviral activity in patients who are hospitalized and on mechanical ventilators or need supplemental oxygen
These drugs cannot be given to all patients, and Paxlovid in particular has the potential for interaction with other drugs.
“The other drugs are quite safe for most people, except there’s a few exceptions for people with severe liver or kidney issues,” Dr. Greene says.
Should patients still use precautions even after vaccination?
When it comes to going about their everyday lives, cancer patients should continue to use caution — but also keep in mind that we are in a much different place than we were in spring of 2020.
For now, the National Cancer Institute still recommends people with an increased risk from Covid continue to follow guidelines like:
- Staying up to date on vaccines and boosters
- Wearing masks that cover the mouth and nose
- Staying six feet away from people outside of your household
- Avoiding crowds, particularly in poorly-ventilated indoor spaces
- Regularly washing hands with soap and water or hand sanitizer
- Monitoring health and being on the lookout for Covid symptoms
“Cancer patients are one of the safest groups of all [when it comes to Covid precautions],” Dr. Greene says. “…The vast majority of them are ultra-safe no matter what, so they’re going to be pretty strict about not going to crowded areas … and if they do, to wear a mask and wash hands frequently and be as distant as possible.”
Dr. Greene also pointed out that despite case numbers, current Omicron is a less severe variant than Delta was. Still, it’s a good idea to continue being cautious as the virus continues to linger.
The CDC also has a tool that lets you check the level of Covid in your community and adjust your Covid precautions as needed.
Questions to Ask Your Doctor
- Should I go in for a second or third booster shot?
- What extra precautions should I take due to vulnerability?
- If I become ill, which approved Covid drugs should I request?