Cancer patients are left behind in the vaccine scramble

"This was a complete – I can't say disaster, but it was pretty close," said Dr. Hanny Al-Samkari, hematologist and clinical investigator at Massachusetts General Hospital and Harvard Medical School. Cancer patients get "mixed news," he said, and the guidance they receive depends largely on their condition. Every day, he receives a barrage of messages from patients asking if they still qualify for the vaccine (in his state the answer is mostly no). They drove four hours to find a vaccination site. "It's the Wild West," he said.

He urged cancer patients to contact their doctors to coordinate the timing of the vaccine according to their treatment, unless they are in remission, have been treated a long time ago, or are receiving only hormonal treatment for breast or breast cancer Prostate cancer, said Dr. Tomasz Beer, professor in the School of Medicine at Oregon Health and Science University and assistant director of the school's Knight Cancer Institute.

Covid19 vaccinations>

Answers to your vaccine questions

Am I eligible for the Covid vaccine in my state?

Currently more than 150 million people – almost half of the population – can be vaccinated. But each state makes the final decision on who goes first. The country's 21 million healthcare workers and three million long-term care residents were the first to qualify. In mid-January, federal officials asked all states to open eligibility to anyone over the age of 65 and adults of any age with medical conditions that are at high risk of becoming seriously ill or dying of Covid-19. Adults in the general population are at the end of the line. If federal and state health authorities can remove bottlenecks in the distribution of vaccines, everyone over the age of 16 is eligible as early as spring or early summer. The vaccine has not been approved in children, although studies are ongoing. It can take months before a vaccine is available to anyone under the age of 16. For the latest information on vaccination guidelines in your area, see your state health website

Is the Vaccine Free?

You shouldn't have to pay anything out of pocket to get the vaccine, despite being asked for insurance information. If you don't have insurance, you should still get the vaccine for free. Congress passed law this spring banning insurers from applying cost-sharing such as a co-payment or deductible. It consisted of additional safeguards prohibiting pharmacies, doctors, and hospitals from charging patients, including uninsured patients. Even so, health experts fear that patients will end up in loopholes that make them prone to surprise bills. This could be the case for people who are charged a doctor's visit fee with their vaccine or for Americans who have certain types of health insurance that are not covered by the new regulations. If you received your vaccine from a doctor's office or emergency clinic, talk to them about possible hidden costs. To make sure you don't get a surprise invoice, it is best to get your vaccine from a Department of Health vaccination center or local pharmacy as soon as the shots become more widely available.

Can I choose which vaccine to get?How long does the vaccine last? Do I need another next year?

That is to be determined. It is possible that Covid-19 vaccinations will become an annual event just like the flu vaccination. Or the vaccine may last longer than a year. We'll have to wait and see how durable the protection from the vaccines is. To determine this, researchers will track down vaccinated people to look for "breakthrough cases" – those people who get Covid-19 despite being vaccinated. This is a sign of a weakening of protection and gives researchers an indication of how long the vaccine will last. They will also monitor the levels of antibodies and T cells in the blood of people who have been vaccinated to see if and when a booster shot might be needed. It is conceivable that people might need boosters every few months, once a year, or just every few years. It's just a matter of waiting for the data.

Does my employer need vaccinations?Where can I find out more?

For example, those receiving chemotherapy might have the best chances of developing an immune response if the vaccine is given if their white blood cell counts aren't at their lowest levels, said Dr. Beer. The recommendations for patients with leukemia or lymphoma who are under treatment or who have recently had a bone marrow transplant are particularly complex and absolutely require consultation and coordination with an oncologist, he stressed.

While some are concerned about the risk of encountering a crowd at a mass vaccination site, Dr. Al-Samkari instructs patients to receive doses wherever they are available, as long as they wear masks and keep their distance from other people. "Fears are clearly well founded," he said. "But we have to get shots in the arms."

In general, people with cancer should get the vaccine "as soon as possible, wherever they can," said Dr. Carol Ann Huff, clinical director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins and one of the authors of the Cancer Network's National Comprehensive Guidelines on Covid-19 Vaccines for Cancer Patients. There are some caveats: Patients who are going to have a bone marrow transplant or CAR-T therapy should wait at least three months before getting the vaccine, she said.

However, depending on the level of virus transmission in the patient community, it may be safer to wait to receive the vaccine. If there is high levels of transmission in the community, "the risks might outweigh the benefits of waiting," said Dr. Beer. Patients with active cancer should contact their oncologist before receiving the vaccine. He advised unless they are in remission, have been treated a long time ago, or are just receiving hormonal treatment for breast or prostate cancer.

Those who take part in cancer clinical trials have a grimmer guide to vaccination. Allyson Harkey, 46, from Maryland, has stage four kidney cancer and is in an immunotherapy study. She said her doctor wasn't sure she should get the vaccine. The National Comprehensive Cancer Network guidelines generally recommend that patients receiving immunotherapy receive the vaccine when it becomes available. However, you should consult with your doctor beforehand as there are so many different studies out there. She feels like she is in a state of limbo, waiting for more information – a process made more frustrating by what she thinks is a ticking clock. "My prognosis is not good. I probably have a few years left," she said. "It's really hard to spend that time because I know I don't have much time left, just in my house."