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Respiratory viruses, COVID-19 and cancer - information for patients

Page updated: Nov. 8, 2024

The best source of up-to-date information on respiratory viruses including COVID-19; influenza (the flu); and vaccines in British Columbia is the BC Centre for Disease Control website.

Coming to your appointment: What you need to know

COVID-19 and respiratory illness symptoms can range from mild to severe. If you have any symptoms, or are not feeling well, contact your cancer care team. Tell them how you are feeling. Some of your symptoms may be a side effect of treatment. Your oncologist will know more.

We may reschedule your appointment or offer you a virtual appointment.

Yes. You are allowed to bring visitors with you.


However, there may be times when you cannot bring visitors, depending on your treatment or the size of the clinic. Please check with your cancer care team to confirm.

We ask visitors with cold or flu symptoms to remain home.

If you are having a virtual appointment (also called a virtual health visit), please read our handout:
How to prepare for your Virtual Health Visit (PDF)

Medical marks are not required in our centres. They are available at main entrances and we encourage everyone to respect and support individual choices around masking.

Influenza (flu) vaccines and cancer

Yes, BC Cancer recommends that all adults with cancer get an influenza (flu) vaccine every year.


People living with cancer are at a higher risk of having influenza (the flu).  Family members, care providers and those in close contact wtih adults with cancer should also get the flu vaccine.


For more information, please review the BC Cancer Influenza Vaccine Recommendations for Adults with Cancer.‎

The influenza (flu) vaccine is free. You can get it at a pharmacy, public health unit, or from your family doctor or nurse practitioner.‎

 

You can get the influenza (flu) vaccine at the same time as, or any time before or after, the COVID-19 vaccine.


‎For more information, please review the BC Cancer Influenza Vaccine Recommendations for Adults with Cancer.

Inactivated influenza (flu) vaccine types for adults
  • Adults with cancer should get inactivated influenza (flu) vaccines.
    • Inactivated vaccines are also called killed or non-live vaccines.
  • Live vaccines are not recommended for adults actively receiving cancer treatments. ‎
    • Family, care providers and those in close contacts with adults with cancer who get a live vaccine (nasal spray FLUMIST®) should avoid close contact with patients with severely low immune systems for at least 2 weeks.
  • For patients who will be receiving stem cell transplant or CART therapy, please talk to your cancer doctor for specific instructions.

For more information, please review the BC Cancer Influenza Vaccine Recommendations for Adults with Cancer.

‎Influenza (flu) vaccine timing in adults with cancer
  • The influenza (flu) vaccine is most effective when your blood counts are near normal range.
  • If possible, you should get your vaccine at least 2 weeks before starting your first dose of chemotherapy. 
  • If you are already receiving chemotherapy, get your vaccine 2 to 3 days before starting your next chemotherapy cycle. We recommend this so we can tell the difference between vaccine-related symptoms and chemotherapy side effects.
  • If you are receiving Rituximab or any other immunotherapy, you can get your vaccine at any time.

COVID-19 vaccines and cancer

People currently receiving cancer treatment and some people who have just finished treatment are considered "clinically extremely vulnerable" as they are at higher risk of getting very sick if they get COVID-19.


This group includes:


  • People receiving systemic therapy for cancer now or within the past 12 months. This includes chemotherapy, molecular therapy, immunotherapy, monoclonal antibodies, hormonal therapy for cancer
  • People receiving radiation therapy for cancer now or in the past 6 months
  • People receiving or who have previously received targeted cancer treatments that can affect the immune system such as CAR-T cell treatments in the past 6 months
  • Anyone with blood or bone marrow cancer (such as leukemia, lymphoma, myeloma, myelodysplastic disorders)
  • People who have had a bone marrow or stem cell transplant in the past 6 months, or are still taking immunosuppressant medicine related to your transplant

If you believe you are in the CEV group but you have not been contacted by the provincial immunization program, please visit www.gov.bc.ca/getvaccinated or call: 1-833-838-2323 and provide your Personal Health Number. The registration system or phone agent will confirm if you are eligible.


If you are still unsure, please speak with your care team.

Yes. All of the COVID-19 vaccines available in Canada are safe for their recommended use.


People with cancer have a higher chance of severe symptoms if they get COVID-19.


Please review special vaccine considerations and FAQs for people with cancer.


If you have:


Please visit the BC Center for Disease Control COVID-19 Vaccine webpage for more information.

COVID-19 vaccines are very safe.


The way the vaccines work means that there is a chance that your immune system will learn to protect you, to some degree, from serious symptoms of COVID-19.


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

 

Before getting your vaccine, please do the following:


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

NEW information is below for patients about to start or planning to start B-cell depleting therapies


Not all people with cancer need to time the vaccine around their treatment or medications.


If you are on treatment or your treatment needs to start before you can get the vaccine, do not delay your cancer treatment.


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


Systemic therapy

  • If you are on cyclical therapy, for example chemotherapy given every 3 - 4 weeks, try and book your vaccine one week before your next treatment.
  • If you are receiving weekly chemotherapy, the best time to get your vaccine a day or two after your treatment.

Radiation therapy

  • If you are receiving radiation therapy to large areas of your body, you may need a blood test before getting your vaccine.
  • If you are having radiation close to one of your arms, you should get the vaccine in your other arm. If you have questions, please speak to your radiation oncologist.
  • If you are going to start radiation therapy in the next 2-4 weeks, and you are currently eligible to get a vaccine (for example, your age group is eligible), try to get the vaccine as soon as possible (within a few weeks). When you have your cancer centre appointment, please let the staff know the date of your vaccine appointment.

Stem cell, bone marrow transplant or CAR-T therapy

  • 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.

Corticosteroids or oral treatments

  • If you are taking systemic corticosteroids, such as dexamethasone, try to book your vaccine 28 days after your last dose of corticosteroids.
  • 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.

B-cell depleting therapies

  • If you have a B-cell lymphoproliferative malignancy and you will be starting or are planning to start:
    • a B-cell depleting agent (like Rituximab or obinutuzumab) OR
    • a BTK inhibitor (like Ibrutinib, acalbrutinib, zanubrutinib) OR
    • Daratumumab OR
    • CAR-T

OR

  • If you have non-malignant conditions but will be starting or planning to start B-cell depleting therapies like Rituximab, alemtuzumab, ocrelizumab or and other CD20 +

Your doctor should have provided your contact information to the provincial immunization program. The provincial immunization program’s call centre will reach out to you to schedule your second dose.


If you are still not sure when to get your vaccine, please contact the care team who is managing your condition.


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, you can also look at the COVID-19 vaccine planning considerations on the BCCDC website for that condition (if available).

Studies are being done looking at vaccines in patients with cancer and results are starting to be presented. Our experts are keeping a close eye on the evidence that is coming out.

COVID-19 and cancer: managing your risk

It is possible that cancer patients might have worse symptoms from COVID-19. This is because some treatments affect how well their immune system works.

COVID-19 treatment information

For information about COVID-19 treatments, visit the Government of BC's COVID-19 treatments webpage.


Vaccines remain the best way of protecting yourself against COVID-19.

If you are immunocompromised or clinically extremely vulnerable, you may benefit from COVID-19 treatments.


To be eligible for treatment, you must have mild or moderate symptoms that started in the past 5-7 days and a positive COVID-19 test result.


If you believe you may be eligible for treatment, please go to the Government of BC's COVID-19 treatments webpage to review the criteria and complete the four-step request process.


As part of this process, a doctor and pharmacist team will decide if treatment is safe and appropriate for you.


If you are receiving active cancer treatment and have questions about COVID-19 treatment and your cancer care, please contact your care team.

Go to the Government of BC's COVID-19 treatments webpage, review the criteria for treatment and start the four-step request process or call the Services BC phone line: 1-888-COVID19 (1-888-268-4319).


OR


  • Contact your family doctor or nurse practitioner
  • If you do not have a family doctor or nurse practitioner, contact your local BC Cancer care team: 
    • BC Cancer - Abbotsford: 604-851-4710
    • BC Cancer - Kelowna: 250-712-3900
    • BC Cancer - Prince George: 250-645-7300
    • BC Cancer - Surrey: 604-930-2098
    • BC Cancer - Vancouver: 604-877-6000
    • BC Cancer - Victoria: 250-519-5500

You should start the process as soon as possible. Delays may mean you are not able to receive treatment, because treatment must be started within 5-7 days of developing symptoms.


If you are receiving active cancer treatment and have questions about COVID-19 treatment and your cancer care, please contact your care team.



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