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Q&A: Cancer and the flu shot

Dec 14, 2021

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The Centers for Disease Control and Prevention recommends everyone six months of age and older should get a flu shot every year.

With winter and flu season underway, John McCarty, M.D., director of the Cellular Immunotherapies and Transplant Program and member of the Developmental Therapeutics research program at VCU Massey Cancer Center, answered some common questions regarding the importance of the flu shot, particularly for cancer patients and survivors.

What is a flu shot?

A flu shot is an injectable vaccine given by needle in the arm that protects against the most common versions of the influenza virus in the current season. The most common flu shots are protein-based vaccines and do not contain live virus.

Is the flu shot effective?

The effectiveness of the flu shot can differ from year to year, and it is not guaranteed to prevent a person from getting the flu. However, it can still prevent you from getting sick, and it has been shown to minimize severity of illness and hospitalizations for vaccinated individuals that do still get sick. Additionally, it’s recommended to consistently receive the flu shot every year to help maximize immunity against different variations of the flu. Each year, the flu shot is adapted to prevent the most dominant versions of the flu at that time, and prior vaccinations may also offer a partial protection against the non-dominant flu strain in any given year.

Should cancer patients and survivors get a flu shot?

Flu shots are approved, safe and highly recommended for cancer patients. Cancer and cancer treatment can weaken a person’s immune system, so it is particularly vital for these patients to be well-armored against the flu to ensure that their health and cancer treatment are not compromised. This applies to cancer survivors as well because they can have suppressed immune systems up to two years after treatment.

If cancer patients get the flu, it can delay their treatment and potentially give the cancer an advantage. For some patients, the flu can become an acutely severe disease. For example, in patients who have had a bone marrow transplant, the flu can cause the very severe side effect of graft-vs-host disease, where the flu virus stirs up the newly developing immune system into a hyperactive state so that it attacks healthy organ systems.

Is the shot my only option to vaccinate against the flu?

There is also a nasal spray version of the flu vaccine, but people with cancer should not get the nasal mist flu vaccine because it contains live, although weakened, virus, which could negatively impact their immune system.

Are cancer patients more likely to get the flu or be at risk for more serious complications than other people?

Although there isn’t evidence that cancer patients contract the flu at higher rates than other people, they are at an elevated risk of developing more serious —potentially life-threatening — complications from the virus.

Should caregivers/family members of cancer patients get the flu shot?

Yes. It is just as important for family members, caregivers and anyone with close contact with patients undergoing cancer therapy to get the flu vaccine to reduce the chance of the cancer patient getting sicker. To use an analogy, if we can’t directly protect the castle, we build a moat or a wall around it to provide additional security. In this case, the castle refers to our most vulnerable patients, and we build the moat or wall by getting vaccinated for them.

Can I get a flu shot while on active cancer treatment?

Check with your oncology care provider to determine the best timing for your flu vaccination. If it is deemed appropriate, you can receive the vaccine during a regularly scheduled appointment.

What are some of the side effects of the flu shot?

Some of the common side effects of the flu shot can include soreness, redness or swelling in the area where the shot was administered, minor headache, fever, nausea, muscle aches and fatigue. If experienced, these side effects are typically mild and go away on their own within a couple of days.

Most flu shots are typically grown in chicken eggs and may trigger allergies in some people. The CDC still recommends a flu shot for patients without severe allergic reactions to egg products or to prior flu vaccinations. Reactions such as rashes and hives are not a barrier to getting the flu vaccine.

Can I get the flu shot at the same time as a COVID-19 vaccine or booster shot?

There is no evidence indicating that a person should avoid getting both at the same time. Because many of the side effects of the flu shot are similar to the COVID-19 vaccines and booster shots, it might actually be desirable to get both at once as opposed to experiencing these side effects on two separate occasions.

For more information on flu vaccination for cancer patients, visit:
https://www.cdc.gov/cancer/flu/basic-info.htm

https://www.cancer.net/blog/2021-09/should-people-with-cancer-and-cancer-survivors-get-flu-vaccine

https://www.lls.org/treatment/flu-shots-and-immunizations

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