Is the COVID Vaccine Safe for People With Lung Cancer?

The SARS-CoV-2 infection leads to COVID-19, a disease that primarily includes respiratory symptoms. Though hundreds of millions of people have contracted the virus, the majority of people recover without problems. However, people with underlying medical issues, including lung cancer or a weakened immune system, are at risk for severe disease. 

Vaccination is an essential tool to protect against COVID-19. It has proven to be safe and effective in people with lung cancer, who are already at an increased risk of death from the virus due to its respiratory factors.

This article discusses why people with lung cancer need to be fully vaccinated against COVID-19.

The COVID-19 Vaccine

The development of the COVID-19 vaccine has been one of the most critical advances in the course of the pandemic. Certain populations can particularly benefit from vaccination, such as those at higher risk for severe disease or death from the virus.

Data from the Centers for Disease Control and Prevention (CDC) shows that unvaccinated adults are 16 times more likely to be hospitalized than fully vaccinated people. It also shows that unvaccinated adults over age 50 are 46 times more likely to be hospitalized than people who have been fully vaccinated and received an additional booster dose.

COVID-19 Vaccine Options

A few different COVID-19 vaccine options are approved for use in the United States, but the most widely used are the mRNA vaccines.

Although the mRNA vaccine technology seems new to the general population, it has been perfected over decades and is proven to be safe and effective.

Pfizer-BioNTech

The Pfizer-BioNTech vaccine is an mRNA vaccine that requires two shots, 21 days apart.

Initially, the vaccine was found to be 95% effective against the original variant in preventing infections in people ages 16 years and older who receive two shots. However, as variants such as Omicron have emerged, updated bivalent boosters are necessary to help restore protection that has decreased.

Moderna

The Moderna vaccine is an mRNA vaccine that requires two shots, 28 days apart. When the original strain was dominant, it was found to be 94% effective in preventing infections in people who receive two doses. However, since variants such as Omicron have emerged and be come dominant, updated bivalent boosters are necessary to restore protection.

The Moderna vaccine is recommended for people ages 6 months and older.

Novavax

The Novavax vaccine is a protein-based vaccine that uses a custom-made spike protein that mimics the natural spike protein in the SARS-CoV-2 virus.

The vaccine was initially found to be 90% effective in preventing infections in people who receive two doses. However, as variants such as Omicron have emerged, updated bivalent boosters are necessary to help restore protection. The Novavax vaccine is recommended for people ages 12 years and older.

Johnson & Johnson's Janssen

The J&J Janssen vaccine is a viral vector vaccine that uses a modified, harmless version of another virus engineered to hold genetic material from SARS-CoV-2. It is given in one shot.

The J&J vaccine is not as effective as the mRNA vaccines and is the least preferred in the United States. It was still effective at preventing hospitalizations and deaths in comparison to not being vaccinated.

Due to the possible side effects of the J&J vaccine, the CDC recommends that people get one of the mRNA vaccines (Pfizer or Moderna) or the Novavax vaccine over a J&J vaccine, where possible.

Is Vaccination Safe for People With Lung Cancer?

The COVID-19 vaccines have been proven safe and effective in initial safety studies, clinical trials, and real-world practice. Hundreds of millions of people have received the COVID-19 vaccine, and most have not experienced problems with it.

Severe complications after vaccination are rare, and have been more common in people who received J&J's Janssen vaccine. Some people have developed myocarditis or pericarditis, inflammation of the heart muscle or the sac that lines the outside of the heart, after receiving the Pfizer-BioNTech or Moderna vaccines. However, most responded well to treatment and did not develop further complications.

The initial clinical trials that evaluated the safety and effectiveness of COVID-19 vaccines did not include people with cancer. However, since the release of the initial vaccines, researchers have spent time assessing vaccination in people with cancer.

Now, after further study, experts agree that COVID-19 vaccination is just as safe for people with cancer as for the general population.

Research has also confirmed that the vaccine is safe in people with lung cancer.

Contraindications for the COVID-19 Vaccine

The only contraindication (reason for harm) to receiving a COVID-19 vaccine is a history of a severe allergic reaction to the vaccine itself or its ingredients.

Polyethylene glycol is a preservative ingredient in mRNA vaccines, and polysorbate is in J&J’s Janssen vaccine. If a person is allergic to these ingredients, they should not receive the vaccine.

COVID-19 Vaccine Side Effects

Side effects from COVID-19 vaccination are similar to those of other vaccines. People can experience:

• Pain, redness, or swelling at the injection site
• Fatigue
• Headache
• Muscle aches
• Chills
• Fever
• Nausea

The side effects are the same in people with cancer, the most common being injection site pain, tiredness, fever, chills, and muscle aches. The side effects typically go away within three days.

Severe problems with vaccination are rare, and if they do occur, they usually happen within six weeks of receiving a vaccine dose.

COVID-19 in People With Lung Cancer

COVID-19 infection damages the lungs, which is particularly concerning for people with lung issues like lung cancer.

People with lung cancer have a 30% mortality rate from COVID-19, which is significantly higher than the general population. Researchers suspect this increased risk of death is because these people already have severe lung injury.

Scientists have already determined that the COVID-19 vaccines are safe, even in people with lung cancer. Instead, their primary concern is whether the vaccines are effective in people with cancer. 

Antibodies are the proteins responsible for helping to prevent and fight infection. People with lung cancer often take medications that weaken the immune system, including corticosteroids, targeted therapy, chemotherapy, and immunotherapy.

Cancer treatments strain the body's ability to develop an appropriate antibody response after any vaccination. This means that the vaccines may not be as effective in people with lung cancer and a weakened immune system.  

However, researchers have demonstrated that people with lung cancer vaccinated with two doses of an mRNA vaccine develop good immunity to SARS-CoV-2. Despite this, they stress the need for extra vaccine doses and boosters to help improve immunity. 

Vaccination Recommendations in People With Lung Cancer

Most experts and professional societies recommend vaccination in people with cancer, including:

• American Cancer Society (ACS)
• American Association for Cancer Research (AACR)
• American Society of Clinical Oncology (ASCO)
  
• Society for Immunotherapy of Cancer (SITC)
• European Society for Medical Oncology (ESMO)

In addition to vaccination, the CDC recommends updated bivalent booster shots 2 months after completing the primary series or last booster for all people over the age of 5, no matter the type of vaccine series initially received.

Children ages 5 years are only eligible to receive the bivalent Pfizer booster. Everyone ages 6 years and older can choose to get the Pfizer or Moderna bivalent booster.

Research does not suggest that vaccination will interfere with cancer treatment. However, people with cancer are advised to speak with their oncologist or another healthcare provider if they have questions about vaccine interference with cancer treatment. 

The CDC recommends that people 12 years and older who are immunocompromised and received Pfizer or Moderna as their primary series get a third dose of the mRNA vaccine. People should obtain the third dose of vaccine at least four weeks after the second vaccine dose, followed by a bivalent booster 2 months after the third dose or last booster. 

The CDC recommends that people who received one dose of the J&J vaccine get an additional dose of an mRNA vaccine at least 4 weeks later, followed by one bivalent booster 2 months later.  

People who received Novavax as a primary series should receive a bivalent booster at least 2 months after the second dose.

In limited situations, people ages 18 years and older who have completed the primary COVID-19 vaccination and have not received any previous booster doses may receive a monovalent Novavax booster dose if they cannot receive an mRNA vaccine. This dose is given at least 6 months after completing the primary series.

Summary

COVID-19 is a severe respiratory illness that can be more serious and even fatal in people with lung cancer. Vaccination is safe and effective for people with lung cancer and is encouraged to prevent severe disease and death.

Four different COVID-19 vaccines are available to help prevent infection. The Pfizer-BioNTech, Moderna, and Novavax vaccines are more effective and recommended for people with lung cancer. The J&J Janssen vaccine can be considered if the other options are not available.

Side effects from the vaccine are the same in people with lung cancer as without. They commonly include fever, chills, fatigue, nausea, and muscle aches. Allergic reactions are rare, but possible.

Since people with lung cancer usually have a weakened immune system, the CDC recommends three vaccine doses plus an additional booster shot.

A Word From Verywell

COVID-19 is dangerous for everyone, but it can be especially so for people with an underlying disease like lung cancer. People with cancer need all the protection they can get to prevent severe illness and death from COVID-19.

The COVID-19 vaccines are proven to be safe and effective, and all people with lung cancer are advised to be fully vaccinated and boosted. Though evidence does not suggest that vaccination interferes with cancer therapy, speak to your healthcare provider if you have concerns.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.