COVID-19 Reference Sheet: Vaccines

December 14, 2020 by Chelsea Backler MSN, APRN, AGCNS-BC, AOCNS®, VA-BC, and Lisa Kennedy Sheldon PhD, ANP-BC, AOCNP®, FAAN 

Last updated: October 18, 2021

To control the COVID-19 coronavirus pandemic, society needs public health measures (e.g., masks, physical distancing, hand washing), treatments for infection, and vaccines to prevent infection or serious disease. As the most trusted profession, nurses have a responsibility to educate patients and the community about the facts and science behind the vaccines. This reference sheet will help guide those conversations and is regularly updated as new information is released.

As of October 2021, several manufacturers’ vaccines have either emergency use authorization (EUA) (Moderna and Johnson & Johnson/Janssen) or U.S. Food and Drug Administration (FDA) approval (Pfizer). Manufacturers are working on three main types of COVID-19 vaccines: 

Although mRNA vaccines are new for human vaccination, the National Institutes of Health began investing in that type of vaccine in the 1990s. mRNA vaccines do not use a live virus, nor do they enter the cell nucleus or change cellular DNA.  

The Pfizer and Moderna vaccines require two doses by intramuscular injection: an initial dose followed by a second dose three to four weeks later. The Johnson and Johnson/Janssen is a single dose. In October 2021, the Centers for Disease Control and Prevention (CDC) recommended that those aged 65 and older, adults with certain medical conditions including cancer, adults in long-term care settings, and people who are at higher risk for COVID-19 exposure and transmission (this includes healthcare workers) receive a booster injection of the Pfizer vaccine six months after their initial vaccination.    

What Are the Vaccine’s Short- and Long-Term Side Effects?

Millions of people in the United States have received COVID-19 vaccines since the EUAs were issued. The most commonly reported side effects are swelling, redness, and pain at the injection site, and flu-like symptoms. Some people experience no side effects following vaccination, and reports of serious side effects (e.g., anaphylaxis) are rare. According to CDC, long-term side effects are unlikely, but the agency is closely monitoring the vaccines’ safety. Providers and patients should report side effects of the vaccines through these systems: 

COVID-19 Vaccination for Patients with Cancer

People with cancer who are infected with COVID-19 may have an increased risk of complications and have overall increased mortality from the infection than those without cancer. Although initial evidence points to both patients with solid tumors and hematologic malignancies being at higher risk compared to the general population, those with metastatic malignancies and immunocompromised states are of particular concern.

Many expert oncology groups recommend that people with cancer or a history of cancer receive the COVID-19 vaccine. Because participants with cancer and those receiving immunosuppressant drugs were excluded from the initial clinical trials, the vaccines’ safety wasn’t established in this population. Experts suggest that although some immunosuppressed patients may experience decreased response, the vaccine may still confer some benefit and is important to reduce the risk or severity of COVID-19 infection. Healthcare providers must counsel patients about the unknown safety profile and effectiveness in immunocompromised populations as well as the potential for reduced immune responses.

The National Comprehensive Cancer Network (NCCN) issued the following guidelines for vaccination in people with cancer:

After vaccination, patients must continue to follow all current guidelines to protect themselves and others against COVID-19 (e.g., wearing face masks, social distancing, handwashing) because vaccinated people, although asymptomatic, may still transmit the virus. Additionally, new COVID-19 variants are emerging and the vaccine’s effectiveness against them is not completely understood.

People with cancer must discuss their desire to get the vaccine with their oncology team before undergoing vaccination. Oncology nurses have a significant role in educating patients with cancer about the COVID-19 vaccine. NCCN has a patient-facing tool that can help guide those conversations.

Copyright © 2020 by the Oncology Nursing Society. User has permission to print one copy for personal or unit-based educational use. Contact for quantity reprints.