What Patients and Oncology Nurses Need to Know About Vaccination and Cancer

April 07, 2022 by Chelsea Backler MSN, APRN, AGCNS-BC, AOCNS®, VA-BC

People with cancer have a particular risk for infection, and vaccines can be a powerful preventive tool. According (https://www.who.int/health-topics/vaccines-and-immunization) to the World Health Organization, immunization prevents 2–3 million deaths every year worldwide from diseases, including diphtheria, influenza, and measles. Here’s what patients and nurses need to know about vaccines and guidelines for people with cancer.

Vaccination Versus Immunization

Immunization is often used interchangebly with vaccination or inoculation, but the terms have different meanings. Vaccination is defined (https://www.cdc.gov/vaccines/vac-gen/imz-basics.htm) as “the act of introducing a vaccine into the body to produce protection from a specific disease,” whereas immunization is “a process by which a person becomes protected against a disease through vaccination.”

Vaccination Considerations With Cancer

Not only is infection risk increased during cancer, but certain patients are more likely to have infections that become serious or life threatening. Individuals with hematologic malignancies tend to be more immunocompromised than those with solid tumors. Other factors affecting infection risk include (https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/low-blood-counts/infections/risk-for-infections.html) malnutrition, age, and other chronic illnesses.

Immunocompromised patients may not be able to mount a sufficient immune response to a vaccine dose. Clinicians must consider timing and type of vaccine administered in the context of a current cancer diagnosis. Evidence-based guidelines for immunocompromised individuals as well as patients with cancer can help guide decisions about vaccination.

ACIP Vaccination Guidelines for Immunocompromised Individuals

The Advisory Committee on Immunization Practices’ (ACIP’s) general recommendations (https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/immunocompetence.html) for individuals with “altered immunocompetence” are:

NCCN Vaccination Guidelines for Cancer Survivors

The National Comprehensive Cancer Network recommends (https://www.nccn.org/professionals/physician_gls/pdf/survivorship.pdf) the following considerations for cancer survivors specifically:

Patient Education

A Healthy People 2030 goal is to increase U.S. vaccination rates (https://health.gov/healthypeople/objectives-and-data/browse-objectives/vaccination). Nurses can contribute by providing patients with clear, evidence-based education about vaccination and why it may be important for them.

Additionally, identifying, understanding, and removing barriers to vaccines are critical. Social determinants of health (https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10862-1), structural inequities (https://www.sciencedirect.com/science/article/pii/S0264410X2030880X), and even political factors (https://www.pnas.org/doi/full/10.1073/pnas.2107873118) can influence (https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-388) whether a person receives a vaccine. As a trusted voice, nurses can advocate for, inform, and guide patients to making the choice that is right for them.

Copyright © 2022 by the Oncology Nursing Society. User has permission to print one copy for personal or unit-based educational use. Contact pubpermissions@ons.org for quantity reprints.