Cancer patients and the flu: to vaccinate or not to vaccinate?

Flu season is not as far away as you might think, and every year cancer patients in treatment and in remission all have the same concern: is the flu shot safe for them?

Ultimately, the decision whether or not to get the flu shot should be made in conjunction with one's health care team—people who are fully informed of your condition and can accordingly determine what is best for you.

In the meantime, let's look at some of the points made in a review article published this past spring in the official journal of the American Society of Clinical Oncology, the Journal of Clinical Oncology, or JCO, "Utility of Influenza Vaccination for Oncology Patients".

First, when it comes to flu vaccines, cancer type does matter: Patients with solid tumor cancers tend to do very well with the vaccine, no worse in fact than the general public. Patients with blood cancers however—i.e. lymphomas and leukemias—do not do quite as well, although in response to the vaccine their immune systems generally are capable of producing a sufficient amount of antibodies to provide protection from the flu.

Second, if you're in the midst of chemotherapy, two factors appear to be the most important:
1) Timing—the best time to get the vaccination is a point that is furthest away from the most recent infusion
2) White cell count—ideally, one's white cell count would be higher than 1000.

Third, if you're on Rituxan maintenance or on any other similar biological therapy, no consensus currently exists, meaning it's something that you and your doctor must discuss.

Fourth, caregivers and people who live with cancer patients should give serious consideration to getting the flu shot, especially if they're thinking about passing on it. Should they come down with the flu, they pose a serious threat to the health of the cancer patient.

RECOMMENDATIONS FROM THE CDC

The US Centers for Disease Control and Prevention currently advise people with compromised immune systems (this especially means you, lymphoma patients) to avoid the live (LAIV) influenza vaccine altogether, and stick with the inactivated vaccine. For a complete run-down of the CDC's recommendations regarding who should NOT receive which vaccines, click here.