Should Cancer Patients Receive H1N1 Vaccine?

While I was waiting to speak at a cancer support group meeting today, the H1N1 virus vaccination issue came up. There were arguments pro and con. Several members said their docs had advised against it because they were too close to transplant or their white blood counts were too low. Here is a related article on CureToday.com Website:

Should you be concerned about the H1N1 virus?
BY ELIZABETH WHITTINGTON | OCTOBER 9, 2009

The H1N1 virus, or swine flu, has steadily swept across the country, and is considered widespread in 27 U.S. states now (view the CDC's interactive map).

And while the virus has primarily stricken young adults, those individuals at high risk for flu complications, which include the elderly and immunocompromised patients, should still consider getting vaccinated.

I had a chance to talk with Dr. Michael Boeckh, a member of the Vaccine and Infectious Disease Institute at Fred Hutchinson Cancer Research Center, last week on how the flu may affect cancer patients and he provided some valuable insight.

Boeckh suggests that there are certain individuals who are recommended to get the vaccine--namely those actively receiving chemotherapy or who are taking immunosuppressive drugs after a stem cell transplantation. Patients in this category who contract the flu, he says, could potentially have their treatment delayed or have other complications. "They are actually in a pretty high tier," he says, along with young children, pregnant women, and individuals with asthma, HIV, diabetes, lung disease, and cardiovascular disease. However, he suggests that most patients, regardless of treatment, be vaccinated.

"Except those who are very close to transplantation, they should all be vaccinated," Boeckh says. And while patients who have undergone a stem cell transplant within the past six months should not get the vaccine, he says it's important that family members and caregivers be vaccinated to reduce transmission of the virus.

For longterm survivors, Boeckh recommends they talk with their physician. Although the virus is least likely to affect people over 65 years of age, survivors may have other underlying conditions that may favor vaccination that would put them in a high tier (including those conditions listed above).

It's also suggested that patients who may have low immunity due to chemotherapy or transplantation receive the inactivated vaccine shot over the nasal mist, which uses a mild, but live, form of the virus. Unfortunately, the first batch of vaccines to be distributed, which began yesterday, is the nasal mist version. The shot version is expected to be widely distributed by mid-month.

And don't forget about the seasonal flu, Boeckh cautions. Individuals should be vaccinated for both the swine flu and seasonal flu.

"This first week of October, the predominant strain circulating, by far, is the swine flu, but that may change at any time," he says. "There is no reason to believe the seasonal flu will not come up. Typically, it's not even here this early. It's just about to start in a normal year."

Last year my oncologist did not want me getting a flu shot while my white blood counts were low. He thought that would decrease the vaccine's effectiveness. Sounds like this year, better to be safe than sorry. So feel good, keep smiling and get those flu shots! Pat