Covid-19 vaccines and lung cancer patients
What are Covid-19 vaccines made of and how do they work? Moreover, should lung cancer patients take them? With the rise of Covid-19 infection rates and the promise of a Covid-19 vaccine, we are going to delve into the questions of “what is a vaccine?” and “should we or should we not take it”?
What is a vaccine?
In broad terms, a vaccine is something that elicits an immune response that helps your immune system to be primed for a future infection where it can attack the foreign object. As illustrated by the diagram, a virus has many parts. One way to introduce a foreign object is to take a piece of the outer layer (shown in bright green) and put it into a vaccine. This part of the virus is called an antigen. In some instances, an entire virus has been killed and put into a vaccine, such as in the case of the polio vaccine. In addition to the antigen, a vaccine has other components: a preservative, a stabilizer, surfactants, a residual, a diluent, and an adjuvant. A preservative helps with the freshness of the vaccine and many single-use vials do not have them. Stabilizers help to prevent chemical reactions from occurring and some known stabilizers are sugar, gelatin, or a protein such as albumin (found in eggs). Surfactants act like a buffer to keep each component in the vaccine separated from others. Residuals are extra leftover items during manufacturing, but not an active ingredient. Diluent is a liquid that helps make the vaccine to the right concentration. Lastly, an adjuvant helps jumpstart the immune response to improve immunity against the virus.
Similar to the clinical trial system for drugs, a vaccine also goes through various phases before it is released. During Phase 1, the vaccine is given to a small number of volunteers to determine the dosage. In phase 2, the vaccine with the proper dosage is given to several hundreds of volunteers. Volunteers may be from a certain age group or ethnic background to determine the specificity of the vaccine in each group. In the last phase, the vaccine is given out to a broader group of volunteers (thousands) to study its efficacy. In Phase 3, there are also placebo groups who get a different vaccine (other than the study vaccine) or are injected with the diluent instead of the vaccine. This way, there is measurable efficacy that can be calculated by the scientists.
What vaccines are now available or in the pipeline?
When WHO declared Covid-19 as a pandemic in late December 2019, a race to generate a vaccine against Covid-19 began. There are currently two vaccines that are FDA-approved in an emergency setting in the United States, however there are more vaccines currently being used in the world. Most vaccines are based on one of the following general ideas: viral vector vaccine, nucleic acid vaccine, inactivated vaccine, or protein vaccine.
Regional approval and government regulations determine which vaccine will be available in which countries.
If there are vaccines available, should or shouldn’t we, ALKies, take it?
As of now, healthcare workers and first responders are being vaccinated with the Covid-19 vaccine (Pfizer or Moderna in the US). If you are currently receiving chemotherapy as part of your cancer treatment, you are considered immunocompromised, and at this time there is not yet data on the efficacy of these vaccines in immunocompromised patients. You may want to allow additional Phase 3 studies to be completed before you take the vaccine, but do consult with your oncologist. If your treatment currently involves only the use of a TKI, you are categorized as “high risk”. If the vaccine is offered to you, whether you are on Crizotinib, Alectinib, Brigatinib, Ceritinib, or Lorlatinib, please consider taking the vaccine. If you have additional high-risk factors, you may want to allow for additional Phase 3 trial results are completed because they are currently ongoing, or talk to your oncologist and any other medical providers you see on a regular basis.
We have ALK-positive members who work in the health industry and have already taken a Covid-19 vaccine. On the other hand, there are members who have voiced their concern about the safety of the vaccine and are hesitant or not willing to take the vaccine if it is offered to them. We have members who would recommend anyone to take it right away. Additionally, there are members posting alternatives to Covid-19 vaccines. In summary, you should engage in conversations with your oncologist to determine the best course for your individual situation.
The general CDC guideline is to take the vaccine unless you have had allergic reactions to previous vaccines. If you are unsure, please consult with your oncologist and follow their recommendation.
Here is a wonderful PBS video on what is Corona-Vaccine and how's it is made. PBS video
If you would like a video on the Covid-19 vaccine: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines/covid-19-vaccine-multimedia#
A timeline for all the WHO’s actions on Covid-19. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen
If you are interested, there is a more comprehensive list of vaccines currently under study. https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines.html
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/vaccine-benefits.html
https://www.who.int/news-room/feature-stories/detail/how-are-vaccines-developed
Author: Alice Chou