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The Pfizer/BioNTech Coronavirus vaccine (BNT162b2), which has been approved for use in Australia is 95% effective in reducing moderate to severe COVID-19.

The vaccine employs a new approach that uses messenger RNA to enable your cells to make a synthetic critical fragment of the virus. These recognisable pieces of the coronavirus stimulate an immune response. By activating the body’s immune pathways, the vaccine offers protection when someone encounters the virus.

The Pfizer vaccine is administered in two doses, at least 21 days apart.

Source: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/learn-about-covid-19-vaccines/about-the-pfizerbiontech-covid-19-vaccine

mRNA isn’t the same as DNA, doesn’t link with our DNA and it can’t change our genetic code.

Source: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/learn-about-covid-19-vaccines/about-the-pfizerbiontech-covid-19-vaccine

On 16 February 2021, the Oxford/AstraZeneca COVID-19 vaccine was provisionally approved  for use in Australia by the Therapeutic Goods Administration (TGA) for people 18 years and older.

The TGA has rigorously evaluated all clinical trial data and information provided by AstraZeneca and has issued provisional approval.

The Oxford/AstraZeneca vaccine is administered in two doses. The Australian Technical Advisory Group on Immunisation has determined that to create the very best immune response, ensure the most effective clinical protection and maximise broader community coverage, the vaccine should be administered at least 12 weeks apart.

Sources: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/learn-about-covid-19-vaccines/about-the-oxfordastrazeneca-covid-19-vaccine

The Therapeutic Goods Administration (TGA) and Advisory Committee on Vaccines (ACV) are the bodies responsible for ensuring that COVID-19 vaccines are safe and effective before approving them for use. We have confidence in the TGAs and the ACVs approval process and the safety of these vaccines. You will be provided with additional information about safety and precautions prior to vaccination in accordance with recommendations published by the Department of Health.

Sources: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/learn-about-covid-19-vaccines/how-covid-19-vaccines-are-tested-and-approved

Certain viruses, including the novel coronavirus, SARS-CoV-2, naturally mutate over time. Often these mutations don’t impact on how viruses affect us. However, some recent variants of SARS-CoV-2 have meant that those strains are more easily spread.

Current evidence from clinical trials indicates that the antibodies induced from COVID-19 vaccines are likely to provide protection to a variety of mutations and minor changes. However, in some cases there may be an impact on how antibody can ‘neutralise’ the virus and this may mean that the effectiveness of the vaccines against a particular strain could be affected. This information is still emerging and is being closely monitored.

In the same way that the influenza vaccine changes each season, the technology used to create the COVID-19 vaccines may be able to be adapted to changes in variants.

Sources: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/covid-19-vaccines-is-it-true/is-it-true-will-the-covid-19-vaccine-work-if-coronavirus-mutate

The Australian Government has secured doses of other COVID-19 vaccines, including those produced by Novavax, which are still subject to TGA approvals and The Australian Technical Advisory Group on Immunisation (ATAGI) advice.

Source: www.health.gov.au

The COVID-19 vaccines we will have in Australia have already been shown to be safe and effective, and it is strongly recommended to get vaccinated as soon as you are offered a vaccine.

Having a COVID-19 vaccine now offers you and others protection against the disease and is the fastest way to reducing our need for strict COVID-19 related measures.

Just like influenza it may be necessary to have further vaccinations or booster doses in future. More data will come on this over time.

There is no evidence of any safety concerns from vaccinating individuals with a past history of COVID-19 infection, or with detectable COVID-19 antibody so people who have had COVID-19 disease (whether confirmed or suspected) can still receive the COVID-19 vaccine. Those individuals with previous exposure to the virus mount an even better immune response after the vaccine.

Source: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/covid-19-vaccines-is-it-true/is-it-true-do-people-who-have-had-covid-19-and-recovered-need-to-get-vaccinated

Everyone should continue to follow government advice on reducing their risk of infection. Continuation of testing, social distancing, hand-hygiene and wearing a mask as recommended continue to be extremely important. Maintaining necessary infection control measures in line with government advice remain the most effective methods for reducing community transmission.

Experts need to understand more about the protection that COVID-19 vaccines provide before deciding whether to change any recommendations.

All GenesisCare centres will continue to adhere to our strict set of safety and quality measures to keep our patients and employees safe.

Stopping a pandemic requires using all the tools available. Continuation of social distancing, hand-hygiene and wearing a mask (as recommended) continue to be extremely important.

Vaccines work with your immune system to equip your body to fight the virus and reduce the severity of the illness if you are exposed. While experts learn more about the protection the vaccine provides under real-life conditions, we must continue to use all the tools available to us to protect ourselves and each other. Vaccination will eventually reduce the need for other infection control measures however we will inform you of any changes to protocols.

Many (but not all) people affected by cancer will be eligible to receive a COVID-19 vaccine in the second phase (phase 1b) of the Australian Government’s COVID-19 vaccine national roll-out strategy, which is expected to begin from mid-March 2021. People affected by cancer fit into the priority group “Adults with an underlying medical condition” (and may also fall into some other groups in phases 1a or 1b, such as adults over the age of 70 years and aged care residents).

At this time, the people affected by cancer who fit into the priority group “Adults with an underlying medical condition” include those who*:

• have blood (haematological) cancers, including leukaemia, lymphoma or myeloma (diagnosed within the last 5 years or who are on, or recently completed, active treatment including chemotherapy, radiotherapy, immunotherapy or targeted anti-cancer therapy or who have advanced disease regardless of treatment)
• have other (non-haematological) cancers (diagnosed within the last 5 years or who are on, or recently completed, active treatment including chemotherapy, radiotherapy, immunotherapy or targeted anti-cancer therapy or who have advanced disease regardless of treatment)
• are adult survivors of childhood cancers
• have had a bone marrow transplant or have received CAR-T therapy.

Speak to your healthcare professional if you are unsure which roll-out group you fit into.

* This is the current list provided by the Australian Health Protection Principal Committee (AHPPC). For more information, visit the following information on the Australian Government Department of Health website:

• COVID-19 vaccine eligibility checker
• Priority groups for COVID-19 Vaccination Program: Phase 1b
• ATAGI clinical guidance on COVID-19 Vaccine in Australia in 2021.

Source: Australian Technical Advisory Group on Immunisation (ATAGI). COVID-19 vaccination – ATAGI clinical guidance on COVID-19 Vaccine in Australia in 2021. ATAGI; 2021. Available from: https://www.health.gov.au/resources/publications/covid-19-vaccination-atagi-clinical-guidance-on-covid-19-vaccine-in-australia-in-2021

Australian Department of Health. Priority groups for COVID-19 Vaccination Program: Phase 1b. Canberra ACT: Australian Department of Health; 2021 [updated 2021 Mar 08, cited 2021 Mar 09] Available from: https://www.health.gov.au/resources/publications/priority-groups-for-covid-19-vaccination-program-phase-1b

Currently, Australia’s COVID-19 vaccine national roll-out strategy does not have a dedicated category for close contacts of people affected by cancer, such as family members and carers.

Some close contacts may fit into other groups within the roll-out strategy. For example:

• Elderly adults aged 70 and older and Aboriginal and Torres Strait Islander people aged over 55 years old are in phase 1b of the roll-out strategy along with younger adults affected by cancer
• Adults aged 50 years and older and Aboriginal and Torres Strait Islander people aged 18-54 years old are in phase 2a, which is the next roll-out phase after phase 1b.

For people affected by cancer, decisions about where to receive the COVID-19 vaccine may be made on an individual basis by the person affected by cancer, in consultation with their healthcare team.

COVID-19 vaccines in Australia will be provided by healthcare professionals through selected hospitals and general practitioners (GPs), GP-led Respiratory Clinics, Aboriginal Community Controlled Health Services, state vaccination clinics and pharmacies.

For more information about where the COVID-19 vaccines will be available, visit How COVID-19 vaccines will be distributed on the Australian Government Department of Health website. This webpage will be updated as more information becomes available.

The decision about who will give people with cancer their COVID-19 vaccine may be made on an individual basis, together with their healthcare team.

Only qualified healthcare professionals can administer the COVID-19 vaccines. Additionally, every healthcare professional who administers the COVID-19 vaccines must complete compulsory COVID-19 vaccination training which covers the handling and administration of COVID-19 vaccines.⁷

For more information about the training required in order to administer the COVID-19 vaccines, visit COVID-19 vaccination training program on the Australian Government Department of Health website.

Source: Australian Department of Health. Mobilising Australia’s COVID-19 vaccine workforce [Internet]. Canberra ACT: Australian Department of Health; 2021 Jan 21 [cited 2021 Feb 04]. Available from: https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/mobilising-australias-covid-19-vaccine-workforce

People with cancer are likely to be offered the same COVID-19 vaccines as the rest of the Australian population.

Based on early clinical trial results, it is likely that all people in Australia (including people affected by cancer) will require two doses of the COVID-19 vaccines.

• The two doses of the Pfizer/BioNTech vaccine should be given at least three weeks apart. It is particularly important for people with cancer to get the second dose of the vaccine as close to three weeks after the first dose as possible to ensure they are adequately protected from COVID-19.
• The two doses of the AstraZeneca vaccine can be safely administered between 4-12 weeks apart, however, the Australian Technical Advisory Group on Immunisation (ATAGI) recommend 12 weeks between the first and second dose.

Whether people will need additional ‘booster’ doses, such as an annual booster, for COVID-19 vaccines is not yet known. This is still being determined by ongoing clinical trials.

Source: Australian Department of Health. Mobilising Australia’s COVID-19 vaccine workforce [Internet]. Canberra ACT: Australian Department of Health; 2021 Jan 21 [cited 2021 Feb 04]. Available from: https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/mobilising-australias-covid-19-vaccine-workforce

It is important for all people to get the recommended dosage of the COVID-19 vaccine they are offered. However, this may be particularly important for people with cancer.

Early results from a study conducted in the United Kingdom (UK) for the Pfizer/BioNTech vaccine found that cancer patients had lower levels of protection from the SARS-CoV-2 virus (the virus that causes COVID-19) following the first dose of the vaccine, compared to people without cancer. However, when cancer patients received their second dose three weeks after the first dose, protection against the SARS-CoV-2 virus improved significantly.

When people who have lower COVID-19 protection come into contact with the virus, they are more vulnerable to COVID-19 and also risk spreading the virus to their close contacts, such as family and carers.

Currently in Australia, there is low community spread of COVID-19 compared to other parts of the world, including where this study was conducted (the UK). However, even after receiving the vaccine, it is still important for people affected by cancer in Australia, and their close contacts, to continue taking other protective measures against COVID-19, including practising good hygiene and maintaining physical distancing.

Source: King’s College London. Delaying second vaccine dose leaves cancer patients vulnerable to virus [Internet]. UK: King’s College London; 2021 [updated 2021 March 11, cited 2021 March 12]. Available from: https://www.kcl.ac.uk/news/delaying-second-vaccine-dose-cancer-patients-vulnerable-virus

No, people with cancer were not included in most clinical trials for the COVID-19 vaccines. This is because clinical trials typically need to see whether the vaccines will work in people with healthy immune systems.

Source: American Cancer Society. COVID-19 Vaccines in People with Cancer [Internet]. USA: American Cancer Society; 2021 [updated 2021 Jan 29, cited 2021 Feb 04]. Available from: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/low-blood-counts/infections/covid-19-vaccines-in-people-with-cancer.html

Many cancer organisations internationally currently recommend COVID-19 vaccination for people with cancer and those with a weaker immune system (this is also known as being immunocompromised).This is because:

• People with cancer are more vulnerable to contracting COVID-19 and are at an increased risk of more severe infection.

• Similar evidence from use of other vaccines suggests that COVID-19 vaccines may be safe and effective for people with cancer.

Because people with cancer were not included in clinical trials, there is limited evidence about whether the COVID-19 vaccines are safe for people with cancer, or people who are immunocompromised because of cancer or cancer treatments. However, in principle there are no theoretical safety concerns for either the Pfizer COVID-19 vaccine (a non-live vaccine) or the AstraZeneca COVID-19 Vaccine (a non-replicating viral vector vaccine) in people who are immunocompromised, on the basis of a general understanding of the vaccines. Information is being collected from COVID-19 vaccination programs internationally, and so far, there have been no reports of any significant safety issues for people with cancer receiving the COVID-19 vaccines in other countries. This will continue to be monitored.

The Australian Technical Advisory Group on Immunisation (ATAGI) recommend people who are immunocompromised should be among the priority groups to receive the COVID-19 vaccines because of their increased risk of severe illness with COVID-19. The decision about whether to receive a COVID-19 vaccine should be made on an individual basis by the person affected by cancer, in consultation with their healthcare team.

Source: European Society for Medical Oncology. COVID-19 vaccination in cancer patients: ESMO statements [Internet]. Lugano: European Society for Medical Oncology; 2020 [cited 2021 Feb 04]. Available from: https://www.esmo.org/covid-19-and-cancer/covid-19-vaccination

Liang W, Guan W, Chen R, Wang W, Li J, Xu K, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020 Mar 01;21(3):335-7.

Yang F, Shi S, Zhu J, Shi J, Dai K, Chen X. Clinical characteristics and outcomes of cancer patients with COVID-19. J Med Virol. 2020 Oct;92(10):2067-2073.

Zhang L, Zhu F, Xie L, Wang C, Wang J, Chen R, et al. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China. Ann Oncol. 2020 Jul;31(7):894-901.

Dai M, Liu D, Liu M, Zhou F, Li G, Chen Z, et al. Patients with Cancer Appear More Vulnerable to SARS-CoV-2: A Multicenter Study during the COVID-19 Outbreak. Cancer Discov. 2020 Jun;10(6):783-91.

Lai AG, Pasea L, Banerjee A, Denaxas S, Katsoulis M, Chang WH, et al. Estimating excess mortality in people with cancer and multimorbidity in the COVID-19 emergency. medRxiv. 2020; doi:10.1101/2020.05.27.20083287.

Moujaess E, Kourie HR, Ghosn M. Cancer patients and research during COVID-19 pandemic: A systematic review of current evidence. Crit Rev Oncol Hematol. 2020 Jun;150:102972.

Wang Q, Berger NA, X R. Analyses of Risk, Racial Disparity, and Outcomes Among US Patients With Cancer and COVID-19 Infection. JAMA Oncol. 2020 Dec 10;doi:10.1001/jamaoncol.2020.6178

Rüthrich MM, Giessen-Jung C, Borgmann S, Classen AY, Dolff S, Grüner B, et al. COVID-19 in cancer patients: clinical charactertistics and outcome – an analysis of the LEOSS registry. Ann Hematol. 2021;100(2)383-393

Venkatesulu BP, Chandrasekar VT, Girdhar P, Advani P, Sharma A, Elumalai T, et al. A systematic review and meta-analysis of cancer patients affected by a novel coronavirus. medRxiv. 2020 May 29;doi: 10.1101/2020.05.27.20115303

Cordonnier C, Einarsdottir S, Cesaro S, Di Blasi R, Mikulska M, Rieger C, et al. Vaccination of haemopoietic stem cell transplant recipients: guidelines of the 2017 European Conference on Infections in Leukaemia (ECIL 7). Lancet Infect Dis. 2019; 19(6):e200-e212..

Although there is currently limited evidence about whether the COVID-19 vaccines work for people affected by cancer, we do have a lot of similar evidence from use of other vaccines that suggests the COVID-19 vaccines may be effective for people affected by cancer:

• Evidence from flu vaccinations suggests that people affected by cancer can mount a protective immune response from COVID-19 vaccines (that is, whether their immune system becomes trained to recognise and fight against specific germs). However, the level of immunity may be affected by a range of factors (such as cancer type, therapies, and immune function).

• There is evidence from other vaccinations used to prevent infection to support their use for people affected by cancer, even in those undergoing immunosuppressive therapy.

However, the immune response to vaccination may be reduced in people who are immunocompromised, which may result in lower vaccine effectiveness and protection compared to people who are not immunocompromised.

Even after receiving the vaccine, it is important for people affected by cancer (especially those who are immunocompromised) and any close contacts, to continue taking other protective measures against COVID-19, including practising good hygiene and maintaining physical distancing.

Source: European Society for Medical Oncology. COVID-19 vaccination in cancer patients: ESMO statements [Internet]. Lugano: European Society for Medical Oncology; 2020 [cited 2021 Feb 04]. Available from: https://www.esmo.org/covid-19-and-cancer/covid-19-vaccination

Cordonnier C, Einarsdottir S, Cesaro S, Di Blasi R, Mikulska M, Rieger C, et al. Vaccination of haemopoietic stem cell transplant recipients: guidelines of the 2017 European Conference on Infections in Leukaemia (ECIL 7). Lancet Infect Dis. 2019; 19(6):e200-e212.

Mikulska M, Cesaro S, de Lavallade H, Di Blasi R, Einarsdottir S, Gallo G, et al. Vaccination of patients with haematological malignancies who did not have transplantations: guidelines from the 2017 European Conference on Infections in Leukaemia (ECIL 7). Lancet Infect Dis. 2019 Jun; 19(6):e188-e199.

Rieger CT, Liss B, Mellinghoff S, Buchheidt D, Cornely OA, Egerer G, et al. Anti-infective vaccination strategies in patients with hematologic malignancies or solid tumors-Guideline of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO). Ann Oncol. 2018 Jun 01; 29(6):1354-1365.

For people with cancer, the decision about when to receive a COVID-19 vaccine should be made on an individual basis by the person affected by cancer in consultation with their healthcare team. Factors to consider include:

• The type of cancer the person has/had
• The type of treatment they are receiving/received
• The timing of their treatment
• The type(s) of vaccine(s) available
• How their immune system is working.

For example, some cancer treatments (like chemotherapy, radiation therapy, or immunotherapy) can affect the immune system, which might make the vaccine less effective in some people.

Source: American Cancer Society. COVID-19 Vaccines in People with Cancer [Internet]. USA: American Cancer Society; 2021 [updated 2021 Jan 29, cited 2021 Feb 04]. Available from: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/low-blood-counts/infections/covid-19-vaccines-in-people-with-cancer.html

Currently, there is no information available from the COVID-19 vaccines clinical trials about whether the COVID-19 vaccines will affect or interact with cancer treatments. This is because most clinical trials for the COVID-19 vaccines did not include people with cancer.

Recommendations vary and there are several factors to consider for every individual, including:

• The type of cancer you have/had
• The type of treatment you are receiving/received
• The timing of the treatment you are receiving/received
• The type(s) of vaccine(s) available
• How your immune system is working

There are some theoretical risks of immune-related side effects for COVID-19 vaccination for people receiving immunotherapy, including checkpoint inhibitors such as pembrolizumab, nivolumab and ipilimumab. However, international cancer organisations and Australian experts recommend vaccination after weighing the benefit of vaccination against risk.

Optimal responses to the vaccine are more likely more than 3-6 months after stem cell transplant or CAR-T cell therapy.

If you are having treatment for cancer, speak to your healthcare team about the best timing for you based on your own situation.

Some organisations have provided recommendations for health professionals about the timing of the COVID-19 vaccines and cancer treatments. These are located at COVID-19 vaccines and cancer – health professional guidance on Cancer Australia’s website.

Source: National Comprehensive Cancer Network. Preliminary Recommendations of the NCCN COVID-19 Vaccination Advisory Committee [Internet]. USA: National Comprehensive Cancer Network; 2021 Jan 22 [cited 2021 Mar 01]. Available from: https://www.nccn.org/covid-19/pdf/COVID-19_Vaccination_Guidance_V1.0.pdf

UK Chemotherapy Board. Clinician Frequently Asked Questions (FAQs) and guidance on COVID19 vaccine for patients receiving Systemic Anti-Cancer Therapy. Accessed 2 Mar 2021. https://4bd2316d-e45d-4e90-96b5-431f1c12dd3e.filesusr.com/ugd/638ee8_bc24796daf974cfa830a432248401191.pdf

Australia and New Zealand Transplant and Cellular Therapies. COVID19 Vaccination Consensus Position Statement [updated 2021 Feb 02, cited 2021 Mar 08]. Available from: https://anztct.org.au/wp-content/uploads/2021/02/FINAL-ANZTCT-COVID19-Vaccination-Position-Statement-Version2-2-Feb-2021.pdf

There have been some reports internationally about people who have received a COVID-19 vaccine having lymph node swelling which is being mistaken for possible breast cancer. This swelling occurs in the lymph glands in the underarm area and is known as lymphadenopathy.

Clinical experts in Australia are working to develop guidance around whether the timing of a screening mammogram or diagnostic imaging for breast cancer symptoms should be impacted for any people who have had a COVID-19 vaccination recently. This FAQ will be updated when information becomes available.

Please contact your centre prior to treatment if you are experiencing symptoms such as fever and/or shortness of breath or cough.

At this stage you do not need to notify GenesisCare of your vaccination status.

GenesisCare does not currently administer the vaccine to patients however our doctors are available if you have any questions or concerns about the vaccine.

Our purpose is to design the best care experiences for cancer patients, and we must remain focused on that priority as we keep all patients and team members safe, and our centres open.

GenesisCare doctors can provide patients with a letter outlining their cancer diagnosis and treatment and confirm their status as an immunosuppressed individual.

It is not recommended to have an influenza vaccine with a COVID-19 vaccine on the same day.

The preferred minimum interval between a dose of seasonal influenza vaccine and the approved COVID-19 vaccines is 14 days to allow the immune system to mount a response to the vaccine. It also allows identification of the causal vaccine if a reaction occurs after administration.

The dose of influenza vaccine can be given in any sequential order in relation to the 2 doses of a COVID-19 vaccine.

An influenza vaccine dose can be administered between dose 1 and dose 2 of the COVID-19 vaccines if sufficiently spaced apart to allow for minimal intervals between vaccines. This is particularly applicable to the Oxford AstraZeneca vaccine for which the 2 doses can be given at least 12 weeks apart.

Source: https://www.health.gov.au/resources/publications/covid-19-vaccination-atagi-advice-on-influenza-and-covid-19-vaccines

• Department of Health
• Therapeutic Goods Administration
• Australian Academy of Science
• World Health Organisation
• National Centre for Immunisation Research and Surveillance

• Cancer Australia
• Medical Oncology Group of Australia