Just for clarity, Pfizer and Moderna are mRNA vaccines, which means that there is not even a complete killed virus involved. In general, concerns over vaccine safety for immunicompromised individuals are associated with weakened live virus vaccines. None of the potential COVID-19 candidates uses that method. (Immunotherapy may present other considerations; I’m not suggesting that, though, just not commenting on it.) While it is my understanding that no clinical trial for COVID-19 vaccines has enrolled immunicompromised patients, significant side effects have not been seen In immunicompromised patients for other killed virus vaccines or recombinant-protein-based vaccines in the past. This includes even patients with hematological malignancies, who generally receive stronger immunosuppressive therapy than solid tumor patients. Johnson & Johnson and AstraZeneca are I believe adenovirus-vector vaccines, which also have good safety histories in immunocompromised people.
While there are, of course, open questions of efficacy in immunocompromised populations, even here the news is relatively promising. While the flu vaccine has widely varying response rates and levels in immunocompromised patients (with lower efficacy in hematological cancer patients, for example), it has shown safety and some levels of effectiveness in even that population. And the flu vaccine not a super-effective vaccine, overall. It’s effectiveness in healthy people is usually 40-60%. By contrast, Pfizer and Moderna reported 95% effectiveness in healthy subjects.
Finally, as long as one seroconverts (develops antibodies) in response to the vaccine, it is likely that the *worst* effects of COVID-19 infection — the most severe consequences — will be avoided regardless of whether infection is blocked. This also is seen with the influenza vaccine, and is another reason to get the vaccine here. Overall, the current COVID-19 vaccine candidates appear likely to be safe for most people whose immune function has been affected by CRC treatment, with efficacy varying by nature and extent of therapy/compromise, active/past therapy, time from therapy, and the individual health of the recipient.
7/19: Rectal cancer: Initially staged as IIIA, T2N1M0
Initially approx 4.25 cm, low/mid rectum, mod. well diff. adenocarcinoma
8/22 -10/14 4 rounds FOLFOX neoadjuvant, 3 w/Oxiplatin (lots of side effects/reduced size est. 70-75%)
Switched to neoadjuvant chemorad in 11/19 (Xeloda and approx. IMRT, 60 Gy, 33 fractions)
Trying to achieve cCR.