COVID-19 Vaccine Benefits Outweigh Risk, Despite Cardiac Concerns, Expert Says

Many patients with cancer may feel uneasy about the COVID-19 vaccines, especially as new stories break about potential heart complications. However, most patients should get the shot as soon as possible, says Brahm Segal, MD.

As news headlines warn the public about potential myocarditis from the COVID-19 vaccine, patients with cancer may be even more apprehensive to get immunized. However, it’s not “a close call at all” when outweighing the risks versus benefits in this population, according to Brahm Segal, MD, who advocates for everyone eligible to be vaccinated.

“Serious toxicities in the general public are few… and so far, there’s no obvious safety concern with patients with cancer that would argue that the vaccine is less safe among them compared to the general public,” said Segal, chair of Internal Medicine and chief of Infectious Diseases at Roswell Park Comprehensive Cancer Center.

Segal mentioned that many cancer treatments – including checkpoint inhibitors, which are widely prescribed across many cancer types – also run the risk of patients developing cardiotoxicity. Additionally, if patients are not immunized against COVID-19 and contract the virus, the disease itself carries risks to the heart.

“The heart is one of the organs that can be affected in a big way,” Segal said.

Segal also stressed that it is important not only for patients with cancer to get the vaccine, but also their loved ones with whom they are in close contact.

“Family members and their household members and friends should all be immunized as well, because in patients with cancer, some of the cancers and some of the therapies for cancer can disable the vaccine from being fully effective,” Segal explained. “So even though they’ve been vaccinated, they may not get the same protection that people with a normal immune system have. The way to address that is for the patients to be immunized, but also – as much as possible – the people around them to be vaccinated, too.”

While most patients should get vaccinated, those who should delay their shots are “few and far between,” Segal said.

“People who are having a stem cell transplant don’t want to have a vaccine right before transplant, right during, or in the immediate [period after] transplant period, because it’s extremely unlikely that there’ll be a lasting response,” he said.

Segal explained that there are specific guidelines for when patients undergoing transplants should be vaccinated, “But for the vast majority of patients with cancer, there’s no reason to wait. They should get immunized,” he said.