• Most people with cancer are recommended to be vaccinated against COVID-19.
• The COVID-19 vaccines are considered safe, effective, and low-risk for most people with ovarian cancer.
• Your doctor is the best person to help you understand your potential risks versus the potential benefits of the COVID-19 vaccines.

Ever since the U.S. Food and Drug Administration (FDA) authorized the first COVID-19 vaccines for emergency use in December 2020, people living with ovarian cancer have had questions about whether these inoculations will be safe and effective for them.

On February 27, the FDA authorized use of the Johnson & Johnson COVID-19 vaccine, providing a third option to the Pfizer and Moderna COVID-19 vaccines. This new vaccine requires a single dose and works in a different way than the first two vaccines.

The American Cancer Society’s latest guidance states, “Many expert medical groups now recommend that most people with cancer or a history of cancer get the COVID-19 vaccine once it’s available to them.” However, many people living with ovarian cancer are still curious about whether they should get vaccinated.

To help address these concerns, MyOvarianCancerTeam sat down with Dr. Christopher Awtrey. Dr. Awtrey is the director of gynecologic oncology at Beth Israel Deaconess Medical Center in Boston, Massachusetts.

The COVID-19 vaccines are so new that there is not yet any specific data on results or side effects in people with ovarian cancer. How can we know whether they are safe and effective for this population?

The COVID vaccines are new, and there’s no specific data on patients with ovarian cancer to this point. However, we do know that, based on data from large populations, these COVID vaccines are safe. And anecdotally, for our patients — more and more of whom are getting vaccinated — they appear to be well tolerated. This past week, I would say that just about half of the patients with ovarian cancer that I care for had at least one of their vaccines and people are doing well. Everything looks very safe with respect to these two types of vaccines for patients with ovarian cancer.

The Johnson & Johnson vaccine is an adenovirus vector vaccine, while the Pfizer and Moderna vaccines are both messenger RNA (mRNA) vaccines. Do we know whether these vaccines might affect the disease process in ovarian cancer?

We do know that there are differences in terms of the efficacy of the Pfizer and Moderna vaccines versus Johnson & Johnson. The Johnson & Johnson vaccine looks a little bit less effective at preventing a COVID-19 infection, but very effective at preventing severe illness. Pfizer and Moderna are both mRNA vaccines and look a little bit more effective. However, both appear to not affect the patient who has an underlying cancer, or ovarian cancer in particular, in any way, shape, or form.

Can medications to treat ovarian cancer cause interactions or impact the effectiveness of the vaccination? For instance, targeted therapy like Avastin (bevacizumab), PARP inhibitors such as Lynparza (olaparib), or hormone therapy?

We have a lot of patients who are on Avastin, PARP inhibitors, or hormonal therapies. It doesn't appear in any way that these medications would impact the effectiveness of the vaccination — nor does the vaccination inhibit the activity of these medications in terms of suppressing cancer or treating cancer.

For those currently undergoing chemotherapy, does the timing of the COVID-19 vaccine matter?

What we've been telling patients is that when you can get the vaccine, go ahead and get vaccinated. Ideally, when we use rules around flu vaccination, we generally try to stagger it between cycles of chemotherapy, not given at the same time. But again, the advice that we're giving folks is that when you're given the opportunity to get one of these vaccines, do it as soon as you're given that opportunity.

Does it matter, whether a person is in remission or actively treating ovarian cancer, when they should take the vaccine?

Regardless of whether somebody is in remission or actively treating ovarian cancer, they should take the vaccine if given the opportunity.

For those receiving radiation treatment, is there any concern about getting the COVID-19 vaccines? Is timing important?

For the most part, we're suggesting to patients that they get the vaccine when they're able to get it. And when it comes to ovarian cancer, radiation therapy is actually a rather uncommonly used mode of treatment. Patients who have breast cancer may be getting radiation treatment, but we believe that for patients who are getting cytotoxic chemotherapy or active chemotherapy, getting these vaccines is both safe and effective.

If someone experienced a bad reaction following a flu vaccine in the past, should they also be cautious about the COVID-19 vaccine?

It depends on the reaction. I think you've got to review that with your primary care physician and perhaps your medical oncologist. There are certain situations where vaccination reactions — and they're very rare events — would lead us to say that vaccinations are not a good idea. I think it would be exceptionally rare, and they depend on your reaction. For the most part, patients are going to be able to get this vaccine without any issue or problem.

Some of our members have expressed worry about how quickly the COVID-19 vaccines were developed. Do you have similar concerns about the speed with which the vaccines were developed? If not, why not?

This is, in many respects, groundbreaking new technology, and whenever there is a sort of new approach, I think all of us take a step back and think about how this new technology works, and people may have concerns about that. With that said, while it is a new manner in which to gain immunity, it does piggyback on some basic biology that's very well understood. So yes, I think mRNA vaccines are new, but to a certain extent they're just in time to help us deal most effectively with this horrible pandemic.

Some people state they’d rather wait before getting vaccinated until more data about long-term effects is available. In your opinion, is there any benefit to waiting?

This is a decision that every patient should have. As a clinician, I am supportive of my patients in terms of making their decision to have any treatment, whether it's vaccination or treatment for their cancer, and so this is really a decision that has to come from a patient. I would say that when considering COVID vaccines in particular, from a national health policy standpoint, we're hoping that we can get as many patients vaccinated as soon as possible to get back to a new normal.

What we do know is that the COVID infection is an incredibly heterogeneous disease, where some patients have mild symptoms and some patients get very ill very quickly. And I think for our patients who are battling ovarian cancer, their bodies are under a tremendous amount of stress already — to add a COVID infection to that is dangerous and potentially quite harmful. And I've certainly seen that, unfortunately, in some of some of the patients that we've cared for who've had ovarian cancer.

Talk with your health care team about the vaccination process and getting vaccinated as soon as you feel comfortable with that decision. I encourage my patients to be vaccinated, and I spend as much time with them as they need to so they feel comfortable with that decision.

Talk With Others Who Understand

On MyOvarianCancerTeam, people come together to ask questions, provide advice, and share their stories with others who understand life with ovarian cancer.

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