There are over 3.8 million breast cancer survivors in the United States, according to the American Cancer Society (ACS). This statistic takes into account individuals who have completed their treatment and those still being treated.

Staying healthy during or after treatment is important for all cancer survivors. This includes receiving any recommended vaccines, such as the COVID-19 vaccine.

The COVID-19 vaccine can reduce your risk of becoming sick with COVID-19. It can also prevent serious illness, hospitalization, or death due to the infection.

Keep reading as we dive deeper into what breast cancer survivors need to know about COVID-19 vaccines.

Receiving some types of cancer treatment can make you more vulnerable to contracting infections like COVID-19. This is because they can affect the way that the immune system works, potentially weakening it.

Breast cancer treatments that may increase your risk of infection include:

According to the ACS, chemotherapy is the most common cause of a weakened immune system in those receiving treatment for cancer.

In fact, a 2016 study in breast cancer survivors found that certain infection-fighting cells remained significantly low 9 months after chemotherapy.

Are breast cancer survivors more vulnerable to COVID-19?

People with cancer or with moderately to severely weakened immune systems are some of the groups at a higher risk of severe illness or death due to COVID-19, according to the Centers for Disease Control and Prevention (CDC).

A 2021 study compared COVID-19 outcomes in people who had been diagnosed with cancer and those who had not. Having a cancer diagnosis was associated with a higher risk of hospitalization and death. This effect was strongest for people with active cancer.

This fact makes vaccination in cancer survivors especially important.

All of the COVID-19 vaccines that are used in the United States are safe and effective, including for breast cancer survivors.

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If you have a weakened immune system, you may have heard that you cannot receive some vaccines. The COVID-19 vaccine is not one of these vaccines.

It’s not typically recommended for people with a weakened immune system to get vaccines that contain a live, weakened form of a virus. Some examples include the measles, mumps, and rubella (MMR) vaccine and the chickenpox vaccine.

None of the three COVID-19 vaccines in use in the United States are live vaccines. The Pfizer-BioNTech and Moderna vaccines are mRNA vaccines while the Johnson & Johnson (J&J) vaccine uses an adenoviral vector that cannot replicate.

Is the COVID-19 vaccine recommended for breast cancer survivors?

The CDC recommends COVID-19 vaccines for everyone ages 5 and up. They note that this is particularly important for people at an increased risk of serious illness, including those with cancer or a weakened immune system.

Additionally, the American Society of Clinical Oncology (ASCO) states that people with cancer, including those undergoing treatment and cancer survivors, be offered the COVID-19 vaccine as long as there are no contraindications. A contraindication is a symptom or medical condition that indicates a person should not receive a certain treatment or medical procedure.

The National Comprehensive Cancer Network (NCCN) also recommends that people with cancer get the COVID-19 vaccine. They note that people with cancer as well as some survivors can have a weakened immune system that puts them at risk of serious illness.

Remember that everyone’s individual situation is different. If you’re a breast cancer survivor, talk to your doctor if you have questions about the COVID-19 vaccines themselves or the recommended vaccination schedule.

Should some people not get the COVID-19 vaccine?

There are some people who should not receive the COVID-19 vaccine. According to the CDC, this includes:

  • people who have had a serious allergic reaction (anaphylaxis) to a previous dose of a COVID-19 vaccine or to one of the ingredients in the vaccine
  • individuals who have a known allergy to one of the ingredients in a COVID-19 vaccine
  • those who experienced a blood clotting condition called thrombosis with thrombocytopenia syndrome (TTS) after a previous dose of an adenoviral vector vaccine (J&J vaccine only)
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The CDC currently recommends that all people ages 5 and older receive a primary COVID-19 vaccine series.

COVID-19 vaccine recommendations for healthy adults

As of this writing, the primary vaccine series recommendations for healthy adults are:

For healthy adultsNumber of dosesTime between first and second doses
Pfizer-BioNTech2 doses3 to 8 weeks
Moderna2 doses4 to 8 weeks
Johnson & Johnson1 doseN/A

mRNA vaccines like those made by Pfizer-BioNTech and Moderna are preferred over the J&J vaccine. This is because a 2021 review found that mRNA vaccines were more effective and had a better safety profile than the J&J vaccine.

Initial studies on the mRNA vaccines found that they were highly effective at preventing COVID-19. However, this effectiveness has declined as new viral variants, such as the Omicron variant, have emerged.

Nevertheless, recent studies have found that both the Pfizer-BioNTech and Moderna vaccine still provide protection against contracting the Omicron variant. Additionally, they’re also still quite effective at preventing hospitalization.

COVID-19 vaccine recommendations for immunocompromised adults

As mentioned earlier, people that are currently having or have recently finished some cancer treatments like chemotherapy often have a weakened immune system.

Individuals with a weakened immune system may produce a weaker response to the vaccine. Because of this, the CDC recommends that they receive an additional vaccine dose as a part of their primary vaccine series.

The primary vaccination recommendations for moderately to severely immunocompromised adults are:

Number of dosesTime between first and second dosesTime between second and third doses
Pfizer-BioNTech3 doses3 weeks4 weeks
Moderna3 doses4 weeks4 weeks
Johnson & Johnson2 doses4 weeks (mRNA vaccine)N/A

As above, mRNA vaccines are preferred over the J&J vaccine.

A 2021 study found that two doses of an mRNA vaccine gave lower protection against hospitalization in immunocompromised people than in healthy people. This supports the need for an extra vaccine dose and a booster in this group.

What else can I do to protect myself?

In addition to receiving your COVID-19 vaccine, there are also other things that you can do to protect yourself from COVID-19:

  • encourage caregivers or those who live with you to get vaccinated against COVID-19
  • wash your hands thoroughly and frequently
  • wear a well-fitting mask when you’re out in public
  • avoid crowded or poorly ventilated areas
  • practice physical distancing when in public
  • clean and disinfect high-touch surfaces around your home regularly
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Protection from your primary vaccine series will gradually wane over time, regardless of your health status. Due to this, the CDC recommends COVID-19 vaccine boosters for everyone ages 12 and over.

Some people are eligible for one booster while others can get two. The current booster recommendations at the time of this writing are as follows:

Booster shotsWho is eligible?What vaccines are recommended?What’s the timeline?
First boostereveryone ages 12 and olderPfizer-BioNTech ModernaMost people: at least 5 months after primary series
Immunocompromised: at least 3 months after primary series
Second booster• adults ages 50 and older
• moderately to severely immunocompromised people over age 12
• individuals who received two doses of the J&J vaccine
Pfizer-BioNTech Modernaat least 4 months after first booster

It’s possible that you’ll experience side effects after getting your COVID-19 vaccine. However, some people may not have any side effects at all.

According to the CDC, the most common side effects of the COVID-19 vaccine are:

These types of side effects are normal and show that your body is making an immune response to the vaccine. They should go away on their own within a few days. You can also do things at home to help ease side effects. These include:

  • exercising or using the arm in which you received your injection
  • applying a cool, wet towel to the injection site
  • drinking plenty of fluids
  • taking over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to ease fever and aches and pains

Serious side effects like anaphylaxis after vaccination are rare. However, contact your doctor if your side effects last longer than a few days or if redness and pain around the injection site get worse after 24 hours.

Side effects in immunocompromised people

A 2022 research review notes that there’s currently no evidence that shows that immunocompromised individuals are at an increased risk of side effects from COVID-19 vaccines.

A 2021 study of the Pfizer-BioNTech vaccine in immunocompromised individuals found that the most frequently reported vaccine side effects were fatigue, fever, and muscle pain. This is similar to common side effects in healthy people.

Specific vaccine side effects for breast cancer survivors

There are some potential vaccine side effects that are important for breast cancer survivors to know.

One is swollen lymph nodes in the armpit, which can happen on the side of your body where you got your injection. These may feel like breast lumps or can show up as an abnormal area on a mammogram.

As such, try to schedule a mammogram at least 1 month after your vaccine. However, if this isn’t possible, just let the person doing your mammogram know that you’ve been vaccinated and on which side you got the injection.

It’s also possible for lymphedema to worsen after vaccination, particularly if you had lymph nodes around your armpit removed as a part of your cancer treatment.

To help avoid this, receive the injection on the side that wasn’t impacted by breast cancer. If you had breast cancer affecting both breasts, consult with your doctor about where to receive your injection before getting vaccinated.

Vaccination against COVID-19 is important for everyone, including breast cancer survivors. This is particularly vital for those who are immunocompromised and are therefore at an increased risk of serious illness due to COVID-19.

If you’re a breast cancer survivor, talk to your doctor about getting the COVID-19 vaccine. They can help to answer any questions that you may have as well as let you know which vaccine schedule to follow.