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COVID-19 vaccination in patients with cancer: Position paper from the Indonesian Society of Hematology and Medical Oncology (ISHMO) of Semarang

Eko Adhi Pangarsa , Budi Setiawan, Santosa Santosa, Ridho Monotoc Naibaho, Daniel Rizky, Suyono Suyono, Mika Lumban Tobing, Muchlis Achsan Udji Sofro, Catharina Suharti

Eko Adhi Pangarsa
Division of Hematology Medical Oncology, Internal Medicine Department, Faculty of Medicine, Diponegoro University/Dr. Kariadi Hospital, Semarang, Indonesia. Email: [email protected]

Budi Setiawan
Division of Hematology Medical Oncology, Internal Medicine Department, Faculty of Medicine, Diponegoro University/Dr. Kariadi Hospital, Semarang, Indonesia

Santosa Santosa
Division of Hematology Medical Oncology, Internal Medicine Department, Faculty of Medicine, Diponegoro University/Dr. Kariadi Hospital, Semarang, Indonesia

Ridho Monotoc Naibaho
Division of Hematology Medical Oncology, Internal Medicine Department, Faculty of Medicine, Diponegoro University/Dr. Kariadi Hospital, Semarang, Indonesia

Daniel Rizky
Division of Hematology Medical Oncology, Internal Medicine Department, Faculty of Medicine, Diponegoro University/Dr. Kariadi Hospital, Semarang, Indonesia

Suyono Suyono
Division of Hematology Medical Oncology, Internal Medicine Department, Faculty of Medicine, Diponegoro University/Dr. Kariadi Hospital, Semarang, Indonesia

Mika Lumban Tobing
Division of Hematology Medical Oncology, Internal Medicine Department, Faculty of Medicine, Diponegoro University/Dr. Kariadi Hospital, Semarang, Indonesia

Muchlis Achsan Udji Sofro
Division of Infection and Tropical Diseases, Internal Medicine Department, Faculty of Medicine, Diponegoro University/Dr. Kariadi Hospital, Semarang, Indonesia

Catharina Suharti
Division of Hematology Medical Oncology, Internal Medicine Department, Faculty of Medicine, Diponegoro University/Dr. Kariadi Hospital, Semarang, Indonesia
Online First: April 01, 2021 | Cite this Article
Pangarsa, E., Setiawan, B., Santosa, S., Naibaho, R., Rizky, D., Suyono, S., Tobing, M., Sofro, M., Suharti, C. 2021. COVID-19 vaccination in patients with cancer: Position paper from the Indonesian Society of Hematology and Medical Oncology (ISHMO) of Semarang. Bali Medical Journal 10(1): 142-150. DOI:10.15562/bmj.v10i1.2273


Patients with active cancer (cancer on treatment, those planning to start treatment, and those immediately post-treatment) consider getting the COVID-19 vaccine, like the other vulnerable populations, to reduce the severe risk of SARS-CoV-2 infection. We suggest patients with cancer should be vaccinated with a non-lived COVID-19 vaccine. Specific consideration belongs to the type of cancer, current treatment, phase of disease along the cancer continuum, and optimal timing for vaccination; they should talk to their hematologist-medical oncologist. Vaccination with the live-attenuated and replicating-vector vaccine is strongly discouraged in patients with active cancer receiving chemotherapy and during other immunocompromising therapies. For patients those receiving intensive chemotherapy (e.g., induction or consolidation therapy in acute leukemia), anti-B-cell antibodies, hematopoietic stem cell transplantation (HSCT), and other immunocompromised conditions, we suggest postponing SARS-CoV-2 vaccination until reaching stable lymphocyte counts due to the risk of vaccine infectivity. Cancer survivors are considered to have the same risk as other persons with matched aged and other risk factors. They also should be vaccinated as early as possible. There are various other risk factors for cancer patients which must consider related to complications of COVID-19, such as age, other comorbid diseases, demographic and social factors. All of these factors should be judged as a comprehensive evaluation of an individual patient. The use of masks, physical distancing, hygienic activities such as washing hands with soap and hand sanitizers are still needed during this pandemic. Caregivers and households should certainly be included in the vaccination strategies.

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