1. Vaccines and breast cancer treatment
Breast cancer treatments like and can affect how your immune system works.
Vaccines help your immune system protect you against disease and reduce your risk of becoming seriously ill.
If you have breast cancer:
- Your treatment team may recommend you have certain vaccines such as the flu vaccine if your immunity is lowered
- You can have the flu, COVID-19, shingles and pneumococcal vaccines safely if you’re having treatment – speak to your treatment team about the best time to have these
- You should not have any vaccines that are “live” while having chemotherapy or targeted therapy and for 6 months afterwards
- There’s no strong evidence that having a vaccination after lymph node removal surgery will cause lymphoedema if you have it in your “at risk” arm – you can still choose to have it in your other arm or you may be offered it in your thigh or tummy (abdomen)
- Some travel vaccines may not be safe while you’re having certain treatments – check with your treatment team if you’re planning to travel
Always check with your GP or treatment team before having a vaccine. They can advise whether it’s safe for you and the best time to have it.
2. Live and non-live vaccines
Live vaccines
Live vaccines contain a small amount of live virus or bacteria.
If you have a weakened immune system, which you may do during breast cancer treatment, they could be harmful.
You should not have any live vaccines while you’re having chemotherapy or targeted therapy.
It’s usually safe to have these vaccinations 6 months after your treatment finishes.
Live vaccines include:
- Measles
- Mumps
- Rubella (German measles)
- Polio
- BCG (tuberculosis)
- Yellow fever
- A certain shingles vaccine (Zostavax)
If anyone you have close contact with needs to have a live vaccine, speak to your treatment team or GP. They can advise what precautions you may need to take depending on the vaccination.
Non-live vaccines
Non-live vaccines, sometimes known as inactivated vaccines, contain viruses or bacteria that have been destroyed.
They’re safe during breast cancer treatment, including chemotherapy.
Common non-live vaccines include:
- COVID-19
- Flu
3. When to have vaccines
If you’re having chemotherapy or targeted therapy
You should not have any live vaccines while you’re having chemotherapy or targeted therapy.
If you need any vaccines you will usually have these before you start chemotherapy or targeted therapy.
If you’re having treatment and need a vaccine, this will usually be at a point in your treatment cycle when your blood counts (the numbers of red and white blood cells and platelets in a sample of blood) have recovered.
It’s usually safe to have live vaccines 6 months after your treatment finishes.
Talk to your GP or treatment team before having any vaccinations.
If you’re having hormone therapy or other treatments
Treatments like hormone therapy, radiotherapy and bisphosphonates do not usually affect your immune system.
This means it’s safe to have vaccines during these treatments.
Vaccination after lymph node removal surgery
If you’ve had surgery to remove some or all of your lymph nodes in your armpit, you may be worried that having a vaccination in the affected arm will increase your risk of lymphoedema.
There’s no strong evidence that having injections in your “at risk” arm will cause lymphoedema. However, you may prefer to use your other arm.
If you’ve had lymph nodes removed from both sides, the vaccine may be given into your thigh or tummy (abdomen) depending on the vaccine.
If you have lymphoedema already, it's recommended you have injections in the unaffected arm.
Having lymph nodes removed or having lymphoedema will not affect your immune system and your body should still be able to fight infections.
4. COVID-19, flu and other common vaccines
COVID-19
COVID-19 vaccines are not live so they’re safe if you’re having breast cancer treatment.
If you’re having chemotherapy or targeted therapies, speak to your treatment team about the best time to have a COVID-19 vaccination.
If you’re unsure about whether you’re eligible, speak to your GP or treatment team.
Flu
The flu vaccine is not a live vaccine so it's safe if you’re having breast cancer treatment.
Anyone at risk of a weakened immune system, and therefore more prone to infection, should have the flu vaccine. This includes people due to have, or already having, chemotherapy or targeted therapy.
Talk to your chemotherapy team or breast care nurse about the best time to have your flu jab.
Do the people I live with also need a flu vaccine?
You can ask your GP about the flu vaccine for people you live with. If your treatment means you have reduced immunity, they may be offered a free vaccination.
If any members of your family are 17 years old and under, they may be offered a nasal flu spray. This contains live viruses so if you’re having chemotherapy, it may be best to avoid close contact with them for around 10 days after they’ve had the spray.
Pneumococcal vaccine
The pneumococcal vaccine helps protect against some bacterial infections such as pneumonia and meningitis.
The pneumococcal vaccine is not a live vaccine so it’s safe if you’re having breast cancer treatment.
If you’re having chemotherapy or targeted therapies, speak to your treatment team about the best time to have a pneumococcal vaccination.
Shingles
Shingles is a common condition that causes a painful rash.
You may be offered a type of shingles vaccine called Shingrix if you have a severely weakened immune system, for example if you’ve recently had chemotherapy.
Shingrix is a non-live vaccine so is safe if you’re having breast cancer treatment.
5. Travel vaccinations
If you’re planning a holiday or need to travel overseas, you may need vaccinations.
Some travel vaccines are live so they’re not recommended if your immunity is lowered or you’re having a treatment that can lower your immunity.
If you’re planning to have any travel vaccinations, check with your treatment team first.
