A lot has changed during this time and we understand the stress you are under. As we provide health care during the pandemic, our priority is keeping you safe. In response to the ongoing and evolving COVID-19 pandemic the Leukemia/Bone Marrow Transplant program has adopted several strategies to do this.
We have organizational structures, plans and processes in place to monitor and address emerging issues; these are proactive and updated regularly. We are working with the Infection Prevention and Control Program at VGH, the BCCDC and the B.C. Ministry of Health.
We are taking critical steps and working together to ensure all patients receive the care they need. This means that things are different – we understand that these changes are difficult but they are important to ensure the safety of all.
We thank you for your understanding during this anxious time.
Please note the sections below for further information:
A group of experts, including some of the top doctors in B.C., have prepared this information to help you plan your vaccine.
Why is planning for a COVID-19 vaccine important?
- Preparing for your vaccine is important because people with blood or bone marrow cancer may need to time their vaccination with their treatment or medications.
- If you are on regular platelet transfusions, please check with your health care provider about timing.
- If you have a serious allergy to other vaccines or medicines, please talk to your health care provider before booking your vaccine appointment.
- You may want to consider telling the person who is giving you your vaccination about your health condition if you need special care or attention.
- You must monitor how you are feeling in the days leading up to your vaccine appointment. If you do not feel well, you should rebook for when you are feeling better.
Should I get the COVID-19 vaccine? Will the vaccine work for me?
- If you are a person with a history of blood or bone marrow cancer , have had a stem cell or bone marrow transplant, or had CAR-T cell therapy, you should strongly consider getting the COVID-19 vaccine because you are at a higher risk of serious disease from COVID-19.
- Doctors and researchers have looked at the evidence. They agree that the COVID-19 vaccine is safe for you.
- Although people with cancer weren’t included in the clinical trials of the COVID-19 vaccine, the way the vaccine works means that your immune system will learn to fight off COVID-19 better than if you did not get the vaccine. You are not at risk of getting COVID-19 by getting the vaccine.
- While the COVID-19 vaccine is very safe, we do not know exactly how much protection it will give people with cancer compared to those who do not have cancer.
What about the medications or treatments that I take?
Some medications and treatments affect how well your immune system responds to the COVID-19 vaccine. Timing your vaccine around your treatment will help the vaccine work best.
Not all people with blood or bone marrow cancer need to time the vaccine around their treatment or medications. Please read the section below. If you are still not sure when to get your vaccine, please call the care provider you most recently saw for your cancer treatment or follow-up. This may be your family doctor, nurse practitioner, oncologist, hematologist, or other.
- You do not need to worry about timing your vaccine if you:
- Have finished treatment or are not on treatment (you are just being monitored).
- Are on daily tablet medication (chemotherapy or other) for your cancer.
- Are on daily steroid medication (for either your cancer or complications).
- Had a bone marrow or stem cell transplant more than 3 months ago
- Had CAR-T cell therapy more than 6 months ago.
- You may need to time your vaccine appointment if you are:
- Planned to start chemotherapy treatment.
- Between chemotherapy cycles.
- Planned for a stem cell or bone marrow transplant or CAR-T cell therapy.
The COVID-19 vaccines currently approved in Canada are given as 2 doses. If possible, it is best to get vaccine at least 2 weeks before starting chemotherapy or cancer treatment. However, if your chemotherapy needs to start before you can get vaccine, you should not delay your cancer treatment.
If you will be starting your first chemotherapy cycle soon, try to book your first vaccine dose about 2 weeks before you start. Try to book your second vaccine dose between your chemotherapy cycles when your blood counts have recovered. This is usually about 1 week before the next chemotherapy cycle starts.
If you are not able to get the first vaccine dose before you start treatment or you are between chemotherapy cycles, try to book your vaccine doses between chemotherapy cycles, when your blood counts have recovered. This is usually about 1 week before you start another cycle of chemotherapy.
If there are days in the week or month when you are not on treatment (intravenous or oral treatment, including steroids), try to book your vaccine appointment on your days “off” treatment.
If you are planned for a stem cell or bone marrow transplant or CAR-T cell therapy, try to book your vaccine at least 2 weeks before you start the chemotherapy that is given before the transplant or CAR-T cells.
If you have already had a transplant , or you did not get one or both vaccine doses beforehand, you are able to get a COVID-19 vaccine dose starting 3 months after your transplant.
How else should I plan for my vaccine appointment?
- It is important that you are feeling as well as possible when you get your vaccine. However, some people with cancer have chronic symptoms, like a cough, tiredness, nausea, vomiting or pain.
- In the days leading up to your vaccine, monitor yourself: are any of your symptoms new or worsening? If you aren’t feeling well, rebook your vaccine appointment for another day. You won’t lose your place in line. Consider reaching out to your health care provider about your worsening symptoms.
- Is there anything about your health condition that the person giving you your vaccine should know? Some people find it helpful to make a list and bring to their vaccine appointment.
What or who should I bring with me?
- You can bring any medical or mobility equipment that you need. If you don’t need it, you don’t have to bring it with you.
- If you need to, you can bring a caregiver or attendant with you to support you through the process. Please only bring one person.
What happens after my vaccine?
- Everyone who gets the COVID-19 vaccine is monitored for 15 minutes after they get their vaccine.
- If you do not feel well after getting the vaccine, please tell the people working at the vaccine clinic
- Many people with blood or bone marrow cancer can have low blood counts or are on blood thinners that may make them bruise or bleed easier after an injection. Press firmly on the injection site for 5 minutes after the vaccination to reduce bruising.
- If you have any new or worsening symptoms once go home after the vaccine, please call your health care team or 8-1-1.
Safety and privacy at vaccine clinics
- All people coming to the clinic for the vaccine and all staff at the clinic must follow the COVID-19 public safety precautions. This includes screening for symptoms, wearing masks and social distancing. You should feel safe coming to a vaccine clinic.
- Your privacy will be maintained at the vaccine clinic. Staff at the clinic are trained health professionals and want you to tell them if there are certain things they need to be aware of about your health.
My vaccine planning checklist
- Read the COVID-19 vaccine information for my condition
- Time my vaccine appointment around my medication and treatments (if relevant to me)
- Talk to my doctor if I have any questions or need any help planning my medication around my vaccine appointment
- Prepare a list of things to tell the person giving me the vaccination about what they should know about my health needs when getting a vaccine
- Monitor how I’m feeling leading up to my vaccination appointment. Is anything new or getting worse about how I usually feel?
- Make sure I am feeling my usual self on the day of my vaccine appointment
- Plan to bring the medical and mobility equipment I need with me, leaving anything non-essential at home
Before admission to the inpatient unit, patients are required to be tested for COVID-19, and will only be admitted to the BMT inpatient unit with a negative COVID-19 result within 72 hours of admission. Please note: if you are tested in BMT Daycare or in your community within this time frame, you are expected to self-isolate until your admission. This means you cannot go to public places like the grocery store, nor can you interact with anyone outside of your immediate household bubble. For unplanned admissions, patients will be tested upon arrival to the facility, and will be temporarily admitted to the COVID Short Stay Unit until a negative result is received, at which time patients will be admitted to the BMT inpatient unit. If a BMT patient is COVID-19 positive, they will be cared for on the appropriate COVID-19 unit under the supervision of the BMT team.
All new admissions with negative COVID-19 results will be placed on Admission Isolation for the first 14 days on the BMT inpatient unit. This is being done with an abundance of caution and in an effort to keep our extremely vulnerable patient population as safe as possible. Admission Isolation means that you will need to stay in your room for 14 days, aside from when it is deemed that you require a medical test or procedure by your health care team. Walking around the unit is not permitted during the 14 day Admission Isolation period. Staff will wear personal protective equipment (gown, mask, etc) when entering your room during this period. You may or may not be in a private room during this time, depending on unit needs; you could be in a shared room with another patient who has been admitted for about the same number of days as you.
We know that having your loved one at your side during your treatment is very important and we want to help as best we can to keep family involved. At any time patients and families can use their own electronic devices to communicate via phone or video chat, etc. We also have tablets that can be used if you do not have an electronic device. Please ask your nurse if you wish to borrow a tablet. At any time during your stay, if you would like your family or loved one involved in a discussion you are having with a doctor or nurse or any other health care provider, please feel free to get your family on the phone so that they can hear what is being said and can ask questions in real time.
Please know that we take your safety very seriously and will let you know when it is safe to have visitors once again. The visitor policy for our units is different than other areas of the hospital that do not care for immunocompromised patients. We will follow advice from our experts from Infection Control and Public Health, as well as other BMT Centers across the globe to provide the best care for you. Please ask questions and reach out as needed.
Visitors to any L/BMT Inpatient unit
Exceptional circumstances do exist, however, visitors are still not permitted at this time on the L/BMT units. Although the rest of the hospital is starting to allow visitors, we cannot. Our patient population is very high risk due to their immunocompromised status. Please work with us to protect everyone. Please do not arrive on the unit without prior approval. Managers must be made aware of any requests for visits and the accompanying exceptional circumstances.
Meal trays are delivered 3x per day on the inpatient unit and snacks can be requested. We have dieticians on our care team that can help address dietary concerns. LB6 Daycare has a limited amount of snacks, so please bring your own snacks in to your daycare appointment. Please be reminded that food deliveries from outside sources, family members or home cannot be accepted on the inpatient unit at this time.
You can receive personal items from home on the inpatient unit once every two weeks but only during working hours on Monday to Friday. This will need to be coordinated with an administrative assistant for the program, not with the RN staff on shift. Family members are to call 604-314-7770 and leave a message to request a drop-off/pick-up time. Example of acceptable items; clean clothes, phone chargers, dry non-perishable foods.