Cancer Vaccines

Prevention, Protection During Cancer Care, and Emerging Treatment Approaches

Cancer vaccines play three distinct roles in oncology. Some vaccines help prevent cancers caused by infections. Others are used to protect cancer patients from serious infections during treatment. A third group—still evolving—includes vaccines used as cancer treatments.

• Vaccines That Help Prevent Cancer

Introduction

Some cancers develop as a result of long-term viral infections. In these cases, vaccination can act as a true cancer-prevention strategy by preventing the initial infection that triggers cancer development.

Human papillomavirus and cervical cancer

Cervical cancer develops in the cervix, the lower part of the uterus. It is one of the most preventable cancers, yet it remains a major public health problem. Globally, cervical cancer caused approximately 660,000 new cases and 350,000 deaths in 2022.

The primary cause is persistent infection with high-risk types of human papillomavirus. While most infections clear naturally, long-term infection can lead to precancerous changes and eventually invasive cancer if not detected early.

The most important cancer-causing strains are:

• Human papillomavirus type 16
• Human papillomavirus type 18

These account for around 70–80% of cervical cancers worldwide, and an even higher proportion in India.

This is why human papillomavirus vaccination is so important—it prevents infection with the highest-risk cancer-causing strains before they can initiate disease.

Hepatitis B and liver cancer

Liver cancer, particularly hepatocellular carcinoma, is an aggressive cancer that often develops in the setting of chronic liver disease.

Major causes include:

• Chronic hepatitis B infection
• Chronic hepatitis C infection
• Alcohol-related liver disease
• Fatty liver disease and cirrhosis

Hepatitis B is especially important because it is preventable through vaccination.

Globally, hepatitis B infection caused about 1.1 million deaths in 2022, mainly due to cirrhosis and liver cancer. In India, chronic hepatitis B contributes to:

• 40–50% of liver cancers
• 20–30% of cirrhosis cases

Liver cancer is often diagnosed late and is difficult to cure in advanced stages. Survival rates are significantly lower in stage IV disease.

Vaccination against hepatitis B therefore prevents not just infection, but also long-term complications including liver cancer.

Human Papillomavirus Vaccine (India-Focused)

Vaccines available in India

Vaccine	Coverage	Notes
CERVAVAC (India)	Types 6, 11, 16, 18	Indigenous vaccine
Gardasil	Types 6, 11, 16, 18	Widely used
Gardasil 9	Types 6, 11, 16, 18, 31, 33, 45, 52, 58	Broader protection

Schedule

Age Group	Schedule
9–14 years	2 doses (0, 6–12 months)
15 years and above	3 doses (0, 2, 6 months)
Immunocompromised individuals	3 doses regardless of age

 

Key patient message

• Prevents infection, not existing disease
• Does not replace cervical cancer screening
• Maximum benefit when given before exposure

Hepatitis B Vaccine

National Immunization Schedule (India)

Age	Schedule
Birth	First dose within 24 hours
6 weeks	Pentavalent vaccine (includes Hepatitis B)
10 weeks	Second dose
14 weeks	Third dose

Adult vaccination

Schedule	Doses
Standard	0, 1, 6 months

Importance in cancer care

• Prevents infection
• Reduces risk of liver cancer
• Prevents reactivation during chemotherapy

Key Takeaway

Human papillomavirus and hepatitis B vaccines are among the few medical interventions that directly prevent cancer, making them critical in long-term cancer prevention strategies.

• Vaccines for Patients With Cancer

Introduction

Patients with cancer are more vulnerable to infections because both the disease and its treatment weaken the immune system.

This is especially seen in:

• Blood cancers such as leukaemia and lymphoma
• Patients receiving chemotherapy or radiation
• Patients on high-dose steroids or targeted therapy
• Stem-cell transplant and advanced immunotherapy recipients

Infections are not minor events in cancer care. They can:

• Delay or interrupt treatment
• Lead to hospitalisation or intensive care
• Increase mortality

Studies show:

• Fatal infections are a significant cause of death in cancer patients
• Hospitalised cancer patients with influenza may have significantly higher mortality
• Patients with cancer have a higher risk of shingles compared to the general population

Vaccination plays a critical role in reducing these risks.

Understanding Vaccine Types

Non-live vaccines (preferred)

These include:

• Inactivated vaccines
• Recombinant vaccines
• Messenger ribonucleic acid vaccines

Examples:

• Influenza (injection)
• Pneumococcal
• Hepatitis B
• Human papillomavirus
• Coronavirus disease vaccines
• Recombinant zoster vaccine

These are generally safe in cancer patients, even during treatment.

Live vaccines (use with caution)

Examples:

• Measles, mumps and rubella
• Varicella (chickenpox)
• Yellow fever
• Oral typhoid

These are usually avoided during active cancer treatment.

Cancer Patient Vaccination Planning Chart

Vaccine	Who should receive it	Timing	Type	Practical message
Influenza vaccine	Most cancer patients	Annually, before flu season	Non-live	Take injection, not nasal spray
Pneumococcal vaccine	Adults with cancer	Before or during treatment	Non-live	Prevents severe pneumonia
Shingles vaccine	Older or immunocompromised adults	Before treatment preferred	Non-live	Prevents painful shingles
Tetanus, diphtheria, pertussis vaccine	All adults	Routine schedule	Non-live	Booster every 10 years
Hepatitis B vaccine	Unvaccinated individuals	Before treatment if possible	Non-live	Prevents reactivation
Human papillomavirus vaccine	Eligible individuals	Before exposure	Non-live	Prevents future cancers
Coronavirus disease vaccine	Most patients	As per latest guidance	Non-live	Follow oncologist advice
Live vaccines	Selected cases only	Before treatment	Live	Only with specialist approval

Timing Strategy

Situation	Recommendation
Before treatment starts	Best time to vaccinate (2–4 weeks before therapy)
During chemotherapy	Non-live vaccines can be given but response may be weaker
During B-cell-depleting therapy	Vaccines may be less effective
After stem-cell transplant	Full revaccination required
Active infection or low counts	Delay vaccination
Live vaccine consideration	Only after specialist review

Household Protection for Cancer Patients

Why family vaccination matters

When a person is undergoing cancer treatment, their immune system is often weakened due to:

• Chemotherapy
• Radiation therapy
• Targeted therapy
• Immunotherapy
• Steroids or other immunosuppressive drugs

This means even common infections like influenza or coronavirus disease can become severe or life-threatening.

One of the most effective ways to protect cancer patients is through “cocooning”, which means ensuring that people around them are vaccinated, reducing the chance of infection entering the household.

Key vaccines for family members and caregivers

Influenza vaccine

Why important:

• Spreads easily within households
• Can cause severe complications in cancer patients

Schedule:

Group	Recommendation
All adults and children above 6 months	One dose every year
Elderly (≥65 years)	Annual vaccination strongly recommended
Caregivers and healthcare workers	Annual vaccination essential

Timing:

• Ideally before flu season (September–November in India)

Important note:

• Use injectable influenza vaccine
• Avoid live nasal influenza vaccines in close contacts of severely immunocompromised patients

Coronavirus disease vaccine

Why important:

• Cancer patients have higher risk of severe disease
• Vaccine response may be weaker in patients themselves

Schedule:

Group	Recommendation
All adults	Complete primary vaccination
Boosters	As per current government guidelines
Elderly or high-risk individuals	Strongly recommended boosters

Key message:

• Family vaccination acts as a protective shield around the patient

Other vaccines for household contacts

Vaccine	Who should consider
Tetanus, diphtheria, pertussis	Adults due for booster
Measles, mumps, rubella	Non-immune individuals
Varicella	Non-immune individuals
Hepatitis B	At-risk household members
Pneumococcal	Elderly family members

Practical household advice

• Maintain strict hand hygiene
• Avoid contact with sick individuals
• Use masks during infections or high-risk periods
• Isolate symptomatic family members early
• Ensure children are fully vaccinated

Key patient message

Protecting a cancer patient is not just about their treatment — it is about protecting their entire environment.

• Cancer Treatment Using Vaccines

Introduction

Cancer treatment vaccines are designed for patients who already have cancer. Their goal is to help the immune system recognise and attack cancer cells.

This is different from preventive vaccines.

Cancer cells often carry abnormal proteins that distinguish them from normal cells. Treatment vaccines attempt to expose these signals to the immune system, allowing immune cells to target cancer more effectively.

However, this field is still evolving, and most therapies are not yet standard treatment.

Approved or Established Approaches

Sipuleucel-T

• Used in advanced prostate cancer
• Uses patient’s own immune cells
• Improves survival in selected cases

Bacillus Calmette–Guérin therapy

• Used in early-stage bladder cancer
• Given directly into the bladder
• One of the oldest and most successful immunotherapies

Talimogene laherparepvec

• Used in certain melanoma cases
• Injected into tumours
• Stimulates immune response

Emerging Approaches

Dendritic cell vaccines

• Train immune cells to recognise cancer
• Mostly experimental

Personalised neoantigen vaccines

• Based on tumour genetics
• Highly individualised
• Currently in clinical trials

Important Patient Message

• Not a replacement for standard cancer treatment
• Not widely available as routine care
• Best accessed through clinical trials or specialised centres