Explained: Covid vaccines in cancer patients

By Dr. Dhaneshwor Naorem
May 25, 2021

The COVID-19 pandemic, continues to impact many people, including cancer patients, their families, and caregivers.Vaccines help a person’s immune system to recognize and protect the body against infections. COVID-19 vaccines have been found to significantly lower the risk of getting infected with COVID-19, lower the risk of having severe disease, being hospitalized, or dying from COVID-19 if one gets infected. 

Here we’ll discuss some frequently asked questions by people with cancer or a history of previous cancer have about the COVID-19 vaccines.

1) Should cancer patients and survivors take the COVID-19 vaccine?

Patients with cancer or a history of cancer should get the COVID -19 vaccine whenever available. Many expert medical groups recommend patients with a recent cancer diagnosis and those on treatment should be given the highest priority. This is because cancer and its treatment can weaken the immune system putting such patients at risk for severe COVID-19 disease. Caregivers and household members of cancer patients should also be immunized whenever possible.

2) Is it safe for cancer patients to receive the COVID-19 vaccine?

At present, there is a lack of data regarding the safety and efficacy of COVID-19 vaccination in cancer patients. Numerous studies have shown that cancer patients are at higher risk for more severe COVID-19 disease and complications. There are no reports of increased risk for side effects of the vaccine in cancer patients. The risks of COVID-19 for cancer patients outweigh the very low risk of vaccination. Because of these, oncology groups including the American Society of Clinical Oncology (ASCO), the American Society of Hematology (ASH), and the American Society for Radiation Oncology have all recommended patients with cancer get vaccinated.

3) Is there any specific approved COVID-19 vaccine for cancer patients?

At this time, no major medical organizations have recommended getting one type of COVID vaccine over another, either for cancer patients or for other people. Health experts believe that getting the vaccine once it becomes available, whichever one it is, is most important, rather than waiting to get a specific vaccine. 

4) What are the side effects of the vaccines?

Common side effects that have been reported after getting the vaccines to include:
• Pain, redness, or swelling at the injection site
• Feeling tired
• Headache
• Fever
• Chills
• Muscle and joint pain
• Nausea

The incidence or the nature of side effects in cancer patients and survivors had been reported to be similar to with the general population. 

Some people (16%) might develop swelling or pain under the vaccinated arm. This is often a normal response by the body’s immune system to the vaccine. A swollen lymph node under the arm might cause concern since this can also be a sign of breast cancer spread.

Oncologists recommend that patients with breast cancer or a history of breast cancer get the vaccine in the arm on the unaffected side.

5) Are there any exceptions for COVID-19 vaccination among cancer patients?

There are few exceptions:

a) Vaccination should be delayed for at least 3 months following bone marrow transplantation and engineered cellular therapy to maximize vaccine efficacy.

b) Vaccination in patients undergoing intensive chemotherapy should be delayed until neutrophil count recovery.

c) Patients undergoing major surgery for cancer should have a gap of few days in-between.

In patients undergoing chemotherapy, the optimum timing for vaccination about the chemotherapy cycle is still unclear. The difference in the efficacy of the COVID-19 vaccine in terms of its immunogenic potential i.e. ability to generate antibodies against coronavirus- SARS-COV-2, when administered along with chemotherapy versus mid-cycle, is still unknown. In absence of robust data, the National Comprehensive Cancer Network (NCCN) for now recommends vaccination when available.

6) Will vaccination affect my cancer-related tests and scans?

Getting a COVID-19 vaccine might result in swollen lymph nodes under the arm in which the injection was given. Swollen lymph nodes might show up on a CT Scan or mammogram is done for breast cancer or other cancers, causing concern and confusion. It is important to communicate with your doctor if you are scheduled to get an imaging test (such as an MRI or CT scan) in the weeks after getting a COVID vaccine. 

7) Do I still need to take precautions if I get the COVID-19 vaccine?

While the vaccine can lower the risk of getting a serious disease from COVID, it doesn’t completely rule out the possibility of getting infected by the virus. It is also not yet clear how well vaccines can prevent the spread of the virus to others. Here it will be appropriate to mention that data tracking the immune response in patients with cancer who have been vaccinated are still evolving. Therefore, even after vaccination, it is advised that everyone continue to follow all COVID-19 prevention protocols.

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News Network
December 6,2025

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New Delhi: IndiGo, India’s largest airline, faced major operational turbulence this week after failing to prepare for new pilot-fatigue regulations issued by the Directorate General of Civil Aviation (DGCA). The stricter rules—designed to improve flight safety—took effect in phases through 2024, with the latest implementation on November 1. IndiGo has acknowledged that inadequate roster planning led to widespread cancellations and delays.

Below are the key DGCA rules that affected IndiGo’s operations:

1. Longer Mandatory Weekly Rest

Weekly rest for pilots has been increased from 36 hours to 48 hours.

The government says the extended break is essential to curb cumulative fatigue. This rule remains in force despite the current crisis.

2. Cap on Night Landings

Pilots can now perform only two night landings per week—a steep reduction from the earlier limit of six.

Night hours, defined as midnight to early morning, are considered the least alert period for pilots.

Given the disruptions, this rule has been temporarily relaxed for IndiGo until February 10.

3. Reduced Maximum Night Flight Duty

Flight duty that stretches into the night is now capped at 10 hours.

This measure has also been kept on hold for IndiGo until February 10 to stabilize operations.

4. Weekly Rest Cannot Be Replaced With Personal Leave

Airlines can no longer count a pilot’s personal leave as part of the mandatory 48-hour rest.

Pilots say this closes a loophole that previously reduced actual rest time.

Currently, all airlines are exempt from this rule to normalise travel.

5. Mandatory Fatigue Monitoring

Airlines must submit quarterly fatigue reports along with corrective actions to DGCA.

This system aims to create a transparent fatigue-tracking framework across the industry.

The DGCA has stressed that these rules were crafted to strengthen flight safety and align India with global fatigue-management standards. The temporary relaxations are expected to remain until February 2025, giving IndiGo time to stabilise its schedules and restore normal air travel.

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News Network
December 4,2025

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Angry outbursts, long queues, and desperate appeals filled airports across India today as IndiGo grappled with a severe operational breakdown. Hundreds of flights have been cancelled or delayed, leaving thousands of passengers stranded through the night and forcing many to spend long hours at helpdesks.

Social media was flooded with videos of fliers pleading for assistance, accusing the airline of misleading updates, and demanding accommodation after being stuck for 10 to 12 hours at airports such as Hyderabad and Bengaluru.

What Triggered the Meltdown?

IndiGo has attributed the widespread disruption to “a multitude of unforeseen operational challenges.” These include:

•    Minor technology glitches
•    Winter-season schedule adjustments
•    Bad weather
•    Congestion in the aviation network
•    New crew rostering rules (Flight Duty Time Limitations or FDTL)

Among these, the most disruptive has been the implementation of the updated FDTL norms introduced by the Directorate General of Civil Aviation (DGCA) in January 2024.

These rules were designed to reduce pilot fatigue and improve passenger safety. Key changes include:

•    Longer weekly rest periods for flight crew
•    A revised definition of “night,” extending it by an extra hour
•    Tighter caps on flight duty timing and night landings
•    Cutting night shifts for pilots and crew from six per roster cycle to just two

Once these norms became fully enforceable, airlines were required to overhaul rosters well in advance. For IndiGo, this triggered a sudden shortage of crew available for duty, leading to cascading delays and cancellations.

Why IndiGo Was Hit the Hardest

IndiGo is India’s largest airline by a wide margin, operating over 2,200 flights daily. That’s roughly double the number operated by Air India.

When an airline of this size experiences even a 10–20% disruption, it translates to 200–400 flights being delayed or grounded — producing massive spillover effects across the country.

IndiGo also relies heavily on high-frequency overnight operations, a model typical of low-cost carriers that aim to maximise aircraft utilisation and reduce downtime. The stricter FDTL norms clash with these overnight-heavy schedules, forcing the airline to pull back services.

Aviation bodies have also criticised IndiGo’s preparedness. The Airline Pilots' Association of India (ALPA) said airlines were given a two-year window to plan for the new rules but “started preparing rather late.” IndiGo, it said, failed to rebuild crew rosters 15 days in advance as required.

The Federation of Indian Pilots (FIP) went further, calling the crisis the result of IndiGo’s “prolonged and unorthodox lean manpower strategy,” and alleging that the airline adopted a hiring freeze even as it knew the new rules would require more careful staffing.

How Many Flights Are Affected?

In the past 48 hours, over 300 flights have been cancelled. At least 100 more are expected to be cancelled today.

City-wise impact:

•    Hyderabad: 33 expected cancellations; several fliers stranded overnight
•    Bengaluru: over 70 expected cancellations
•    Delhi, Mumbai, Chennai, Kolkata: widespread delays and missed connections

Passengers shared distressing accounts online.

One customer at Hyderabad airport said they waited from 6 PM to 9 AM with “no action taken” regarding their delayed Pune flight. Another said IndiGo repeatedly told them the crew was “arriving soon,” only for the delay to stretch over 12 hours.

IndiGo has apologised for the disruption and promised that operations will stabilise within 48 hours, adding that “calibrated adjustments” are being made to contain the chaos.

What Should Passengers Do Now?

For those flying in the next few days, especially with IndiGo, here are key precautions:

1. Keep Checking Flight Status
Monitor your flight closely before leaving for the airport, as delays may be announced last-minute.

2. Arrive Early
Expect long queues at counters and security due to crowding and rescheduling.

3. Carry Essentials
Pack snacks, water, basic medicines, chargers, and items for children or senior citizens. Extended waiting times should be anticipated.

4. Use Flexible Booking Options
If you booked tickets with a free-date-change or cancellation option, consider using them.
If you haven’t booked yet, prefer refundable or flexible fares, or even consider alternate airlines.

5. Follow IndiGo’s Updates
Keep an eye on IndiGo’s official social media channels and contact customer support for rebooking and refund queries.

What Needs to Change?

Pilot groups have raised concerns not just about staffing but also the planning practices behind it.
The Federation of Indian Pilots accused IndiGo of:

•    Imposing an unexplained hiring freeze despite knowing the FDTL changes were coming
•    Entering non-poaching agreements that limited talent movement
•    Keeping pilot pay frozen
•    Underestimating the need to restructure operations in advance

They have urged DGCA to approve seasonal schedules only after airlines prove they have adequate pilot strength under the new norms.

ALPA also warned that some airlines might be using the delays as an “immature pressure tactic” to push DGCA for relaxations in the new rules — which, if granted, could compromise the very safety standards the norms were meant to protect.

Both pilot bodies stressed that no exemption should dilute safety, and any deviations should be based solely on scientific risk assessment.

Is a Solution in Sight?

While IndiGo says normalcy will return within two days, aviation experts believe that fully stabilising operations could take longer, depending on how quickly the airline can:
•    Re-align rosters
•    Mobilise rested crew
•    Boost staffing
•    Adjust its winter schedule to match regulatory requirements
Passengers are advised to remain prepared for continued delays over the next few days as the airline works through its backlog. 

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News Network
December 6,2025

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With IndiGo flight disruptions impacting thousands of passengers, the airline on Saturday said that it will offer full waiver on all cancellations/reschedule requests for travel bookings between December 5, 2025 and December 15, 2025.

Earlier in the day, the civil aviation ministry had directed the airline to complete the ticket refund process for the cancelled flights by Sunday evening, as well as ensure baggage separated from the travellers are delivered in the next two days.

In a post on X, titled 'No questions asked', IndiGo wrote, "In response to recent events, all refunds for your cancellations will be processed automatically to your original mode of payment."

"We are deeply sorry for the hardships caused," it further added.

Several passengers, however, complained of not getting full refund as promised by the airline.

Netizens have shared screenchots of getting charged for airline cancellation fee and convenience fee.

"Please tell me why u have did this airline cancellation charges when u say full amount will be refunded (sic)," a user wrote sharing a screenshot of the refund page.

"Well, but you have still debited the convenience charges," wrote another.

Passengers have also raised concerns about the "cancel" option being disabled on the IndiGo app. "First enable the 'Cancel' button on your App & offer full refund on tickets cancelled by customers between the said dates," wrote a user.

A day after the country's largest airline, IndiGo, cancelled more than 1,000 flights and caused disruptions for the fifth day on Saturday, the ministry said that any delay or non-compliance in refund processing will invite immediate regulatory action.

The refund process for all cancelled or disrupted flights must be completed by 8 pm on Sunday, the ministry said in a statement.

"Airlines have also been instructed not to levy any rescheduling charges for passengers whose travel plans were affected by cancellations," it said.

On Saturday, more than 400 flights were cancelled at various airports.

IndiGo has also been instructed to set up dedicated passenger support and refund facilitation cells.

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