COVID vaccine FAQs

Now that the COVID-19 vaccination programme has begun here in the UK, you may have questions about this approved vaccine and how it affects blood cancer patients. We've put together a blog answering your most common questions on the COVID-19 vaccine.

Correct as of 18/01/2021. We will update this with further information as soon as possible. Please get in touch with us at support@leukaemiacare.org.uk for further help. 

There are several vaccines for COVID-19 in development, three of which has been approved for use in the UK so far; the Pfzier-BioNTech vaccine, the Oxford-AstraZeneca vaccine and the Moderna vaccine. This is positive news in the fight against COVID-19, but we understand that those affected by blood cancer may still have concerns or questions. This blog will help answer some of those.

Note: the Moderna vaccine has only recently been approved at the time this was updated. This blog is based on all publicly available information at the time of writing. 

When and how will I be invited to have a COVID-19 vaccine?

The JCVI have published a list of who will be prioritised for the vaccine, which can be read here: https://www.gov.uk/government/publications/priority-groups-for-coronavirus-covid-19-vaccination-advice-from-the-jcvi-30-december-2020/joint-committee-on-vaccination-and-immunisation-advice-on-priority-groups-for-covid-19-vaccination-30-december-2020. The highest priority is currently health and social care workers and those over the age of 80.

On the 18th of January 2021, the UK government announced that the vaccine programme will be extended to the next 2 priority groups. This means any person who is considered clinically extremely vulnerable to COVID-19 (including blood cancer patients who have been shielding) will now be invited to be vaccinated, along with those aged 70-74. You may receive the vaccine earlier than others if you fall into one of the older age brackets or meet the criteria due to your occupation. Your family or those you live with will not be invited to have the vaccine too unless they also fall into one of these priority groups and receive their own invite.

NOTE: the exception to this advice is those who are pregnant and children under 16, both of whom are currently advised not to have the vaccine.

As each group is invited to start having a vaccine, you will receive a letter to inform you of this. Please do not contact you GP to request an earlier vaccination, as this will not be possible and will prevent others from being able to get through for appointments (see next question for further details on logistics).

Where can I get a vaccine?

The COVID-19 vaccines are now being delivered across a variety of sites to suit the local requirements. This includes GP surgeries, local hospitals, pharmacists, in care homes, workplaces and mass vaccination centres.

Most people will be offered a vaccine by receiving a letter that invites them to make an appointment. The letter will explain how to do this; it is possible to book an appointment online here: https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/book-coronavirus-vaccination/. Do not try to book an appointment if you have not been invited, as you will be rejected by the system. There should also be a phone number on the letter if you are unable to use the online service, or if you have any other concerns.

Some GPs may also actively reach out to their patients who are eligible to book appointments. They may also call you at short notice if they have cancellations; please use these appointments if you are able.

Please do not contact your GP to request an appointment, as they are extremely busy. Please wait to receive your letter, bearing in mind these may take a while to arrive.

Additionally, it may be some time before all groups are vaccinated. This is the largest mass vaccination programme ever undertaken by the NHS. Additionally, there are only two vaccines currently approved for use in the UK; other vaccines will be needed to have enough doses available to cover the whole population of vulnerable and elderly people, let alone the wider population if the programme is extended. Please continue to follow all guidance on reducing the spread of COVID-19, including after you have had the vaccine (see “can I stop following guidelines” below).

I’ve not had a shielding letter; will I be invited for a vaccine?

If you have not received a shielding letter but believe you should be classed as extremely clinically vulnerable, please speak to your GP or your haematology team as soon as possible. They should be able to add you to the list and therefore ensure you receive a vaccine invitation. If you are unsure if you should be shielding, please also check this with either your GP or haematology team.

If you have been told that you do not need to shield, you will not be included in the extremely clinically vulnerable group and will not yet be invited for a vaccine.

Can my family/those I live with also be vaccinated at my appointment?

Your appointment is only for you to be vaccinated and only those people who have an appointment will be given a vaccine. If your family or household also fall into the groups currently eligible, they will receive their own letter and be asked to book a separate appointment. If your family are not in the current priority groups, they will be unable to have a vaccine at this time. Please do not request that your GP or vaccine centre vaccinate them, as they will be unable to do so.

Are the vaccines safe for people with blood cancers?

The advice from the Joint Committee for Vaccine and Immunisation (JCVI), the group which advises the government on vaccines, is that everyone who is offered either the Pfizer-BioNTech vaccine or the Oxford-AstraZeneca vaccine should have it. Our clinical advisers have also confirmed that this is the case. Additionally, neither vaccine is a live vaccine, so does not pose a risk to immunocompromised people as some live vaccines can (see our vaccines web page for further information on the different types of vaccines). We will provide further information should this be different with other vaccines in development.

The Moderna vaccine has been approved only recently by the regulators, but we expect the advice to be the same as the way this vaccine works is very similar to the way the Pfizer one works. We will update the blog as further information becomes available.

If you have any concerns about receiving the vaccine, we advise that you speak to your haematologist about it once you have received your invitation.

Is it safe for me to go out for the vaccination?

If you are shielding, it is understandable to be nervous about leaving the house. Vaccination is one of the reasons you are encouraged to do so. The vaccine centres will be well prepared to receive vulnerable people, with the use of PPE and strict social distancing in place.

We would also suggest that you take care to reduce your contacts on the way to and from the vaccination centre, such as not using public transport. If you cannot travel to your appointment safely, contact the number on your letter to discuss your alternative options. Also try to only take someone with you if absolutely necessary. This will reduce the number of people at the vaccination centre, protecting others there.

Can I stop shielding once I have received the vaccine?

The government and the JCVI have advised that those who have received the vaccine should continue to shield for the time being, whilst they evaluate whether the vaccine has worked in the extremely vulnerable population.

It is also important that you continue to follow social distancing guidelines and other advice for the general population; it is not yet clear whether the vaccine prevents you from passing COVID-19 to others. You may catch it after you have had your vaccine and not be ill, but still be able to pass it on. Whether this is true or not will become clearer as more people are vaccinated.

How do the vaccines work?

Vaccines can prevent diseases from impacting upon society in two ways; by preventing those who are vaccinated from getting severely ill and/or by preventing spread of illness. They do this by delivering a molecule that tricks your immune system into thinking you have been infected, encouraging it to develop a response that will protect you in the event you became infected with the virus itself. In the Pfizer-BioNTech vaccine, the immune system responds to a piece of genetic material called mRNA. In the Oxford-AstraZeneca vaccine, the immune system reacts to a COVID-19 protein, which is delivered into the body by being attached to a different virus. Neither vaccine is a live vaccine, as neither contain whole COVID-19 virus, and neither can give you COVID-19. You can read more general information about vaccination and blood cancers here: https://www.leukaemiacare.org.uk/support-and-information/information-about-blood-cancer/living-well-with-leukaemia/vaccines.

Clinical trials of the COVID-19 vaccines announced so far in the media, have shown that the vaccines reduce severity of illness and the number of people who require hospital treatment. However, it is not yet known whether any of these vaccines can prevent people from passing on the virus to other people who not yet been vaccinated. Therefore, if you do receive a vaccine, it is important you continue to observe social distancing and other actions to make sure that you do not spread COVID-19 unknowingly to non-vaccinated people (see “can I stop following guidelines if I have the vaccine” below). Scientists expect the vaccine will impact on transmission, but this will not be known for sure until more people have been vaccinated.

What is the difference between the various vaccines?

As mentioned in “how do vaccines work”, the vaccines use different methods of encouraging the immune system to react. As you may have heard in the media, they also differ in how they need to be stored, meaning they will be delivered to different groups of people in different locations. It is unlikely that you will be able to choose which vaccine to have; both the Pfizer-BioNTech and Oxford-AstraZeneca vaccines are effective and are considered safe (see “have the vaccine been tested in people with blood cancer” below).

Are any of the vaccines currently available in the UK live vaccines?

No. One of the vaccines currently available, the Oxford-AstraZeneca vaccine, contains whole virus particles, but these are not whole COVID-19 viruses. It is a different virus that has been used to deliver a part of the COVID-19 vaccine that the immune system can respond to; this type of vaccine is called a viral vector.

The virus used as the vector is called an adenovirus, and it usually causes the common cold in monkeys. It has been modified so it cannot replicate. Therefore, you are not able to become ill from either the adenovirus or COVID-19 from this vaccine.

Have the vaccines been tested in people with blood cancer?

Pfizer has confirmed that their vaccine was not tested in immunocompromised populations, which includes blood cancer patients. It has been tested in many people over the age of 55 (approximately 40% of the study was in this age range). Your immune system worsens with age, so it is thought that if the treatment works well in the older population, it may also be effective in people who are immunosuppressed for other reasons, although this will be settled in time as more people have the vaccines.

The Oxford-AstraZeneca vaccine is not thought to have been tested in people with blood cancers specifically. Like with the Pfizer vaccine, it was tested in elderly people, who are also immunocompromised due to age, as well as being tested in people with other comorbidities.

Data in some of the trials did include some people with a history of leukaemia, but these were likely people who had recovered from leukaemia some time ago.

Both the Pfizer and the Oxford vaccines are considered safe for blood cancer patients, based on currently available information, and therefore those who are offered the vaccine should take up the offer (see next question).

This is likely to be the same with the Moderna vaccine too, although the announcement is too recent to provide further updates on this at the time of writing.

Are the vaccines safe for people with blood cancers?

The advice from the Joint Committee for Vaccine and Immunisation (JCVI), the group which advises the government on vaccines, is that everyone who is offered either the Pfizer-BioNTech vaccine or the Oxford-AstraZeneca vaccine should have it. Our clinical advisers have also confirmed that this is the case. Additionally, neither vaccine is a live vaccine, so does not pose a risk to immunocompromised people as some live vaccines can (see our vaccines web page for further information on the different types of vaccines). We will provide further information should this be different with other vaccines in development.

The Moderna vaccine has been approved only recently by the regulators, but we expect the advice to be the same as the way this vaccine works is very similar to the way the Pfizer one works. We will update the blog as further information becomes available.

If you have any concerns about receiving the vaccine, we advise that you speak to your haematologist about it once you have received your invitation.

Will the vaccines work for me?

We know from other studies that people with leukaemia or similar blood cancers do not always respond as well to some vaccines as those with fully functioning immune systems. We do not yet know if this is the case for any COVID-19 vaccines approved or those still in development (see “has the vaccine been tested in people with blood cancers” above). Additionally, you may be more or less immunocompromised than another person, depending on your type of blood cancer, any treatments you are having or due to your age and/or other illnesses you have. However, a weak immune system does not mean that you will not respond at all; a small amount of protection is better than none at all.

It is important that you get all the doses of the vaccine that you are scheduled to receive, as this gives maximum protection. Both the Pfizer and Oxford vaccines involve a two-dose strategy (we will update for the Moderna vaccine when this becomes available.

Will I have side effects?

The side effects of these vaccines are minor and are not expected to be any worse for those with blood cancers. You can read about these here: https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/coronavirus-vaccine/. If you do experience side effects, we encourage you to report these to the MHRA via the Yellow Card Scheme; there is a specific version for the vaccine here: https://vaccinemonitor-yellowcard.mhra.gov.uk/. They are particularly keen to hear from certain groups, such as those with blood cancers, to monitor the response of these people.

I have received one dose of a vaccine, but the second dose has been delayed. Why is this?

On the 30th of December, the government announced that the Pfizer-BioNTech vaccine would now be delivered with the second dose up to 12 weeks after the first dose, rather than within 3 weeks as previously advertised. This decision was made to allow as many people as possible to receive the first dose, which offers some protection, whilst more vaccines are manufactured.

Will I receive two doses of the same vaccine?

Each approved vaccine has only currently been trialled with two doses of the same vaccine. However, trials are ongoing to see if the vaccines will be effective if you mix one dose of one vaccine with a dose of a different vaccine afterwards.

Public Health England has stated that “every effort should be made to determine which vaccine the individual received and to complete with the same vaccine”. They have suggested that there may be circumstances in which it is not known which vaccine was used for the first dose, or if a person needs a vaccine immediately, where the second dose could be a different vaccine.

If you are concerned about which vaccine you are receiving, please discuss this with your GP or with the person administering the vaccine prior to receiving it.

I am currently having chemotherapy. Should I have the vaccine?

This is a group in which the vaccines have not be specifically tested. As with other vaccines, such as childhood vaccinations or the flu jab, there are specific times when these should be had whilst you are on chemotherapy, to give the vaccines the best chance of working. If you are invited for the vaccine during a course of chemotherapy, please speak to your haematology team if you are unsure when is the most appropriate time for you to have it or to discuss any other concerns.

I have had or am currently having a transplant. Should I have the vaccine?

This is another group in which the vaccines have not be specifically tested. We do not yet know who was tested in the trials for other vaccines in development. You can have the vaccine whilst on cancer treatment, but it is preferable that it is delivered at a time when you have an immune system working at some level. For those people currently having or have recently had a transplant, there times when it is best to receive vaccines to make sure you have all the cells in your body that you need to respond to the vaccine. If you have invited to have a vaccine, please speak to your care team for advice about when to have it.

I have already had COVID-19. Should I get a vaccine?

Natural infection with COVID-19 will generate an immune response, such as producing antibodies, as this is how your body fights off the virus. However, it is not clear how long this last in a person’s body. Initial studies have suggested that antibodies are short-lived after infection, and there have been cases of reinfection reported, although rare. Therefore, it is recommended that you still have the vaccination, as this has been designed to give strong and lasting protection.

Can I stop following the social distancing guidelines once I am vaccinated?

No, we advise you to continue to follow all guidelines to reduce the spread of COVID-19 until the government advises otherwise. As mentioned in previous questions, we do not know how effective the vaccine will be in those affected by blood cancer and we also do not know if the vaccine will prevent you from passing COVID-19 to other people who are not yet vaccinated. This applies to everyone, regardless of the whether you have completed your full course of vaccination or whether your family have also received the vaccine.

I have an allergy. Should I receive the vaccine?

On the 9th of December, it was reported that 2 of the first recipients of the Pfizer-BioNTech vaccine had experienced an anaphylactoid reaction after receiving the vaccine; this is where the person develops a rash, breathlessness and a drop in blood pressure, but this is not the same as an anaphylaxis reaction, which can be fatal. The two people affected had severe allergies, which meant that had to carry an epi-pen at all times. The NHS is no longer giving either the Pfizer-BioNTech or the Oxford-AstraZeneca vaccine to people with history of severe allergic reactions to any of the ingredients in the vaccines.

You can find the ingredients of the Pfizer-BioNTech vaccine here: https://www.gov.uk/government/publications/regulatory-approval-of-pfizer-biontech-vaccine-for-covid-19/information-for-uk-recipients-on-pfizerbiontech-covid-19-vaccine#ingredients.  You can find the ingredients of the Oxford-AstraZeneca vaccine here: https://www.gov.uk/government/publications/regulatory-approval-of-covid-19-vaccine-astrazeneca/information-for-uk-recipients-on-covid-19-vaccine-astrazeneca#contents-of-the-pack-and-other-information.

It is not yet clear if this will also apply to the Moderna vaccine, but will provide a further update when this information is available. If you are unsure if this applies to you, please check with your GP or care team before having the vaccine.

Are there any alternatives if I cannot be vaccinated?

We encourage everyone who is able to have the vaccine to take up the offer. There are a small number of people who cannot have the vaccine for clinical reasons. There are other alternative protective measures in trials currently, such as an antibody treatment being developed by AstraZeneca. We will update on these when more information becomes available.

If you have any additional questions about the COVID-19 vaccine, please email support@leukaemiacare.org.uk.

You can also call our helpline: 08088 010 444, or use our WhatsApp service: 07500068065

For a patient’s experience of receiving a COVID-19 vaccination, read Hannah Mahoney’s blog by clicking here.

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