Coronavirus (COVID-19) vaccine and cancer

There has been a lot of interest in the coronavirus vaccines. It is understandable that you and your loved ones would have questions about it.

  • Specialists say that it is important for people with cancer to have the vaccine and it is safe. Your cancer treatment can also go ahead if you've had the vaccine. 
  • People whose immune system Open a glossary item was severely weakened when they had the first or second vaccine should have a third vaccine according to the Joint Committee on Vaccination and Immunisation (JCVI). This is for anyone over the age of 12 years.
  • A booster vaccine programme has been running since September 2021. This means that people most at risk of COVID-19 have an extra injection of the vaccine. This is different from the third vaccine - please see below.
  • People with cancer who had the COVID-19 vaccines can sign up for the NHS National COVID Cancer Survey. This can help them to see how well they have formed antibodies Open a glossary item.

Four vaccines were approved for use in the UK. They are made by:

  • Pfizer-BioNTech
  • AstraZeneca-Oxford
  • Moderna
  • Jansen (Johnson and Johnson)

The single-dose Johnson and Johnson vaccine will be available later in the year. 

What is a vaccine?

A vaccine is a type of medicine. It trains the body's immune system Open a glossary item to fight a disease it has not come into contact with before. For infectious illnesses, vaccines try to prevent people from becoming ill with a disease.

COVID-19 vaccines

The Medicines and Healthcare products Regulatory Agency (MHRA) approved 4 vaccines for use in the UK:

  • Pfizer-BioNTech
  • AstraZeneca-Oxford
  • Moderna
  • Johnson and Johnson
VaccineHow it worksDosesStorage
Pfizer-BioNTech This vaccine is an mRNA vaccine and doesn't contain a live virus. mRNA vaccines work by carrying a 'genetic message' to your cells. They instruct them to make antigens. This prepares the immune system to make antibodies to fight the virus.2 doses at least 8 weeks apart-70°C
AstraZeneca-OxfordThis vaccine is made from a harmless virus. It usually causes the common cold in chimpanzees. It doesn't cause a cold in humans. Scientists have changed this virus so it has the gene for the coronavirus spike protein. Injecting this vaccine prepares the immune system to attack the virus. This is without exposing the body to the full virus.2 doses at least 8 weeks apart2 to 8°C
ModernaThis vaccine is also an mRNA vaccine.2 doses at least 8 weeks apart-20°C
Johnson and JohnsonThis vaccine is made from another virus. It is called Adenovirus 26. It usually causes colds or flu-like symptoms. Scientists have changed this virus so it has the gene for the coronavirus spike protein. Injecting this vaccine prepares the immune system. It can then attack the virus without exposing the body to the full virus.a single dose2 to 8°C

Do I need a third vaccine?

The Joint Committee on Vaccination and Immunisation (JCVI) published new advice on the 1st September 2021. They say anyone over the age of 12 years should have a third vaccine. This is only for people whose immune system was very weakened when they had the first or second vaccine.

For people who have cancer or have had cancer this includes those:

  • who had a blood cancer and were having treatment at the time they had their vaccines, or who had treatment to cure their cancer in the previous 12 months
  • people with blood cancer such as myeloma, chronic lymphoid leukaemia (CLL), low grade lymphoma
  • have had a stem cell transplant more than 2 years ago but continue to have a weakened immune system or have graft versus host disease (GVHD)
  • who were having chemotherapy or radiotherapy that weakened their immune system or had this treatment in the previous 6 months

JCVI suggests you should have the third vaccine 8 or more weeks after your second one. If you are having cancer treatment your specialist will tell you when is the best time to have this jab. They may arrange it for you or write to your GP recommending when is best.

From the 26th of November 2021, you can book an appointment online for a third vaccine through the NHS booking system. You will need a referral letter from your doctor.

Talk to your specialist if you are not sure whether you need to have a third vaccine, they will be able to tell you.

This is separate from the booster vaccine programme. You may still need a booster. This is in the same way the general population may need it after their first two doses.

What is the booster vaccine?

A booster programme started in September 2021. This means that people most at risk of COVID-19 have an extra injection of the vaccine. This will help to continue protection against COVID-19 during the winter months.

The JCVI suggests a booster jab because immunity against the virus might become less over time.

The people most at risk include priority groups 1 to 9. These groups had their vaccine during the first phase of the vaccine programme last year.

JCVI has expanded the list. It also includes adult household contacts of people with weakened immune systems.

The booster programme happens in 2 stages and includes the following groups:

Stage 1

  • adults aged 16 and over who have a weakened immune system 
  • people living in residential care homes for older adults
  • all adults aged 70 and over
  • adults aged 16 and over who are clinically extremely vulnerable
  • frontline health and social care workers

Stage 2

As soon as practicable after stage 1, the following groups will be called:

  • all adults aged 50 and over
  • all adults 16 - 49 years with underlying health conditions that put them at higher risk of severe COVID-19
  • adult household contacts of immunosuppressed people

The JCVI says that people most at risk should have the booster injection no earlier than 6 months after the second jab of their last course.

JCVI suggests the Pfizer vaccine as the booster jab of choice. This is because research has shown that this vaccine works well as a booster jab.

Or, you may have a half dose of the Moderna vaccine. If you can’t have the Pfizer or Moderna vaccines due to allergies, you can have the Astra Zeneca vaccine if you had it before.

Talk to your GP or healthcare team if you have questions about your situation.

National COVID Cancer Survey

The NHS has launched a National COVID Cancer Survey. The survey is for people with cancer who had the COVID-19 vaccines. It will help them to find out how well they have formed antibodies Open a glossary item. The survey is looking for people to sign up now.

There is some research that shows that a small number of people with cancer may have formed lower levels of antibodies. This is when compared with the general population. Lower levels of antibodies may mean these people are not protected well from COVID-19.

By taking part, you can help doctors to learn more about antibody levels mean for people with cancer. It will also help doctors to provide the best treatment, care and support for people with cancer. And you will find out about your own antibody levels.

Vaccine side effects

Severe allergic reaction (anaphylaxis)

People with a history of a severe allergic reaction (anaphylaxis) to a vaccine, medicine or food should not have these vaccines.

Swollen lymph nodes

A side effect of the Moderna and Pfizer-BioNTech vaccines is lymph node swelling. You might have swollen lymph nodes in the armpit of the arm that had the vaccine for up to 2 weeks. Talk to your doctor if it doesn't get better. 

Talk to your healthcare team or GP if you are worried about the side effects of the vaccines. They will be able to give you advice about your situation. It is best to do this before going for the vaccine.

The vaccinator at the vaccination centre will also give you advice. They will talk to you about the general side effects of the COVID-19 vaccines.

How well do the vaccines work for people with cancer?

Specialists agree that the vaccines are safe for most people having systemic anti cancer therapy (SACT) (see questions further down on this page). Systemic anti cancer therapy includes treatments such as chemotherapy. It can cause a weakened immune system Open a glossary item.

A weakened immune system means it might not work as normal. It can't protect the body against infections.

So, having the vaccines with a weakened immune system may cause the body to not form enough antibodies. As a result, it might not create enough antibodies to give protection against the virus.

This means that people with a weakened immune system, who had the vaccine, should continue to protect themselves. This way they can reduce their risk of infection.

Studies on how well the vaccines work for people with cancer 

Several studies have now published results on how well the vaccines work for people with cancer. In general, it showed that if you have a weakened immune system Open a glossary item you might have less protection against the virus. This is after both jabs. People with blood cancer in particular have less protection. This is when compared to people with solid cancers or those without cancer.

Protection against the virus does increase after two jabs, but people with blood cancer might still be at the greatest risk of becoming severely ill from the virus.

People with blood cancer should continue to take extra care to protect themselves. Speak to your healthcare team if you are uncertain about your risk of getting ill with COVID-19.

You can read more about these studies on our clinical trials database by following the links below or reading the Cancer Research UK Science blog.

Coronavirus (COVID-19) vaccine and cancer treatment

Talk to your doctor or specialist nurse for specific advice for your circumstances. 

The information below is about the Pfizer-BioNTech, AstraZeneca-Oxford and Moderna vaccines. It is only a guide.

Specialists say that everyone having SACT should be considered for the vaccine. Your cancer treatment can also go ahead if you've had the vaccine, and there is no need for your treatment to be delayed because of it.

Can I have the vaccine when I’m having immunotherapy?

Immunotherapy can trigger an increased immune response causing side effects. But there is not enough evidence that it might happen with these vaccines. Specialists say that the benefit of having the vaccine should be weighed against the risk of not having it and becoming ill with COVID-19.

People having immunotherapy can have the vaccine at any time in their treatment cycle.

Can I have the vaccine when I’m taking part in a clinical trial?

You can have the vaccine when on a clinical trial for SACT unless the trial criteria say you may not have a vaccine or exclude people who have had the vaccine.

When is the best time to have the vaccine when I’m having treatment?

Whenever possible you will have the vaccine before you start treatment. Ideally, you should have the vaccine 2 weeks before you start your first cycle of SACT.

If you are already having treatment, your doctor will discuss with you when it is best to have the vaccine.

Can I have the vaccine if I have low levels of white blood cells (neutropenia)?

Ideally, you should not have an injection if you are unwell with neutropenia and until your level of white blood cells is back to normal.

People who have chronic neutropenia should have the vaccine.

Can I have the vaccine if I have low platelets or a bleeding disorder?

Your healthcare team will decide when it is safe for you to have the injection. It will depend on your level of platelets and the risk of bleeding.

Can I have the vaccine if I've recently had an autologous (your own) or allogeneic (donor) stem cell transplant?

People who've had a stem cell transplant can have any of the 3 vaccines. Specialists say that if you’ve had an autologous stem cell transplant, you can have the vaccine 2 months after the transplant. If you’ve had an allogeneic stem cell transplant, you can have the vaccine 3 to 6 months after your transplant.

People with Graft versus Host Disease (GvHD) or those receiving high dose steroids protection might have to wait a little longer before having the vaccine. This is because they still have weakened immune systems.

Talk to your healthcare team to find out when would be the best time for you to have the vaccine.

Can I have the vaccine if I've had CAR-T therapy?

Talk to your healthcare team to find out whether you can have the vaccine if you've had CAR-T therapy.

I am having radiotherapy, can I have the vaccine?

The vaccine is recommended for people having radiotherapy and you can have it during treatment. This is because it doesn't affect your immune system like chemotherapy and other cancer drug treatment does. 

I am going to have surgery, can I have the vaccine? 

Having surgery in itself is not a reason not to have the vaccine. Wherever possible people having surgery should have the vaccine at least 1 week before surgery.

I had cancer treatment to my lymph nodes, can I have the vaccine?

People who had surgery to remove their lymph nodes, or who had radiotherapy to their lymph nodes, are at risk of lymphoedema. Injections in an arm on the side of lymph node treatment can trigger lymphoedema. You should ask to have the vaccine on the opposite arm of your cancer treatment. If you had treatment on both sides, you should have the vaccine in your thigh.

More information

You can read more about what the COVID-19 vaccine means for people with cancer on the Cancer Research UK science blog.

Related links