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. This is the advice from the Joint Committee on Vaccination and Immunisation (JCVI). The advice 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. On the 29th of November 2021, the booster programme was updated to include anyone over the age of 18 years. This is to make sure more people have extra protection against the new variant of the coronavirus. It is called the Omicron variant. The booster jab 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?

In September 2021, the JCVI published advice on having a third vaccine. The advice said anyone over the age of 12 years should have a third vaccine. This is only for people who had a very weakened immune system when they had their 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 caused a weakened immune system or had this treatment in the previous 6 months

JCVI suggests that people who have not yet had their third vaccine should have it now without further delay. 

How to get your third dose of a COVID-19 vaccine

If you're eligible for a third dose, your GP or hospital consultant should contact you to let you know.

If you have a letter

You may also have received a letter from the NHS telling you that you can have your third vaccine and that you should talk to your doctor about it.

Your doctor will tell you how you can get your vaccine. You'll usually have it at your local hospital or a local NHS service, such as a GP surgery.

If you are aged 18 or over and have a letter from a GP or hospital consultant confirming that you can have a third dose, you can also book your vaccination appointment online through the National Booking System. Or you can go to a walk in vaccination site. Take the letter with you to your appointment.

    NHS booking system

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

    If you do not have a letter

    If you are eligible, but do not have a referral letter from your GP or hospital consultant, you can still do a walk in vaccination appointment. You will need to take medical documents that state your medical diagnosis with you. You will have an assessment at the centre by a qualified healthcare professional.

    It’s important to know that not every walk in site will give jabs to people with very weakened immune systems. Use the online walk in site finder to make sure you choose the right site for you.

    Examples of medical documents that can be used to confirm that you qualify for a third jab can be:

    • a hospital letter describing your condition at the time of your first or second dose
    • documents showing your prescribed medication at the time of your first or second dose. This can be either a hospital letter that describes the medication you are taking, or a copy of your prescription, or a medication box with your name and the date on it

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

    The third vaccine is separate from the booster vaccine programme. You still need a booster jab. This is the same as it is for the general population, who have 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. A booster jab is necessary because immunity against the virus might become less over time.

    On the 29th of November 2021, JCVI updated the booster programme to include anyone over the age of 18 years. This is to make sure more people have extra protection against the new coronavirus variant. It is called the Omicron variant.

    The booster jabs programme is given in the order of age. This means that they are starting with the oldest people. People more at risk of severe COVID-19 will also be first.

    You can have the booster jab at least 3 months after your first course of jabs.

    Adult household contacts of people with weakened immune systems can also have a booster jab.

    Pfizer and Moderna as booster jabs

    JCVI suggests that the Pfizer and Moderna vaccines are the booster jabs of choice. This is because research has shown that they work well as a booster jab.

    If you can’t have the Pfizer or Moderna vaccines due to allergies, you can have the AstraZeneca vaccine. This is if you had it before.

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

    Getting a booster if you have a severely weakened immune system

    If you are aged 18 and over and have already received a third dose of the vaccine, you should get a booster three months after your third jab.

    If you are eligible for a booster, your GP or hospital consultant should contact you to let you know. They will invite you to book your appointment.

    Your doctor will discuss with you how you can get your vaccine. You'll usually get vaccinated at your local hospital or a local NHS service, such as a GP surgery.

    If it has been three months since your third dose and you haven’t heard from your doctor yet, contact them to discuss your vaccination.

    If you have a letter

    Alternatively, if you already have a letter from a GP or hospital consultant confirming your eligibility for a third dose, you will be able to get a booster. You can do it at a walk in vaccination site. Take the letter with you. You will have an assessment on site by a qualified healthcare professional.

    It is important to know that not every walk in site will give boosters to people with very weakened immune systems. So check the online walk in site finder to make sure you choose the right site for you.

    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 the following should not have the vaccines:

    • a vaccine
    • medicine
    • food

    Speak to your healthcare team or GP if you suffer from severe allergies. They can refer you to a doctor who specialises in allergies. They are called allergists or immunologists. They can do tests and suggest which vaccine might be safe for you.

    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. It includes those having systemic anti cancer therapy (SACT). (Please 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. Unfortunately, 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. Follow the links below or read 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 following vaccines:

    • Pfizer-BioNTech
    • AstraZeneca-Oxford
    • Moderna

    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. 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. Unfortunately, if the trial criteria say you may not have a vaccine or exclude people who have had the vaccine, you will not be able to have it.

    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. Or you should have it at the time of diagnosis, or pre or post surgery where possible.

    You can have the second dose of your vaccine 3 or 4 weeks from the first dose or as soon as practically possible following the first dose.

    If you had a very weakened immune system when you had your first or second dose, you should have a third jab.

    If you are already having treatment, your doctor will discuss with you when it is best to have the vaccine. Generally, doctors say that it is best not to have it on the day of chemotherapy.

    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.

    The following people might have to wait a little longer before having the vaccine:

    • those with Graft versus Host Disease (GvHD)
    • those receiving high dose steroids protection
    • those taking  immunosuppressant drugs

    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. Follow the link to the Cancer Research UK science blog.

    Related links