COVID-19 Vaccines For Cancer Patients (Update)

08 March 2021

There has been some confusion around what COVID-19 vaccine priority groups people with cancer will fit into.  This is obviously a very unsettling time for people with underlying health conditions (especially cancer).

In January, NHS England (NHSE) stated that people with cancer who weren’t prioritised in Group 4, such as those treated a long time previously and who were treated surgically, would be covered in priority Group 6.

This information was initially published on the CRUK website on 28 January (which has since been amended).  However, it appears that this guidance has not been communicated in any public setting.  Unfortunately, NHSE has been unable to provide further confirmation.

Those who fall into Group 4, and who are considered Clinically Extremely Vulnerable (CEV), include:

• People with cancer who are undergoing active chemotherapy
• People with lung cancer who are undergoing radical radiotherapy
• People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
• People having immunotherapy or other continuing antibody treatments for cancer
• People having other targeted cancer treatments that can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
• People who have had bone marrow or stem cell transplants in the last 6 months or who are still taking immunosuppression drugs

According to page 11 of the Green Book, anyone with lowered immunity due to disease or treatment who is not in group 4 will be in Group 6, including:

• Patients undergoing chemotherapy leading to immunosuppression
• Patients undergoing radical radiotherapy, solid organ transplant recipients, bone marrow or stem cell transplant recipients
• Individuals who are receiving immunosuppressive or immunomodulating biological therapy including, but not limited to, anti-TNF, alemtuzumab, ofatumumab, rituximab, patients receiving protein kinase inhibitors or PARP inhibitors, and individuals treated with steroid sparing agents such as cyclophosphamide and mycophenolate mofetil
• Individuals treated with or likely to be treated with systemic steroids for more than a month at a dose equivalent to prednisolone at 20mg or more per day for adults
• Anyone with a history of haematological malignancy, including leukaemia, lymphoma, and myeloma

Individuals who are about to receive highly immunosuppressive treatment, or those whose level of immunosuppression is about to increase may be re-prioritised and be able to have vaccination sooner, if therapy can be safely delayed or there is sufficient time before therapy starts. Those who have had cancer, or have cancer, but who are not part of Group 4 or 6 will have the vaccine with their age group, depending on their circumstances.

If you have any concerns or questions about when you will be invited for a COVID-19 vaccine, please speak to your GP or cancer specialist.