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Covid-19 Primary Care Resources

Chemotherapy and the Covid vaccine

Guide on vaccinating individuals undergoing chemotherapy

This information is sourced from the Specialist Pharmacy Service (SPS), The Green Book Chapter 14a, and the UK Chemotherapy Board

  • Patients receiving chemotherapy will fall into the CEV groupings set out by the JCVI
  • Consider everyone receiving systemic anti-cancer therapy for vaccination in collaboration with secondary care
  • If there is sufficient time between the decision to start treatment and the start date, vaccination should take place during this window when the patient has intact immune function
  • The shortest licensed dose interval should be used (or as soon as practicably possible) and a third primary dose should be offered
  • Try to vaccinate when blood counts are recovered if possible
  • Avoid vaccine on same day as chemotherapy is delivered
  • Consider thrombocytopenia (as it’s an IM injection) – prefer platelet count over 20×109/L
  • Neutropenia: delay if patient is unwell until neutrophils >1×109/L and patient is well again
  • Those with chronic neutropenia can be vaccinated as soon as possible
  • Chemotherapy delivered by bladder instillation does not impact the timing of the vaccination
  • All adult household members of those on systemic chemotherapy should be offered vaccination. 
  • It is wise to counsel patients that, due to the unknown efficacy of the response to vaccination, ‘shielding’ may still be appropriate regardless of vaccination status.
  • The only contraindications are those of allergy to a component; no one vaccine is preferred over another.

Written by Dr Carrie St John Wright

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