Clinical update

COVID-19 vaccine and chemotherapy: advice and guidance

The UK Chemotherapy Board has published guidance for healthcare professionals on COVID-19 vaccination for patients receiving systemic anticancer therapy

The UK Chemotherapy Board has published guidance for healthcare professionals on COVID-19 vaccination for patients receiving systemic anticancer therapy

Essential information

As the COVID-19 vaccination programme rolls out to different prioritised groups, people living with cancer are asking clinicians about the safety of the vaccines, particularly in relation to systemic anticancer therapy (SACT).

This is reflected on the websites of major cancer organisations, many of which have been updated to address queries about vaccination.

The UK Chemotherapy Board has published guidance for healthcare professionals on COVID-19 vaccination for patients receiving systemic anticancer therapy

COVID-19 (SARS-CoV-2)
Picture: iStock

Essential information

As the COVID-19 vaccination programme rolls out to different prioritised groups, people living with cancer are asking clinicians about the safety of the vaccines, particularly in relation to systemic anticancer therapy (SACT).

This is reflected on the websites of major cancer organisations, many of which have been updated to address queries about vaccination.

Three vaccines – Pfizer/BioNTech, Oxford University/AstraZeneca and Moderna – have so far been authorised for use in the UK and although the review process was quicker than usual, all have met the safety standards of the Medicines and Healthcare products Regulatory Agency (MHRA).

However, none of the three vaccines has been specifically trialled in patients receiving SACT.

What’s new?

The UK Chemotherapy Board (UKCB), whose membership includes the UK Oncology Nursing Society, provides guidance on the development of high-quality chemotherapy services.

In December, the UKCB published a document providing guidance and addressing questions being raised by clinicians about the COVID-19 vaccines and patients receiving SACT.

The document, hosted on the UKCB website, is based on guidelines from Guy’s and St Thomas’ NHS Foundation Trust and will be updated as new evidence emerges.

The FAQs in the document are relevant to all patients who are receiving chemotherapy and to all clinical staff involved in the management of those patients.

Implications for nurses

The UKCB publication serves two useful functions for nurses.

It considers key questions in relation to SACT and the coronavirus vaccines, and it signposts to extensive further information produced by other organisations such as the MHRA, the British Society for Haematology and the European Society for Blood and Marrow Transplantation.

The FAQs in the document address issues such as timing vaccine administration relative to the patient’s SACT cycle and whether, or when, to vaccinate a patient with neutropenia.

The document’s clear recommendation is that all patients receiving SACT are vaccinated against coronavirus providing they meet the eligibility criteria laid out in national protocols.

But if postponing vaccination is being considered, this needs to be balanced against the risk of the patient contracting COVID-19 in the intervening period, the document states. And it adds that practitioners should always exercise clinical judgement.

What this means for patients

The pandemic has given rise to many questions and concerns for people with long-term conditions and the COVID-19 vaccine has offered hope of some return to normality.

But, understandably, patients with cancer want to be sure that vaccination will not adversely affect their treatment. The authors of the UKCB publication hope it will help meet that aim by providing clinicians with consistent, evidence-based answers to common questions, updated in line with emerging data.

Expert comment

 Nisha Shaunak, lead pharmacist for oncology, Guy’s and St Thomas’ NHS Foundation Trust, and joint lead author of the UK Chemotherapy Board document

Nisha Shaunak, lead pharmacist for oncology, Guy’s and St Thomas’ NHS Foundation Trust, and joint lead author of the UK Chemotherapy Board document

‘Back in early December it was quickly apparent that information available on the COVID-19 vaccine was limited.

‘Obviously, the vaccines were very new but at Guy’s and St Thomas’ we felt we needed guidance for clinicians who might be answering questions from patients receiving systemic anticancer therapy.

‘People would be asking the same questions no matter where they were based, so we wanted to provide information in a consistent way for clinicians across the country.

‘There are lots of grey areas but we’ve tried to cover as many questions as possible with some straightforward, practical information so clinicians can use their own clinical judgement to make decisions based on their patients and their treatment.

‘We also felt it would be beneficial to have a document where we could signpost clinicians quickly to the most recent information available rather than them having to delve through the internet and look up lots of different documents.’


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