COVID-19 vaccine and cancer – latest updates

As the pandemic continues to develop and new variants emerge, we will be using this article to make sure everyone has access to important information regarding COVID-19 and what it means for people with cancer. 

We’ll be updating this post regularly as new data and information emerges.

18 July – UK autumn COVID-19 booster programme announced 

Last week, the Government announced that a new COVID-19 booster jab programme would begin later this year.  

The Department of Health and Social Care (DHSC) has accepted the latest advice from the Joint Committee on Vaccination and Immunisation (JCVI) for autumn jabs. Governments in Wales, Scotland and Northern Ireland are also following the JCVI guidance. 

The latest advice includes offering a COVID-19 booster jab to: 

• All adults aged 50 years and over 
• Those aged 5 to 49 years in a clinical risk group, including pregnant women 
• Those aged 5 to 49 years who are household contacts of people with immunosuppression 
• Those aged 16 to 49 years who are carers 
• Residents in a care home for older adults and staff working in care homes for older adults 
• Frontline health and social care workers 

As well as the booster, the DHSC will be widening the offer of the free flu vaccine to additional groups. These groups will only be eligible for the vaccine once the most vulnerable (which includes pre-school and primary school children, those aged 65 years and over and those in clinical risk groups) have been offered the jab.  

The additional groups set to be offered the free flu vaccine in England will be: 

• All adults aged 50-64 years 
• Secondary school children in years 7, 8 and 9, who will be offered the vaccine in order of school year (starting with the youngest first) 

A complete list of those who are now eligible for a free flu vaccine in each UK nation can be found, here:

• England
• Scotland
• Northern Ireland
• Wales

Further information is set to be released about the rollout of the programme, including when and how people can book appointments for these vaccinations.  

25 February – Restrictions lifted in England as ‘living with COVID’ strategy implemented 

Earlier this week, Boris Johnson made a statement on England’s strategy for living with COVID-19.  

The strategy announced that from today, 24 February, there will no longer be a legal requirement to self-isolate following a positive test. Routine contact tracing will also be stopped and the Government will no longer be asking fully vaccinated close contacts, and those under 18, to test daily for 7 days as well as removing the legal requirement for close contacts who are not fully vaccinated to self-isolate. 

Until 1 April, the Government is still advising those who test positive with the virus to stay at home. But after that, have asked that people with COVID-19 symptoms exercise personal responsibility. 

On Tuesday, First Minister Nicola Sturgeon unveiled plans for Scotland to relax many of its remaining rules, but included testing and isolation as examples of measures which could continue to help keep the virus under control. Measures are also easing in Wales and Northern Ireland.  

However, we understand that the lifting of legal COVID-19 restrictions may be concerning to people with cancer, many of whom are more vulnerable to COVID-19 or may have less protection from the vaccines.  

We encourage everyone who is eligible to play their part in helping protect vulnerable people by getting vaccinated and self-isolating if they catch the virus.

25 January – First data on Omicron response after vaccination in people with cancer 

New results, published today in The Lancet, have revealed that nearly half of blood cancer patients don’t have detectable levels of antibodies that can neutralise the Omicron variant, following a third vaccine dose.

Researchers used a highly accurate test, developed at The Francis Crick Institute, to assess whether levels of antibodies in the blood are adequate to block at least 50% of the virus, under laboratory conditions. The study involved 115 people with solid cancer and 84 with blood cancer.

“The results were very positive for patients with solid cancer,” says Dr Samra Turajlic, lead author of the study. “Most of them have antibodies that can neutralise Omicron after three doses. Overall, their response is similar to individuals without cancer of a similar age”. A third dose of COVID-19 vaccine effectively increased the proportion of patients with levels of antibodies able to neutralise Omicron to 90%, compared to just 37% after the second dose.

“For patients with blood cancer, there has been a big question mark on how effectively booster would improve their antibody response, especially as we found that most did not have antibodies against Omicron after two doses” says Turajlic.

Researchers found that while the response was lower in people with blood cancer, the number of people with a detectable antibody response rose significantly after the third dose of the vaccine. 19% of patients showed detectable levels after two doses compared with 56% after the booster. “Although patients with blood cancer were less likely to have a response after a third dose compared to patients with solid cancer, the proportion of patients with antibodies does go up with each additional dose, which shows how important it is for patients with blood cancer to get their 4th dose.”

“It is my hope that these findings will help people with blood cancer and their doctors consider what additional precautions to take to protect themselves from the virus. And because some protection is better than none, I would encourage cancer patients to take up all relevant doses of the vaccine to give them the best possible protection from COVID-19,” says Michelle Mitchell, chief executive of Cancer Research UK.

“Ultimately, this is an important reminder that it is up to all of us to keep each other safe. Despite recent changes to UK Government guidelines, Cancer Research UK continues to encourage everyone to help keep cancer patients and other clinically vulnerable people safe by taking sensible precautions such as wearing masks in crowded spaces and getting vaccinated and boosted.”

5 January – New results on effectiveness of third vaccine dose for cancer patients 

New results from the CAPTURE study, looking at how cancer patients respond to COVID-19 vaccines, were published last week. 

Encouragingly the latest results suggest that for people with solid tumours, the detectable antibody response to the initial virus, and Beta and Delta variants, increased after a third dose, including in most of those who didn’t develop a response to the Delta variant after the first two doses of vaccine.  

People with blood cancer who had a response after two doses also had a better response against all variants after their third dose. However, in people with blood cancer who did not have a detectable response against the Delta variant after two doses, almost half still had no detectable antibody response against Delta and Beta variants after the third dose of the vaccine.  

This follows previous results from the CAPTURE study, which suggested that people with blood cancer showed a poorer immune response to the first two doses of a COVID-19 vaccine compared to people with solid tumours. 

This study also looked at the T cell response in a subset of patients and found that this was boosted after a third dose in both people with solid tumours and blood cancers, potentially offering additional protection. T cells are a type of white blood cell which play a key role as part of our immune system in killing virus infected cells. 

The CAPTURE study is contributing to a growing picture on the effectiveness of COVID-19 vaccines are for people with cancer.  

With the full picture still emerging, we’d recommend that anyone undergoing cancer treatment continues to follow the recommendations of their doctors and specialists. And we encourage all who have been offered the vaccine to take it. 

10 December – New COVID-19 treatments to be offered to most at-risk groups in the UK  

This week, the Government announced that thousands of the most vulnerable people in the UK will have access to life-saving, innovative antiviral and antibody treatments. Two new treatments, molnupiravir and Ronapreve, have recently been approved for non-hospitalised adults with mild to moderate COVID-19 based on clinical trial evidence showing they reduce the risk hospitalisation or death. 

A national study called PANORAMIC, run by the University of Oxford in close collaboration with GP hubs, will recruit around 10,000 UK patients who are at risk of severe cases of the virus. Participants will have the opportunity to take the treatment molnupiravir at home after receiving a positive PCR test. 

If eligible, you will be contacted by the study team or a healthcare professional following your positive PCR test. Alternatively, if you wish to sign up as a participant, PANORAMIC will be recruiting through its website. 

While this study is needed to provide more evidence, people who are at high risk from COVID-19, or who may be less protected by vaccination won’t have to wait to access this, or another new innovative treatment for COVID-19. Those at highest risk who test positive for COVID-19, which includes cancer patients and people who have compromised immune systems, will also be able to access either molnupiravir or the novel monoclonal antibody Ronapreve outside of the study from next week (16 December 2021). 

People who are eligible will be contacted by the NHS. You can find more detail about who is eligible on the NHS website. If you feel that you may be eligible to take part, but haven’t received a letter, you can contact your GP or consultant. Your GP will make an assessment of any conditions you may have, and if you are eligible, they will issue you with a copy of the letter to provide further information on the next steps. 

6 December – JCVI updated advice on vaccine response to Omicron variant  

It’s still not clear how much protection current COVID-19 vaccines will provide against the Omicron variant. Lab studies have suggested that high levels of antibody after COVID-19 vaccination – which is designed to protect against the original or ‘wild-type’ virus – gives protection against other variants. Studies are underway to assess whether this is also true for the Omicron variant.  

On Monday the government accepted updated advice from the Joint Committee on Vaccination and Immunisation (JCVI) on immediate measures to be taken within the COVID-19 vaccine programmes, including: 

• Those eligible for the booster vaccine should be expanded to include all adults aged 18 years to 39 years old. 
• Booster vaccination should now be offered in order of descending age groups, with priority given to the vaccination of older adults and those in a COVID-19 at-risk group. Booster vaccination should only be given from 3 months after the completion of the primary course. 
• Severely immunosuppressed individuals who have completed their primary course (all 3 doses) should be offered a booster dose a minimum of 3 months after their third primary dose. Anyone who hasn’t yet received their third primary dose should be given it now to avoid further delay. A further booster dose can be given in 3 months, in line with the clinical advice on optimal timing. 

People who are considered severely immunosuppressed include those who have had, or currently have, blood cancer, or those who have a weakened immune system due to a treatment (such as steroid medicine, biological therapy, chemotherapy or radiotherapy).  

You can find out more information on who is in a COVID-19 at-risk group or severely immunosuppressed on the NHS website.  

For more information on the difference between a booster dose and the third primary dose, see our update from 22 September.  

27 October – New study assesses cancer patients’ response to the COVID-19 vaccines

Results from the CAPTURE study have been published today in the journal Nature Cancer, which looked to understand the level of protection the Pfizer/BioNTech and Oxford/AstraZeneca vaccines give to people with cancer.

The study looked at 585 people with different types of cancer, and supports previous findings that people with cancer, especially those with blood cancer, don’t develop as strong a response to the vaccine compared to people who don’t have cancer.

A number of different studies have investigated vaccine responses in people with cancer, updates about which can be found within this article. Cancer Research UK still encourages cancer patients to take up all relevant doses of the vaccine – though the vaccine may not be as protective for people with cancer (especially those with blood cancer) – it still appears to confer some protection.

People with cancer, especially those with blood cancer, may want to consider what precautions they take to protect themselves from the virus.

Michelle Mitchell, chief executive of Cancer Research UK: “This new study adds weight to the growing evidence that, for people currently affected by blood cancers, the available vaccines give less protection against variants like Delta compared to people with other cancer types and the general public. In the future, we will need to understand what this means for blood cancer patients who may catch COVID-19 variants of concern, for example whether they are more likely to require hospitalisation.”

Cancer Research UK has signed an open letter, along with 39 other cancer charities, appealing to the general public to help protect people clinically vulnerable people – including many cancer patients. The letter hopes to promote continued usage of masks in crowded spaces, keeping a social distance from those they don’t know and getting vaccinated.

22 October – Study suggests poor immune response in double-vaccinated blood cancer patients

Many double vaccinated blood cancer patients may have been left with little protection against COVID-19, according to new data published today in Cancer Cell. This adds to the evidence from previous studies into vaccination in groups with compromised immune systems.

The SOAP-02 study examined the level of immune protection to COVID-19 in blood cancer patients after receiving their second Pfizer-BioNTech vaccine. The trial included 159 participants, 128 of whom were cancer patients.

Although the second dose increased the development of antibodies to SARS-CoV-2 in blood cancer patients from less than 20% following a single dose, 57% of double-vaccinated blood cancer patients still did not have an antibody response to the virus.

Professor Charles Swanton, chief clinician at Cancer Research UK, said: “This study shows that over half of blood cancer patients are unable to mount an antibody response to SARS CoV2 despite being vaccinated twice, which we know is an important step in preventing severe infection risk.

“These results add to a growing body of evidence confirming the vulnerability of patients with blood cancers during the COVID pandemic despite being vaccinated.

“As the world begins to return to normal, we must not forget vulnerable patients like this, who will need ongoing measures to protect them from transmission and additional approaches to reduce the risk of severe disease. If not, we could see them being confined to isolation approaches for the foreseeable future.”

The results also reinforce the need to prioritise groups with compromised immune systems, such as blood cancer patients, to receive a third dose and any subsequent booster doses that are offered, and to monitor the effect of this on their immune responses. You can read more about third doses and booster vaccines in our 22 September update.

27 September – National COVID Cancer Survey launched 

A National COVID Cancer Antibody Survey launched this September. The survey will assess antibody responses to the COVID-19 vaccines among people with cancer and is open for recruitment now.  

The study aims to understand antibody levels in people with cancer and what this means for protection against COVID-19. It could also help doctors to provide the best treatment, care and support for people with cancer.

There are 10,000 places on this study and the NHS will be asking people to join over the next 2 to 3 months. If you live in England and have either been diagnosed with cancer in the last year or are having cancer treatment, you can enroll in the survey. 

Find out more about the study on our website. You can sign up to the study on the COVID cancer survey website: https://covidcancersurvey.uk/  

Update: We have been made aware of an issue with signing up to the survey on the website. We have been told that you should ignore the text which asks you not to continue if you are not working, and that you still qualify for an antibody test, regardless of your employment status. If you answer the question regarding employment and click ‘continue’, you can still book your test. The issue is being looked into and will be fixed imminently.

Update (06/10/21): The website hosting the survey is experiencing a technical issue that means no one can complete the request for a kit. The team are working on the issue and will update the covidcancersurvey.uk website as soon as it’s fixed.

22 September – The difference between a booster jab and the third dose 

With information about a booster jab and the third dose being released in recent months, there have been some questions about who’s eligible for what. We have summarised the difference below with the all the current information:  

The booster jab: 

• The booster jab, as outlined in the update from 14 September, is for all of those who were initially vaccinated as part of the first phase of the vaccine programme, in priority groups 1-9, as well as adult household contacts of immunosuppressed people. 
• The booster is for people who are likely to have made a good immune response to their initial 2 doses of vaccine, but whose protection may have started to wane and require a booster dose to continue to protect them through the winter months. These people may also be at a greater risk of developing severe COVID-19 or passing it on to other vulnerable people. 
• A booster vaccine is not required until at least 6 months after your last vaccine. 
• The Joint Committee on Vaccination and Immunisation (JCVI) has recommended that the Pfizer-BioNTech vaccine is used as the booster, regardless of what vaccine types were used for the first and second doses. Alternatively, a half dose of Moderna can also be used as a booster.  

The third primary dose:  

• The third primary dose is for anyone who might have been immunosuppressed at the time of their first two vaccine doses. A list of people who are immunosuppressed can be found, on the UK Government website. This includes some people with blood cancers those who have received stem cell transplants and those who had received immunosuppressive chemotherapy or radiotherapy in the last 6 months.  
• The third primary dose is for people who may not have got as much protection from their first 2 jabs, to help them generate a more robust immune response. 
• It’s not possible to know exactly who will have responded to the vaccine, so the JCVI is recommending that all people with certain conditions or on certain treatment should receive the third dose. 
• The third dose should be given at least eight weeks after your second dose but the exact timing may depend on individual circumstances e.g. if you are receiving treatment that might affect your immune system. This decision should be made by your specialist. 
• It’s not yet known whether those who will be offered a third dose will be offered a booster at a later date.  

14 September – JCVI update advice on booster jab  

The Joint Committee on Vaccination and Immunisation (JCVI) has updated its advice on the COVID-19 vaccine booster programme today. 

To maintain a level of protection against COVID-19 during the winter months, the JCVI is advising that booster jabs are offered to those more at risk from serious disease, and who were vaccinated during the first phase of the vaccine programme: priority groups 1 to 9. 

Today’s update includes expanding the groups eligible for a booster vaccine, outlined in their original announcement (see our update from 1 July), to now include:  

• Those living in residential care homes for older adults 
• All adults aged 50 years or over 
• Frontline health and social care workers 
• All those aged 16 to 49 years with underlying health conditions that put them at higher risk of severe COVID-19 
• Adult household contacts of immunosuppressed individuals 

Those who were vaccinated early during phase 1 of the initial vaccine rollout will have received their second dose approximately 6 months ago. The JCVI has suggested that the booster vaccine programme to begin in September 2021, as soon as operationally practical. .

The guidance that was suggested by the JCVI has been accepted by the Government, and all four UK nations will follow the JCVI’s recommendation.

Please contact your GP or specialist if you have any questions based on your individual circumstances.

2 September – Third COVID-19 jab recommended for severely immunosuppressed 

The Joint Committee on Vaccination and Immunisation (JCVI) has advised that people with severely weakened immune systems should have a third vaccine dose, it was announced last night. 

According to the latest advice, this third jab should be offered to anyone over the age of 12 who was severely immunosuppressed at the time of their first or second dose. This includes people with certain types of blood cancers, advanced HIV and who have had recent organ transplants. 

This third dose is separate to the booster programme, which is still in the planning phase.

Health and Social Care Secretary, Sajid Javid accepted the recommendation this morning. He said: “The NHS will contact people as soon as possible to discuss their needs and arrange an appointment for a third dose where clinically appropriate.” 

Exactly how people will be contacted is still being planned, but  it’s likely that people who are eligible will receive a letter from their GP or local vaccination centre. As a general guide, it should be at least 8 weeks after the second jab, but with flexibility to adjust the timing so that, if feasible, immunosuppression is at a minimum when the third vaccine dose is administered. 

Javid added: “We know people with specific conditions that make them particularly vulnerable to COVID-19 may have received less protection against the virus from two vaccine doses. I am determined to ensure we are doing all we can to protect people in this group and a third dose will help deliver that.” 

We’ll update with more information as soon as we have it.  

24 August – New results on COVID-19 vaccine for people with reduced immune systems

Further results looking at the immune response to COVID-19 vaccination in people with compromised immune systems, including some people with cancer, went live today at Preprints with The Lancet.  

The trial recruited people with a variety of immune-mediated diseases, including 47 people with solid cancer (breast and lung cancer) and 18 people with blood cancer (multiple myeloma and acute myeloid leukaemia). 

Early data from the trial show that 39% of those with blood cancer and 17% of those with solid cancers had a lower antibody responses after both doses of a COVID-19 vaccine, either Pfizer-BioNTech or AstraZeneca, compared to the lowest response detected in healthy individuals. The study didn’t however look at how this response translates to COVID-19 protection.  

Professor Charlie Swanton, Cancer Research UK’s chief clinician said, “This latest study broadly reflects the evidence we’ve seen so far and includes only a small number of cancer patients, with a limited number of cancer types. So it’s not clear if these results can be generalised or the level of protection given by the antibody response. Questions remain around whether a booster would provide more protection. 

“Overall, the majority of cancer patients had an immune response to the vaccine, even if levels of antibodies were lower in some cases than healthy controls, but the study didn’t look at how this response translates to COVID-19 protection. 

With a lot to still understand, these results may potentially be concerning for those who are clinically extremely vulnerable. However, anyone undergoing cancer treatment should continue to follow the recommendations of their doctors and specialists, and we encourage all who have been offered the vaccine to take it. 

“With restrictions easing, you may wonder if you should be shielding – talk to your doctor, family and friends and ultimately do what’s right for you,” adds Swanton.  

OCTAVE is a UK-wide trial led by the University of Glasgow and co-ordinated by the University of Birmingham’s Cancer Research UK Clinical Trials Unit.

20 July – JCVI issue advice on COVID-19 vaccination of children and young people

Yesterday, the Joint Committee on Vaccination and Immunisation (JCVI) advised that children and young people under the age of 18 who are at increased risk of severe COVID-19 should be offered the Pfizer-BioNTech vaccine. This includes children aged 12 to 15 with immunosuppression.  

The committee has also recommended that people aged 12 to 17 who live with an immunosuppressed person are offered the vaccine, to help protect their household members.  

Following existing advice, young people aged 16 to 17 with underlying health conditions, with a higher risk of contracting serious COVID-19, should have already been offered a COVID-19 vaccination. 

20 July – ‘Not too much to mask’ campaign 

Monday 19 July marked so-called ‘freedom day’ across England, as restrictions were lifted. However, for many, including those living with cancer, the lifting of restrictions may feel like a worrying and uncertain time.  

Cancer Research UK is among a group of cancer charities who have written an open letter to the public as a ‘message of solidarity’, urging them to help keep vulnerable people safe by continuing to wear masks and maintain social distancing.  

You can read the full statement, here. 

13 July – Guidance for the clinically extremely vulnerable from 19 July 

The Government has updated guidance for those in England who have been identified as Clinically Extremely Vulnerable (CEV) from the 19 of July, the date that current restrictions will come to an end.  

The statement advises those who are CEV to follow the same guidance as everyone else when restrictions are lifted next week.  

However, depending on someone’s individual circumstances, the advice suggests that “you may wish to think particularly carefully about additional precautions you might wish to continue to take”. These include taking precautions when meeting others you do not usually meet to reduce the risk of catching or spreading COVID-19, such as meeting outside where possible.

We understand that the change to restrictions may be of concern to cancer patients. In line with government advice we encourage all cancer patients to have both doses of the vaccine when offered, and those considered vulnerable to have the booster jab, if and when it becomes available.  

There is different guidance for clinically extremely vulnerable people living in Scotland, living in Wales and living in Northern Ireland. 

12 July – New data on the effectiveness of COVID-19 vaccines for at-risk groups  

Last week, Public Health England (PHE) published results from a study which suggests that COVID-19 vaccines may be almost as effective at preventing symptomatic disease in people with underlying health conditions as they are in the rest of the population.  

The study, which included 1 million people with underlying health conditions, found that vaccine effectiveness was lower in people who were immunocompromised but was still considered to be high at around 74% after two doses, compared to approximately 85% in people without a compromised immune system. This rises from 4% after a single dose, indicating the importance of a second jab.  

Effectiveness of the vaccine will likely vary for different people depending on their individual circumstances and the statement from PHE highlights that some people may not respond as well to the vaccines. Although the study findings are encouraging, more data is needed to understand vaccine effectiveness for different groups.  

1 July – Vaccine booster programme recommended in interim advice 

The NHS has been advised by the Joint Committee on Vaccination and Immunisation (JCVI) that booster vaccines will help maintain protection against COVID-19, and new variants of the virus, for those most at risk.  

The interim advice recommends that the first stage of a booster vaccination programme, beginning September 2021, is offered to the following groups: 

• Adults aged 16 years and over who are immunosuppressed 
• Those living in residential care homes for older adults 
• All adults aged 70 years or over 
• Adults aged 16 years and over who are considered clinically extremely vulnerable 
• Frontline health and social care workers 

As far as we are aware, the definitions of these groups have not changed, but we will update if we get any further information on priority groups. 

The JCVI says it will publish final plans before September and that the advice “may change substantially” based on data from the next few months. 

“The primary objective of any potential COVID-19 booster vaccine programme should be to reduce serious disease, including death,” said Professor Wei Shen Lim, COVID-19 Chair for JCVI. “We will continue to review emerging scientific data over the next few months, including data relating to the duration of immunity from the current vaccines. Our final advice on booster vaccination may change substantially.” 

The NHS has been given the green light to begin planning a booster programme in the UK. Wales’ health minister has said the advice “very much aligns with our thinking and our planning assumptions to date”.

18 May – Initial data show cancer patients have high protection after second dose of vaccine

New research, awaiting independent review by other scientists but covered in the media, has examined the immune protection of over 8,000 people after both doses of either the Pfizer-BioNTech or Oxford-AstraZeneca vaccines. The study included 881 volunteers who had been diagnosed with cancer at some point in their lives, 74 with blood cancer.

Researchers at University College London and London School of Hygiene and Tropical Medicine found that a high proportion of volunteers had a positive response to the vaccine after receiving 2 doses, including those who had been diagnosed with cancer at some point in their lives.

Despite this, the researchers note that in between their first and second dose, fewer cancer patients and those on immunosuppressive treatments – including radiotherapy, chemotherapy or following an organ transplant – showed an immune response and that caution is still required until both doses are given.

The data doesn’t show whether responses were different in people who have cancer now compared with those who had it years ago.If you have any questions about the vaccine, please speak to your specialist or contact your GP.

20 April – New findings on the effectiveness of the COVID-19 vaccine for cancer patients 

A new study, published in The Lancet Haematology has looked at the immune response to the first dose of the COVID-19 vaccine in patients with myeloma.

Researchers at The Institute of Cancer Research (ICR) in London and The Royal Marsden NHS Foundation Trust tested for antibodies against the COVID-19 virus in 93 people with myeloma. People who took part in the study had either received the Oxford–AstraZeneca or Pfizer-BioNTech vaccine and been given a first dose at least 3 weeks before their antibody test. The study didn’t follow up with the results of a second dose.

Of the 93 people, 56% had antibodies against the virus spike (which it uses to infect cells). Data on patients that didn’t have these antibodies (40 people) suggest that another type of antibody could be detected in up to 70%.

These results come a few weeks after findings from a different study were announced. The study, which we covered in the blog post on March 11th, and is in the process of being reviewed by other scientists and published, found that detectable antibody responses at 3 weeks following the first dose of the Pfizer-BioNTech vaccine were seen in 13% of the people with blood cancers. 

Experts say the differences seen between these studies reflect how complicated this is to understand. Many different factors can affect response to vaccination, including cancer type, treatment type, timing of treatment relative to vaccination, as well as a whole host of non-cancer factors. Both studies have only analysed blood samples from a small number of people with cancer, and we’ll be awaiting more evidence on this before we can start drawing robust conclusions.  

There‘s no reason to suspect that one vaccine is better than another and ultimately, any protection provided by a vaccine is better than none. We encourage everyone who can to get the vaccine when offered.  

If you have any concerns, please speak to your specialist or contact your GP. 

13 April – Over-45s in England invited to book vaccine

As the country’s vaccination programme enters Phase 2, people in England over the age of 45 are now eligible for their COVID-19 vaccination.

This comes as the programme reached its target of offering a first dose to the 9 most vulnerable groups including the clinically vulnerable and those with other conditions that put them at higher risk.

People in this group can book their appointment online. In addition to this, text messages from local vaccination centres are set to go out.

With over 32 million people in the UK having had their first vaccine dose, Prime Minister Boris Johnson has said the programme is on track to offer a first dose of a vaccine to all adults in the coming months.

He was quoted as saying “we will now move forward with completing essential second doses and making progress towards out target of offering all adults a vaccine by the end of July.”

6 April – JCVI recommends adults living with immunosuppressed people be prioritised alongside priority group 6 

The Joint Committee on Vaccination and Immunisation (JCVI) has advised the government to prioritise vaccinating people who are over 16 and living with adults who have weakened immune systems alongside priority group 6, who are now receiving invites.  

This includes (but is not limited to) adults living with people undergoing immunosuppressive treatments (including chemotherapy) and those with blood cancer. 

In a letter to the Government, the JCVI stated that adults with weakened immune systems (or who are immunosuppressed) are more likely to have severe COVID-19 symptoms and that the vaccine may be less effective for these groups. 

The JCVI’s advice does not currently extend to: 

• Household contacts of immunosuppressed children 
• Children who are household contacts of immunosuppressed adults 

Information on this prioritisation has been sent to GPs, who will contact anyone who’s now eligible for a COVID-19 vaccination. Dr Mary Ramsay, Head of Immunisation at Public Health England, said that “our surveillance systems and research studies are showing that the COVID-19 vaccines can reduce asymptomatic infection and limit transmission of the virus. By vaccinating those who live with adults who are immunosuppressed, we can further help protect vulnerable people.” 

Your GP will be in contact to book a vaccination appointment if you currently live with an adult who is immunosuppressed.  

UPDATE: As of April 14th, Wales and England have accepted the JCVI recommendation. 

18 March – shielding for ‘clinically extremely vulnerable’ to end in April  

From 1 April, those considered “clinically extremely vulnerable” who have been following shielding advice during the pandemic will no longer be advised to shield.  

Anyone affected will receive letters from today with updated guidance on steps they can take to reduce their risk of getting COVID-19, including maintaining strict social distancing and working from home where possible. 

Following the Government’s ‘COVID-19 Response – Spring 2021’ roadmap, letters and emails will be sent out to more than 3.79 million people who can begin to follow the national lockdown restrictions. 

The update comes alongside the news that more than 9 in 10 people who are considered clinically extremely vulnerable have received a first dose of a vaccine.

16 March – Health charities back vaccine drive for at-risk groups

Cancer Research UK has joined 17 other health charities to encourage people with underlying health conditions (including cancer), learning disabilities and their carers to book a COVID-19 vaccination.

More than half of priority group 6 have already received a vaccine and it’s hoped that this open letter will increase uptake. GP services are already contacting people in this cohort, but those who have not yet received a letter can get a quick appointment at by using the national booking system or calling 119. The NHS have sent text messages to people in this group with a link so they can book their appointment.

 

The underlying health conditions included in priority group 6 include:

• chronic respiratory, heart, kidney, liver disease and neurological conditions, including multiple sclerosis (MS) and epilepsy
• stroke
• vascular disease
• diabetes mellitus
• immunosuppression due to a health condition or treatment
• asplenia or dysfunction of the spleen
• morbid obesity
• severe mental illness
• sickle cell
• lupus
• those on GP learning disability registers

Additionally, this group includes carers who are eligible for a carer’s allowance, or those who are the sole or primary carer of an elderly or disabled person who’s at increased risk of severe COVID-19.

Minister for Vaccines Nadhim Zahawi said that “the vaccine is our way out of this pandemic and offers the chance to protect yourself and others – that’s why it’s vital that people get their jab. This open letter should help to reassure those with any concerns the vaccine is safe and supported by more than twenty of our most trusted charities. I would like to thank them all for backing this life-saving campaign and offering their expertise and assistance to support the largest medical deployment in British history.”

11 March – Initial data suggests single dose of Pfizer vaccine less effective for people with cancer

Awaiting independent review by other scientists, initial data from the world’s first reported trial examining the level of immune protection conferred to cancer patients after the Pfizer–BioNTech vaccine has been released today.

The results have been covered by BBC News and others, suggesting that people with cancer may not get the same level of protection after the first dose as people without cancer. While this information may be worrying for people with cancer, there are some things to take into consideration when looking at the results, as our head information nurse explains.

“This is an interesting study and it’s important to assess how cancer patients are responding to the vaccines being rolled out. But at this stage, we are looking at data that hasn’t been peer-reviewed, where other experts in the field would flag errors and limitations within the results,” said Martin Ledwick, head information nurse at Cancer Research UK.

“The numbers of patients looked at in the study are also relatively small, particularly for those with blood cancers. We know that this information could be worrying, but anyone undergoing cancer treatment should continue to follow the advice of their doctors, and we encourage all who can to take up the vaccine.”

What did the study find?

Led by researchers at The Francis Crick Institute and Kings College London, the SOAP study involved 205 volunteers – 54 people who didn’t have cancer and 151 people with cancer who were undergoing immunosuppressive treatment (95 with solid cancers, such as breast or lung cancer, and 56 with blood cancers).

Researchers measured the level of antibodies in the volunteers’ blood to examine their immune response to the COVID-19 virus. The study has shown that detectable antibody responses at week 3 following the first dose of the vaccine were found in:

• 38% of the group with solid cancers
• 18% of the group with blood cancers
• 94% of the group without cancer

The study found that when the second dose was given at this point (3 weeks after first dose), immune responses were found in 95% of the group with solid cancers 14 days later (5 weeks after the first dose). Not enough participants with blood cancer received a second dose to know if this improved their response.

In contrast, those with cancer who did not get this second dose at 3 weeks saw no real improvement at 5 weeks:

• 30% of the group with solid cancers
• 11% of the group with blood cancers
• 86% of the group without cancer

The researchers suggest these results could show that a gap of 12 weeks between doses of the Pfizer-BioNTech vaccine could leave many cancer patients vulnerable to severe COVID-19. The study does not suggest that people who were treated for cancer some time ago might be less likely to have a positive response to a single dose the vaccine.

When looking at the results, there are some caveats to take into consideration. The study only focused on one of the available vaccines, and many of the participants with solid tumour were in an older age group and had more advanced cancer (meaning that it is difficult at this stage to know if the results will be the same for all cancer patients undergoing cancer treatment).

There are other studies, such as the OCTAVE study, which are also looking into how well the vaccines work in people with cancer.

UPDATE: This paper was published in The Lancet Oncology on 27 April with amended percentages. We have updated the stats to reflect the published figures.

24 February – COVID-19 vaccine priority groups 4 and 6 

There has been some confusion around what COVID-19 vaccine priority groups have meant for people with cancer. In January, we received communications from NHS England that set out 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 by priority group 6.  

This information was initially published as an update on our blog post on the 28th January (which has since been amended). However, it appears that this guidance has not been communicated in any public setting, and unfortunately we have been unable to get further confirmation from NHSE that this guidance still holds true.  

We’re very sorry for the confusion and frustration this has caused at this unsettling time. We encourage people to continue following the advice set out by The Joint Committee on Vaccination and Immunisation (JCVI) and the Green Book as follows: 

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. 

18 February – Updated shielding guidance

This week the Government has updated its shielding advice, asking a further 1.7 million people to stay at home at all times and only going out to exercise or attend medical appointments. Of the people recently identified as now needing to shield, only half have been vaccinated. GPs will now urgently prioritise those who haven’t been vaccinated but who do need to shield.

The new shielding advice takes into account someone’s ethnicity, whether they live in a deprived area and their weight. As well as their age, prescribed medications and underlying health conditions. Underlying health conditions taken into consideration include:

• Lung or oral cancer
• Blood and bone marrow cancers
• If someone has received chemotherapy in the last 12 months
• Whether someone had been prescribed prednisolone or immunosuppressants 4 times or more in the last six months.

All of these measures are taken together to assess someone’s risk of becoming seriously ill if they caught COVID-19.

If you now fall into the extended shield category you will be sent a letter by the NHS informing you of your new status. This status means you are entitled to statutory sick pay, prioritisation for shopping slots online and assistance collecting medication.

16 February – Advice for people with lymphoedema or people who have received lymph node treatment following breast or skin cancer

A known side effect of the Moderna and Pfizer-BioNTech vaccines is lymph node swelling. If someone has lymphoedema in their arm or leg due to cancer treatment, it’s advised they get the vaccine in the opposite arm or thigh to their existing swelling.

The British Lymphology Society has also advised that those who have received cancer treatment that involves treating the lymph nodes directly, for example radiotherapy or surgery to the lymph nodes for breast or skin cancer, should have the vaccine in the opposite arm or leg to where they received their lymph node treatment. If they have received treatment on both sides they should receive their vaccine in the thigh. If you have any concerns, we’d recommend chatting to your vaccinating team, GP or cancer specialist.

8 February – Oxford-AstraZeneca vaccine shows 76% protection between doses  

The University of Oxford has revealed that the efficacy of a single dose of the Oxford-AstraZeneca vaccine reaches 76% after  22days, and remains at this level until at least  day 90. The Government has stated that leaving longer between doses than the three weeks used in clinical trials, combined with initial prioritisation of the first vaccine dose, would increase vaccine supply in the short term, and allow for more first doses to be delivered to more people earlier. 

Researchers at the University of Oxford published an analysis of further data from the ongoing trials of the vaccine, in Preprints with The Lancet.  

This draft write-up hasn’t yet been scrutinised by independent scientists, but is currently under review at The Lancet. The report highlights that there might be benefits to increasing the time between doses, with vaccine efficacy increasing from 54.9% with an interval of less than 6 weeks, to 82.4% when spaced 12 or more weeks apart. 

The study also looks at the potential for the vaccine to reduce transmission of the virus. Analysis of COVID-19 tests taken weekly by UK participants suggests that the vaccine schedule being used in the UK (two standard doses) can reduce transmission, with a 49.5% reduction in positive tests in people who had the vaccine. 

In other news, scientists have found that the Oxford-AstraZeneca vaccine offers “minimal protection” against mild cases caused by a variant of the COVID-19 virus called the South African Variant. Over 100 cases of this variant have been found in the UK. The results came from a recent study, which has not yet been peer-reviewed, involving around 2,000 people. Professor Sarah Gilbert, the lead Oxford-AstraZeneca vaccine developer, has confirmed that the vaccines should still protect against severe cases of the disease. She added that they were working on a modified version of the vaccine to be ready by the Autumn to increase protection against the South Africa variant.

5 February – UK regulator confirms COVID-19 vaccines are ‘extremely safe’ 

Data published by the UK’s independent drugs regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), has confirmed that both the Pfizer-BioNTech and Oxford-AstraZeneca vaccines are extremely safe.  

The MHRA assessed safety reports from nearly 7 million doses of the vaccine given up to 24 January – the majority of which were the Pfizer-BioNTech jab.  

Results found that approximately 22,820 suspected reactions were reported, the equivalent to approximately 3 in every 1,000 people vaccinated.  

Almost all cases were mild and include sore arms, headaches and chills. These after–effects are not the disease itself, but are caused by the body’s response to the vaccine.

28 January – More clarity on priority groups for people with cancer 

The Joint Committee on Vaccination and Immunisation (JCVI) has prioritised the following groups for vaccination:

1. Residents in a care home for older adults and their carers
2. All those 80 years of age and over and frontline health and social care workers
3. All those 75 years of age and over
4. All those 70 years of age and over and clinically extremely vulnerable individuals
5. All those 65 years of age and over
6. All individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
7. All those 60 years of age and over
8. All those 55 years of age and over
9. All those 50 years of age and over

But there has been a question mark over who would fall into group 4 and group 6. According to communications we received from NHS England, priority group 4 includes people who are clinically extremely vulnerable and will include people having many types of active cancer treatment as well as many in follow-up.

The communications also set out that all other cancer patients such as those treated a long time previously and who were treated surgically would be covered by priority group 6. However, this information has not yet appeared online and we’ve heard from some people with cancer and some GPs that they have not had this information. We understand that this is frustrating and have relayed this to NHS England.

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

21 January – COVID-19 vaccination centre opens at London’s Francis Crick Institute

As part of the country-wide vaccination programme, University College London Hospitals have partnered with the Francis Crick Institute to set up a new, large scale vaccination centre set to open by the end of January. Equipment and unused space within the research institute – of which Cancer Research UK is a major funder – is being used to create a vaccination centre that will be administering doses 7 days a week.

At maximum capacity, the centre has been designed to deliver just over 1,000 vaccinations per day (from 8am – 8pm). However, the number of people that can be invited will depend on the level of vaccine stocks received by the centre. Our news report has the details.

18 January – Vaccine rolled out to over-70’s and “clinically extremely vulnerable” in England

From today, those aged 70, and over and those considered “clinically extremely vulnerable”, will begin receiving invitations for a COVID-19 vaccination. People considered “clinically extremely vulnerable” are those who were asked to shield at various points during the pandemic, and 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

The Department of Health and Social Care have acknowledged that those in the top 2 prioritisation groups – care home residents, those over 80 years old and front-line health care workers – will remain as the top priority to receive the vaccine.

The announcement today means that areas that have already vaccinated the majority of people in the top 2 priority groups will now be able to keep up the momentum and start vaccinating additional groups.

15 January – Guidance on the COVID-19 vaccine for patients receiving Systemic Anti-Cancer Therapy 

The UK Chemotherapy Board has produced a comprehensive document of FAQs on the Pfizer–BioNTech and Oxford-AstraZeneca COVID-19 vaccines for healthcare professionals treating patients on systemic anti- cancer therapies (SACT) such as chemotherapy, antibody therapy or immunotherapy.  

The document outlines that all patients receiving SACT should be considered for a COVID-19 jab.  

These FAQs were produced in response to questions by cancer specialists about giving the vaccine to people with cancer receiving SACT. They may be used by cancer specialists, along with any local guidelines, to help decide the best timing for giving the vaccines in people receiving SACT.  

You can talk to your GP or cancer specialist when you’re offered the vaccine to discuss timings. We’ve got further information about the different vaccines, summarising the guidance from the UK Chemotherapy Board, here.

11 January – Government publishes latest vaccine delivery plan  

The Government has set out its latest vaccine delivery plan to administer at least 2 million vaccinations per week, as part of the ‘largest vaccination programme in British history’.

The plan includes the commitment set out last week by Boris Johnson to offer the first vaccine dose to all those in the top 4 priority groups, as recommended by the Joint Committee of Vaccination and Immunisation (JCVI), by 15 February. This includes those considered “clinically extremely vulnerable” including people with cancer who are undergoing chemotherapy, people with cancers of the blood or bone marrow, and people with lung cancer who are undergoing radical radiotherapy. You can find a complete definition of clinically vulnerable groups, on the Government website.

8 January – Third vaccine approved for rollout across the UK  

A vaccine made by Moderna – a US based biotech company – has become the third vaccine to be approved for mass rollout across the UK, although supplies are yet to arrive in the country and may not do so for several months.

This vaccine is the latest to have been approved by the Medicines and Healthcare products Regulatory Agency (MHRA). Similarly to the Pfizer-BioNTech vaccine, which was approved in December 2020, the Moderna vaccine is not a ‘live’ vaccine, but contains a molecule called mRNA, which contains genetic information that causes the body to produce tiny fragments of a molecule made by the coronavirus.

In trials with more the 30,0000 people, the Moderna vaccine was assessed to see whether it could prevent symptomatic infection and was found to have an efficacy of almost 95%. There were also no cases of severe COVID-19 in the group that had the vaccine. It is unclear at this stage what impact the vaccine might have on infection without symptoms. The Moderna vaccine can be stored at –20°C (normal freezer temperature) for up to 6 months.

7 January – Study examines immune response to COVID-19 in people with cancer 

The news that 2 COVID-19 vaccines have been approved and are now being rolled out offers hope of a return to normal life in 2021. For people with cancer this could mean less anxiety about attending hospital appointments, fewer changes to treatment and shorter waiting times. At this stage, although we can’t be sure whether the vaccines will work quite as well in people having cancer treatment because of the effect that cancer treatment can have on the immune system, experience with other vaccines suggests that the COVID-19 vaccines should offer protection against COVID-19 for people with cancer.

Studies looking at how people with cancer have responded to the virus that causes COVID-19 may also provide some clues. Results just published from one of these studies – the SOAP study – suggest that patients with solid cancers have a similar immune response to the virus as people without cancer. Those with blood cancers were found to have a more variable response, with some people responding similarly to people with solid cancers, while others didn’t manage to clear the virus or develop antibodies against it. The numbers in this study weren’t big enough to determine whether patients with particular blood cancers or receiving particular treatments had a poorer response.  

These findings may have implications for COVID-19 vaccination, for example it may be that some people with cancer would benefit from more frequent boosters or monitoring to check their response. The SOAP study plans to investigate this in the next phase of their project, which will look at the immune response to the vaccine in people with different type of cancer. 

It’s important to remember that some protection is better than none and that people with cancer are encouraged to take the vaccine when it is offered. As with other vaccines, the timing of COVID-19 vaccination may depend on the type and timing of cancer treatment.  

5 January – COVID-19 vaccine and questions about safety for people with cancer 

Are these vaccines safe? And which vaccines are most appropriate for people living with cancer? These are questions we’re frequently being asked, and understandably so.

While we’re not able to comment on individual circumstances, we’ll continue to update this blog post as new findings and information are released.

To get an ‘on the ground’ view, we recently spoke to Dr Neil Smith, a GP based in Lancashire, about how he is advising his cancer patients in his clinic. “My general advice is yes, it is, safe. You’ve got to understand your individual circumstance, but for people with cancer, or for people who have previously had treatment for it, it is safe. For most people, it’s much safer to have it than not have it. And because it’s not a vaccine that uses a ‘live’ virus, it doesn’t pose a threat to somebody’s immunity, instead It helps them to produce their own immunity against the coronavirus.”

The Medicines and Healthcare products Regulatory Agency (MHRA) – the organisation which grants licenses to companies to sell their medicines in the UK – have confirmed that both the Pfizer-BioNTech vaccine, and the Oxford-AstraZeneca vaccine, are safe for rollout across the country. Whilst doses of the other vaccines have been purchased, they are yet to be approved by the MHRA.

Similarly, another government body – the Joint Committee on Vaccination and Immunisation (JCVI), which advises UK health departments on immunisation – commented that the Pfizer-BioNTech vaccine “appears to be safe and well-tolerated, and there were no clinically concerning safety observations,” and that the Oxford-AstraZeneca vaccine “appears to have a good safety profile.” These comments apply to the general population – but what about people affected by cancer?

Some people who were asked to shield during the pandemic (and who are considered “clinically extremely vulnerable”), which includes a number of cancer patients (please see the update from 28 November for the complete list), will be prioritised to receive their first dose of vaccine as soon as possible. However, the JCVI thinks that others who are considered “clinically extremely vulnerable” and who also have some degree of immunosuppression, or are immunocompromised, may not respond as strongly to the vaccine – despite this, the vaccines will, they think, still offer these people some protection. So the COVID-19 vaccines are likely to be made available to cancer patients at some point. However, these people, including those on chemotherapy, have been advised to continue to follow Government shielding advice to reduce their risk of infection, even after vaccination.

Whatever their situation, people invited for vaccination will be able to discuss their concerns with a doctor. “When people arrive at a COVID-19 vaccine centre, they’ll go through a normal consent process. And within that consent process, if there’s any specific issues, they’re often advised beforehand to contact the GP, and so a GP will be in contact with several patients wanting a bit more information,” says Smith. “But in my experience of that, it’s been a very positive conversation where I’ve been able to reassure people – ‘Yes, the vaccine for you is safe, and you should go ahead’.”

Smith is extremely hopeful for the vaccine. “It’s one of the best things I’ve seen in my 30 years of the NHS, and the main thing it does, is it makes the world a better place and makes us safer. So what I’m hoping going forwards, it’s safer for me to see patients and it’s safer for patients to feel confident they can see me to talk about cancer again, and to talk about the fears and concerns, it’s safe for me to refer them and to do investigations, and it becomes much safer for people to carry on having the cancer treatments early. The COVID-19 vaccine will help us to continue to diagnose and cure cancer and save people’s lives.”

30 December – Oxford-AstraZeneca vaccine approved for use and rollout next week

The Oxford-AstraZeneca vaccine has been approved for use in the UK. It is the second jab to be approved in the UK after the Pfizer-BioNTech vaccine was given the go-ahead earlier this month.

This vaccine contains a weakened form of a common cold virus (harmless to humans) that has been modified to include the gene for the coronavirus spike protein. Once injected, this primes the immune system to attack without exposure to the full virus. This is then followed by a second dose – up to three months later – for maximum protection.

16 December – Fifth vaccine begins clinical trials in UK  

Speciality vaccine company Valneva is the latest to begin clinical trials of their COVID-19 vaccine, currently being developed in West Lothian in Scotland. 

The Valneva trial will begin by testing the safety and efficacy of the vaccine on volunteers at 4 sites across the UK and is currently enrolling 150 healthy participants aged 18 to 55.  

The Valneva vaccine is what’s known as an “inactivated whole virus” vaccine. While the vaccine does hold some of the same virus particles that cause COVID-19, they are weakened and made inactive so that they cannot give you the virus. But they are able to prime the immune system to be able to recognise and destroy the virus responsible for COVID-19, which may prevent you from getting sick if you’re exposed to the virus in the future. 

15 December – Latest COVID-19 vaccine trial data published 

Results from the clinical trial of the vaccine developed by Pfizer/BioNTech – currently being rolled out across the country – have been published in The New England Journal of Medicine, showing that the vaccine may provide protection as early as 12 days after the first dose. 

The phase 3 trial involved 42,000 people, with around half receiving the vaccine and the others a dummy vaccine (placebo). 170 people developed COVID-19, with 8 cases in the vaccinated group and 162 in the placebo group, demonstrating that the vaccine has an overall efficacy of 95%.  

The AstraZeneca Oxford vaccine have also been published, this time in The Lancet, with data suggesting that the vaccine is safe and offers protection against COVID-19. The results are a combination of 2 clinical trials in the UK and Brazil. When the interim trial results were released a few weeks ago, the vaccine had an efficacy between 62 and 90% depending on how doses were administered. 

This paper shows that the vaccine offers protection against symptomatic COVID-19 when the 2 doses are administered with a 6-week gap between them. This could mean that this vaccine could take longer to roll out than others, with the Pfizer vaccine being given in 2 doses spaced as little as 3 weeks apart. However, it doesn’t need to be stored at –70 degrees, meaning that it might be easier (and perhaps cheaper) to deliver. 

11 December – Progress of COVID-19 vaccine vs cancer research

The development of multiple COVID-19 vaccines over an extraordinary 10-month period has brought up some questions about why there haven’t been similar transformative leaps in treating cancer.

Cancer is a highly complex disease, with over 200 different types that vary in biology, genetic make-up and behaviour. Not only that, but each person’s cancer is unique with its own set of challenges, so it’s very unlikely there will ever be one single cure that can be applied to everyone.

One of the biggest challenges our researchers face is that cancer can evolve, adapt and diversify and eventually outwit the immune system. For now, COIVD-19 doesn’t appear to rapidly change its make-up like cancer. And with COVID-19, researchers have been able to define specific targets that are found on the virus, which makes it much easier to treat than cancer.

Much of the science behind the development of the recent COVID-19 vaccines have been underpinned by previous research to understand the body’s immune system for other diseases, including cancer. And the extraordinary progress of the COVID-19 vaccine is in part because scientists, governments, industry and academic institutes around the world turned their focus to this one goal. To further accelerate development, different phases of vaccine trials and production have overlapped.  

Although progress against cancer might not look as quick or dramatic as that against COVID-19, we have made great strides. Thanks to our research, we’ve helped cancer survival double over the last 40 years.

But there’s still more to do, and the technologies and insights that have come from the COVID-19 vaccine work could help us with future advancements in cancer research. We are relentless in our ambition to beat cancer and will continue to fund ground-breaking research to find new ways to prevent, diagnose and treat cancer.

8 December – Vaccine rollout begins across the UK  

90-year-old Margaret Keenan has become the first person to receive the Pfizer-BioNTech COVID-19 vaccine, as mass rollout begins across the UK. BBC News has the latest.

50 hospitals in England have been selected to receive the first doses of the vaccine and deliver the first rounds of the vaccination programme. Scotland, Wales, and Northern Ireland are also set to begin their vaccination programmes from hospitals today.

With the first 800,000 doses arriving this week, limited quantities will be available until further doses arrive. To begin, elderly people who are hospital outpatients, as well as those who are being discharged after a stay in hospital, will be among the first to be offered the vaccine. Each individual will require two jabs, administered within 21 days of each other, so the initial 800,000 doses will vaccinate 400,000 people.

Prioritisation groups are based on who has the greatest risk of becoming seriously ill or dying from the virus.

2 December – Pfizer–BioNTech vaccine approved for use in the UK and to be rolled out next week  

The UK has become the first country to approve the Pfizer–BioNTech vaccine for widespread use, after the Medicines and Healthcare products Regulatory Agency (MHRA) confirmed that the vaccine is safe for rollout across the country.  

The mRNA vaccine, which trials suggest offers up to 95% protection against COVID-19, should be available to those who need it most, including elderly and care home patients and staff, within the week. Protection from the vaccine should stop people from becoming ill with the virus. So far, the UK has ordered 40 million doses, enough to vaccinate 20 million people, with the first 800,000 doses arriving early next week.  

The vaccine will be distributed from Pfizer centres in Germany, Belgium and the USA. Approximately 50 hospitals across the country have been prepared to deliver the first of the vaccination programme. Specialist vaccination units in spaces such as conference centres are also being set up and some GPs and pharmacists may have access to vaccines, if they have the available cold storage facilities required to store the jab.

To find out more, head to BBC News.  

30 November – Final results from Moderna confirm vaccine is 94% effective 

The final results from Moderna’s vaccine trials have confirmed that their vaccine showed 94% efficacy against COVID-19, and nobody who received the vaccination developed a severe case of the virus.  The latest news has initiated an approval process with regulators around the world who will study the trial data for the vaccine and decide if the data on its safety and effectiveness are robust enough to be recommend for roll out.  

The UK has now bought 7 million doses of the vaccine, which are expected to arrive in the UK in March. On top of that, the UK has pre-ordered 40 million of the Pfizer/BioNTech vaccine and 100 million of the AstraZeneca Oxford vaccine. Full trial data has not yet been released but you can read more about the Moderna vaccine at BBC News and The Guardian. 

28 November – Extremely vulnerable given high priority for COVID-19 vaccine in UK 

The provisional priority list published by Public Health England has listed people aged 18 years and over who are deemed “clinically extremely vulnerable” as the same priority as the over-70s to receive a COVID-19 vaccine. 

People considered “clinically extremely vulnerable” are those who were asked to shield during the pandemic, and 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 

Although this prioritisation list is subject to further potential changes as the vaccine is still waiting approval from the Medicines and Healthcare products Regulatory Agency (MHRA), those considered “clinically extremely vulnerable” have now been placed in priority group 4 of 9. Based on these changes, the interim guidance, advised by the Joint Committee on Vaccination and Immunisation (JCVI), says the order of priority should be: 

1. Older adults in a care home and care home workers
2. All those 80 years of age and over and health and social care workers
3. All those 75 years of age and over
4. All those 70 years of age and over and the clinically extremely vulnerable individuals, excluding pregnant women and those under 18 years of age
5. All those 65 years of age and over
6. Adults aged 18 to 65 years in an at-risk group
7. All those aged 60 and over
8. All those 55 and over
9. All those aged 50 and over

23 November – Initial results of AstraZeneca-Oxford vaccine announced

The day’s big news was of results from clinical trials in Britain and Brazil of the vaccine led by drug company AstraZeneca and researchers in Oxford. The trials involved over 20,000 individuals and showed differing levels of protectivity depending on how the doses were administered (between 62 and 90%). Like all the recent results, these findings were announced in a press release and have not yet been independently verified.

The trials explicitly excluded people with a history of cancer apart from a few exceptions; those with localised prostate cancer (where the cancer is contained in the prostate and has not spread to anywhere else), non-melanoma skin cancer that has been treated, cervical carcinoma in situ (pre-cancer) that has been treated, or those with a low risk of either their cancer coming back, or spreading to other parts of the body.

So far, we haven’t seen any data about how effective the vaccine was in these people, nor how many were on the trials – we’ll be looking out for this information as it emerges.

The UK government has already pre-ordered 100 million doses of this vaccine.

23 November – Last trials of COVID-19 ‘antibody cocktail’ treatment begin

In addition to vaccine development, AstraZeneca have started large-scale trials of an “antibody cocktail” aimed at providing short-term protection to people with a weakened immune system, who would be unlikely to develop immunity after a vaccine. Antibodies form a key part of the immune system’s response to infection and it’s hoped that these antibodies developed in the lab will help the immune system to fight off the virus. AstraZeneca have described it as “almost like a passive vaccination.”

5,000 people around the world will be taking part in the trial of this treatment that scientists hope could give individuals immediate protection lasting up to 1 year. If successful, this may make up part of the UK’s wider COVID-19 treatment portfolio and be available to people whose immune systems are compromised.

23 November – Experts react to COVID-19 vaccine news   

Like most of us, Cancer Research UK-funded experts have been following the news closely and have called the progress ‘exceptional’.  

News of an effective COVID vaccine is great to hear. Having a vaccine will make the world safer, which means it will be safer for people with cancer too and it will become much easier for cancer treatments to continue.

We look forward to getting a better understanding of the best time to give the vaccine to cancer patients to give them the best level of protection.

– Martin Ledwick, Cancer Research UK’s head information nurse

Normal drug or vaccine development would take in the range of 5-10 years, sometimes much longer, so these developments have been extraordinary.  

But experts have been keen to emphasise that the rapid turnaround of the COVID-19 vaccines isn’t because standards have dropped. In fact, the COVID-19 trials have involved more people than standard vaccine trials and have been able to draw on cutting-edge developments in technology and data analysis.  

The extraordinary progress is in part because scientists, governments, industry and academic institutes around the world have turned their focus to this one goal. And to further accelerate development, different phases of vaccine trials and production have overlapped.  

Finally, while the initial results are extremely promising, it’s early days yet. Preliminary data from one vaccine trial led by Pfizer suggested the vaccine offered 90% protection against developing COVID-19, whilst more recent data revealed the vaccine was 94% effective in over-65s. Initial reports from a second vaccine trial made by Moderna disclosed similar figures. 

Experts expect more results – including important safety data – to materialise in the next 4 to 6 weeks. Vaccination will only be approved once it has passed the usual high standards set by the Medical and Healthcare products Regulatory Agency (MHRA) in the UK.  

You can read more about the various COVID-19 vaccines in this piece by journalist Tom Chivers, who’s taking part in the Oxford-AstraZeneca vaccine trial.

23 November – Who’s taken part in COVID-19 vaccine trials? 

We don’t have information on how many people living with cancer, or with a history of cancer, have been involved in COVID-19 vaccine trials so far. But some people with cancer have been able to take part in these trials, although who can take part varies from trial to trial.  

For example, the earliest phase of the Pfizer trial involved healthy people aged 18 to 55 or 65 to 85. People with pre-existing conditions were able to take part as long as they didn’t require a significant change in therapy or hospitalisation for worsening disease in the 6 weeks prior to enrolment.  

In later phases of the trial (phases 2 and 3) the lower age limit was reduced to 16 years old and individuals identified as being in a ‘high-risk’ group based on their use of public transport, being a frontline essential worker or other factors were included. Although people with cancer weren’t explicitly excluded from this list, those who are immunocompromised or receiving immunosuppressive therapy were not able to take part, and anyone taking part needed to have stable disease prior to enrolment.  

For the late phase trials of the Oxford vaccine, anyone over the age of 18 who’s considered to be ‘medically stable’ – someone who’s not expected to be hospitalised or change their therapy less than 3 months before enrolment – could enrol in the trial. The criteria for the Oxford trial explicitly excludes anyone with a history of cancer, apart from a few cancer types, or those with a low risk of either their cancer coming back following curative treatment or spreading to other parts of the body.  

Another vaccine that’s hit the news recently is the Moderna vaccine. Similar to the Oxford vaccine trial, medically stable people aged 18 or over were able to take part in the Moderna vaccine trials. However, those who are immunocompromised or have taken immunosuppressive treatments in the 6 months before the trial were not able to enrol. 

Beyond vaccine trials, studies looking at how people with cancer’s immune systems respond to COVID-19 may also provide useful information on if the vaccine will be effective for people with specific types of cancer. 

Lilly, Katie, Angs and Lyndsy