Will aplastic anaemia patients be able to have the coronavirus vaccine?

We understand that information about vaccines is really important to our community, so we’ve created this handy page to give you all of the latest information about Coronavirus vaccines.

We will be working closely with our clinical experts to update this information as things develop.

In addition to the information on this page, we've also created a page with answers to some of the common questions asked by our community, which you can find here.

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Will it be safe for me to be vaccinated against COVID-19? 

Since December 2020, three vaccines have been approved for use in the UK by MHRA, the Medicines and Healthcare products Regulatory Agency - Pfizer/BioNTech, Oxford/AstraZeneca and Moderna.

All of the vaccines which have been approved are 'inactivated', meaning that they do not contain a live form of the COVID-19 virus. This means that it is not possible to develop COVID-19 as a result of receiving the vaccine.

During the approval process, MHRA deemed that all of the vaccines currently available are suitable and safe for people who are immunocompromised. We understand that for people with aplastic anaemia, there is a small risk of relapse associated with all vaccinations, and research is still ongoing into this. The general advice is that the benefit of being vaccinated against COVID-19 outweighs the risk associated with vaccination, however, you should discuss your own circumstances with your medical team.

The vaccine is administered intra-muscular, meaning that it is injected into a muscle, which can, in some cases increase the risk of bleeding. In conjunction with the guidance given by PNH Leeds, if your platelet count is below 30, you should seek advice from your medical team.

We strongly recommend that you discuss any queries that you may have about vaccinations with your own medical team, who will be expecting your questions.

Is there a risk of developing a blood clot after I have been vaccinated?

There have been a number of reports in the media that a very small number of people developed blood clots after being vaccinated with the Oxford/AstraZeneca vaccine, which led a number of countries around the world to suspend the use of this vaccine. We understand that for our community, such stories can be worrying.

MHRA, the body in the UK which tests and approves drugs for use has reiterated that the Oxford/AstraZeneca vaccine is safe, and has undergone rigorous testing. Their studies have shown that less than one in a million people in the UK who have been vaccinated have developed blood clots, an issue that can also occur naturally, and that these cases do not appear to be linked to the vaccine. Furthermore, the number of people developing blood clots has not increased as a result of the vaccine being rolled out. As a result of these findings, the AstraZeneca is now only routinely given to those aged over 40, as it believed that there is a slightly higher risk of developing blood clots amongst younger people. Those aged under 40, or women who are pregnant will usually be offered the Pfizer/BioNTech or Moderna vaccines. Those aged under 18 will be offered the Pfizer/BioNTech vaccine.

We strongly recommend that you continue to receive your COVID-19 vaccination if you are able to, regardless of the type of vaccine that you will be given.

If you have any concerns, your own medical team will be ready and on hand to answer any questions you may have.

For more information, click here for the latest updates from MHRA.

What is the medical advice?

This is the latest update from Professor Judith Marsh, Department of Haematological Medicine at King's College Hospital, on the advice that she and her colleagues at the British Society Haematology published in 2021.

At the time that this statement was released, no individuals with aplastic anaemia had been included in vaccine trials, and any references to the risk of relapse following vaccination relate to anecdotal reports of relapse following other vaccinations.

There are case reports of AA developing post-vaccination, and of recovered AA patients relapsing following vaccine administration. The evidence for this is limited, but we do know that a viral response is likely to be an important trigger in the initial development of aplastic anaemia.

In the setting of the COVID-19 pandemic, current ASH COVID-19 and AA guidance is that the risk versus benefit would favour vaccine administration, particularly in those with additional risks for severe COVID-19 disease (age, obesity, other comorbidities associated with increased risk).

So far we do not have access to any data on how effective any of the vaccines in development are likely to be in immunosuppressed patients. Those patients within 6 months of ATG/CSA initiation are unlikely to mount an appropriate immune response to a vaccine. Those AA patients remaining on CSA more than 6-12 months post-ATG treatment may respond to a vaccine. Vaccinations may be given after thoroughly considering and balancing risk versus benefit.

Post-transplantation AA patients should follow standard post-transplantation guidelines for vaccine administration. These will be updated regarding SARS-CoV-2 vaccines when they become available, extrapolating from recommendations for other vaccines.

As you can tell from Professor Marsh's update - there are a number of considerations involved, which is why it is so important to discuss your own case with your medical team, who are the experts on what is the best course of action for you.

You can find detailed information on Covid-19 and Stem Cell Transplants, including the latest information on the vaccine, on the Anthony Nolan website here.

How and when can I get my vaccine?

Image created by Blood Cancer UK: Source: https://bloodcancer.org.uk/support-for-you/coronavirus-covid-19/covid-vaccine-blood-cancer/how-to-get-vaccine/ 

As of December 2021, the vast majority of adults across the UK have now been vaccinated. All adults aged 16 and over are eligible for two doses of the Coronavirus vaccine, which can be accessed at numerous vaccination centres across the UK. A number of locations are able to offer walk-in vaccinations, alternatively, you can book an appointment for your vaccination via the NHS website.

As studies have shown that people with immunological disorders often do not mount a decent immune response to the vaccine, individuals with conditions such as aplastic anaemia are eligible for a third primary dose of the vaccine, a minimum of three months following the second dose. Regardless of the vaccine that you received for the first two doses, the vaccine used for the third primary dose is usually Pfizer/BioNTech or Moderna. It is not an issue for you to receive a different vaccine for your third dose. People who were formerly shielding and classed as Clinically Extremely Vulnerable are able to visit any walk-in vaccination centre to receive their third primary dose vaccination. It is important that you take proof of your need for a third dose vaccination with you, such as a letter from your GP or consultant, as you may be turned away. We have also produced a letter that you can take with you, which may help, which can be found by clicking on the button below.

Third primary dose vaccination letter

Confusion between 'booster' vaccinations and the third primary dose

As many adults in the UK are now also eligible for a 'booster' vaccination, people with conditions such as aplastic anaemia have reported that medical staff are unaware of the existence of the third primary dose programme for people with weakened immune systems. As people with weakened immune systems will also be eligible for a further booster dose three months after their third primary dose, it is very important that your third vaccine is recorded as a third primary dose rather than a booster, as it may make it difficult for you to access a further booster/fourth dose in the future.

Can children and young people with aplastic anaemia receive the vaccine?

Young people aged between 12 and 15 are now eligible to receive a single dose of the Coronavirus vaccine, which will usually be given to them at school. It is also possible for young people to be vaccinated at certain vaccination centres, for which an appointment can be booked via the NHS website.

Young people aged 12 to 15 who are at a higher risk of developing COVID-19, or those who live with someone who is at an increased risk of developing COVID-19 are also eligible for a second dose of the COVID vaccine. If your child is eligible for a second dose, such as if they have aplastic anaemia or live with someone who does, you will be contacted by your GP to arrange an appointment for the second dose. If you haven't heard anything, we recommend that you contact your GP or medical team at the hospital for further advice.

Should young people receive the COVID-19 vaccine? 

  • We understand that you may have concerns about receiving a COVID-19 vaccination, particularly as people with aplastic anaemia are often advised not to receive their routine vaccinations. As is the case for adults, clinicians advise that in the case of the COVID-19 vaccine, the benefits of being vaccinated against COVID-19 far outweigh the risks associated with vaccinations. As always, you should discuss any questions or concerns you may have about your own medical history and circumstances with your medical team, to decide whether you should receive your COVID-19 vaccination. 

Is the Pfizer-BioNTech vaccine safe for young people? 

The Pfizer-BioNTech vaccine is currently the only one in use in the UK that has been approved for use in young people. A study of more than 1000 young people which took place in the USA showed that very few people suffered from severe side effects, that that the side effects were comparable with those that adults experience. MHRA, the Medicines and Healthcare Products Regulatory Agency which approved medicines and vaccinations for use in the UK has also confirmed that the Pfizer-BioNTech vaccine is safe for use amongst young people aged 12-17. (Source: https://www.pfizer.com/news/press-release/press-release-detail/pfizer-biontech-announce-positive-topline-results-pivotal)  

Will the Covid-19 vaccine work effectively for aplastic anaemia patients?

We are thrilled to announce that the results of Professor Hillmen's research into the efficacy of the Coronavirus vaccine for people with aplastic anaemia and PNH have now been released. Overall, whilst the research shows that people with AA and PNH usually do not mount a significant immune response after the first vaccination, the second vaccination is highly effective - with almost 100% of participants in the trial mounting a decent antibody response following the second vaccination - broadly similar to the response seen in healthy volunteers who took part in the trial. More information about the research is available here.

How does Covid-19 affect aplastic anaemia patients?

Read the latest Coronavirus shielding guidance and find support.

Did we answer your questions?

Our team are working hard to keep our Coronavirus Resources useful and up to date. If you have a question that isn't answered here, or you have an issue you would like our help with, please email us at [email protected] or call our helpline on +44 (0) 300 102 3202.

Last updated: 7 December 2021