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 early December, 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?

In recent weeks, a number of stories have circulated in the media, reporting 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.

We strongly recommend that you continue to receive your COVID-19 vaccination if you are able to, regardless of the type of vaccination 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 our trustee 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 plan to publish.

At present, no individuals with aplastic anaemia have been involved in COVID-19 vaccine trials, and any references to case reports made below relate to previous vaccine studies unrelated to COVID-19.

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?

People who are considered as Clinically Extremely Vulnerable and have been advised to shield are currently in Group 4 in the priority order of vaccination. The Government has stated that they aim to have vaccinated all people in the first four priority groups, including those who are shielding by 15 February.

Arrangements for booking and receiving a vaccination vary across England, Scotland, Wales and Northern Ireland, however, you will be contacted either by your GP or local health authority when it is your turn to be vaccinated. In some areas, large vaccination 'hubs' have been set up to vaccinate large numbers of people, or in some areas, you may be invited to go to a local hospital, GP surgery or pharmacy. The Government currently advise that you should not contact your GP or hospital to ask for an appointment, as you will be contacted in due course.

UPDATE (29 March 2021): JCVI, The Joint Committee for Vaccination and Immunisation have now recommended that household members of people who are clinically extremely vulnerable should be prioritised to receive their COVID-19 vaccination, and should be put into priority group six. We have received confirmation that this will be put into place in England, and that local authorities will begin to implement this soon, but we have not yet received confirmation as to when, or if Wales, Scotland and Northern Ireland will offer this.

We have also received a number of enquiries as to whether people within the support bubble of someone who is shielding would be prioritised for the vaccine, particularly if they live in another household. We have contacted the Specialised Healthcare Alliance to clarify this, and will provide you with an update as soon as we receive it.

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

On 20th July 2021, JCVI, the Joint Committee for Vaccination and Immunisation issued new guidance about Covid vaccinations for children and young people. While vaccinations will not be offered to all children and young people, it is now recommended that children and young people in the following groups are offered the Pfizer-BioNTech vaccine. 

  • Young people aged 12 to 15 who are immunocompromised – either through their condition or its treatment 
  • Young people aged 12 to 17 who live with someone who is immunocompromised 

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)  

Priority groups for vaccination

On Wednesday 2 December, JCVI, the Joint Council of Vaccination and Immunisation announced changes to the priority order for vaccination. Following these changes, individuals who are clinically extremely vulnerable are now included in group four, alongside people who are aged 70 or over. You can find the full statement from JCVI about the prioritisation for vaccination here.

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

Many of our community members expressed their concern at the prioritisation given to people with blood disorders such as aplastic anaemia, and we approached the Specialised Healthcare Alliance to share their concerns.

It’s important to note that the Department of Health and Social Care has insisted that this is an interim list based on clinical necessity, and although unlikely to change, the Government could eventually deviate from this prioritisation list, owing to other considerations such as logistics and efficacy.

You may find it reassuring that Deputy CMO Professor Jonathan Van-Tam recently stated that the time between the elderly, healthcare workers, and the clinically vulnerable in receiving the vaccine would likely be a matter of 2-3 weeks. However, we understand any delay can be frustrating for those who have had to shield and could be exasperated if there are logistical challenges in rolling out a vaccine.

James Maxwell, The Specialised Healthcare Alliance

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

We understand that the recent news reports about the Covid-19 vaccine's efficacy for cancer patients and those with a compromised immune system will be concerning for our patient community.

We have consulted with Professor Peter Hillmen and Dr Darren Newton from the haematology team at Leeds and have published an update 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: 27 July 2021