Last Updated 31 March 2022.
The COVID-19 vaccines are free and available to everyone over 5 in Australia from January 10, 2021. Check your eligibility here.
We recently talked with experts about COVID-19 vaccinations and people living with blood cancer.
What is immunocompromise?
Being ‘immunocompromised’ means having a weakened immune system due to a medical condition or treatment. Many conditions can cause immunocompromise, including:
- Cancer, especially blood cancer
- Treatments for cancer (e.g., chemotherapy, targeted therapies, radiotherapy and CAR-T cell therapy)
- Having a bone marrow or stem cell transplant.
Should I have a vaccine for Covid-19?
You should have a COVID-19 vaccine if you are 5 years or older and are immunocompromised or are taking immune-weakening treatments.
You should also have a COVID-19 vaccine to protect yourself and others around you if you aren’t immunocompromised.
What about 5-11 year olds?
Approval for the Comirnaty (Pfizer) vaccine was given by the TGA in December 2021.
Vaccinating children can help prevent children from passing the virus onto younger siblings, grandparents and the wider community.
Everyone 5 years and over can now book an appointment for a COVID-19 vaccine with vaccinations available from 10th January 2022.
- More information is available here.
- Click here for the Australian and New Zealand Children’s Haematology/Oncology Group (ANZCHOG) consensus statement for children 5 years and older undergoing treatment for chance and non-malignant haematological conditions.
Why should I have a vaccine for COVID-19?
Vaccination protects you from having severe illness and reduces your risk of needing to go to the hospital as a result of getting COVID-19.
Many immunocompromising conditions can cause a higher risk of severe illness and complications from COVID-19, including:
- blood and solid organ cancers or their treatments, including:
- immune therapy
- blood/marrow stem cell transplant, and
- CAR-T cell therapy.
What about third doses?
ATAGI recommends a 3rd primary dose of COVID-19 vaccine in severely immunocompromised populations aged ≥5 to address the risk of non-response to the standard 2 dose schedule.
The 3rd dose is intended to maximise the level of immune response to as close as possible to the general population.
It is recommended that you have a 3rd dose from 2 months but no later than 6 months after dose 2.
What about booster doses?
People aged ≥16 who have had a 3 primary dose course of vaccination due to immunocompromise are now recommended to receive a booster/4th dose at 3 months after dose 3.
Atagi recommends an additional booster dose of the COVID-19 vaccine to increase vaccine protection before winter for selected population groups, including people >16 who are immunocompromised. Availability will commence in April and doses should be given 4 months after dose 4 or 4 months after COVID-19 infection.
Read the full statement here.
For people who are not immunocompromised, a booster dose is recommended for all people aged >16 if it has been 3 months since dose 2.
To be considered up to date with COVID-19 vaccination, you must have had all the doses recommended for your age and health needs.
A booster dose increases your protection against:
- infection with the virus that causes COVID-19
- severe disease
- dying from COVID-19.
A booster dose will continue to protect you, your loved ones and your community against COVID-19.
ATAGI recommendations for vaccine types
|Approved aged group||5+||12+||18+||18+|
|Third dose for immunocompromised people||Yes||Yes||Not preferred ||Yes|
|Booster dose||Yes||18+||Not preferred ||No|
| AstraZeneca can be given as a booster dose in some circumstances
 Nuvaxovid (Novavax) can be used if no other COVID-19 vaccine is considered suitable for that person
Third dose vaccine questions answered
Is it safe?
Yes, all COVID-19 vaccines available in Australia are recommended for people who are immunocompromised. Comirnaty (Pfizer) and Spikevax (Moderna) are not live vaccines. Vaxzevria (AstraZeneca) vaccine contains a virus that cannot replicate or spread to other cells. It does not behave like a live vaccine and cannot cause infection. Nuvaxovid (Novavax) is a protein-based vaccine and does not contain any live virus.
A very rare side effect involving blood clotting and low blood platelet count may occur after vaccination with the Vaxzevria (AstraZeneca) vaccine. This condition is called thrombosis with thrombocytopenia syndrome (TTS). There is no evidence that people with immunocompromise have a higher risk of TTS. Comirnaty (Pfizer) and Spikevax (Moderna) vaccines are not associated with a risk of TTS.
A very rare side effect involving the heart muscle may occur after vaccination with the Comirnaty (Pfizer) or Spikevax (Moderna) COVID–19 vaccines. These conditions are called myocarditis and pericarditis. Most reported cases have been mild, self-limiting and recovered quickly, although longer-term follow-up of these cases is ongoing. Cases have been reported after the second vaccine dose.
Fact sheets with more information can be found here:
- After your Comirnaty (Pfizer) vaccine
- After your Vaxzevria (AstraZeneca) vaccine
- After your Spikevax (Moderna) vaccine
- After your Nuvaxovid (Novavax) vaccine
- COVID-19 vaccination – Moderna information and consent form for parents and guardians of children aged 6 to 11 years
Is it effective for blood cancer patients?
People who are immunocompromised can have reduced responses to vaccines, meaning they may not be as well protected as people whose immune system is normal. However, as there are a lot of risks identified with COVID-19, immunocompromised people should get vaccinated as soon as possible.
As people with blood cancer may have reduced immune responses to the COVID-19 vaccine, it is strongly recommended that their family and carers should be vaccinated as soon as possible. This may provide an additional level of protection for people with blood cancer.
Should I still take precautions after vaccination?
After your vaccination, continue to follow other protective measures against COVID-19, including:
- physical distancing
- hand washing
- wearing a face mask, and
- COVID-19 testing and self-isolation or quarantine according to instructions of your local public health authority.
When should I have the vaccine?
Most people will need to continue their treatment before and after vaccination, but you should discuss the best timing of vaccination with your treatment team.
What about antibody testing?
Current COVID-19 antibody tests have not been evaluated to assess the level of protection provided by an immune response to COVID-19 vaccination.
Rapid antibody tests only show whether antibodies are present, without providing any information as to what this means for you.
In other words, just because someone has a positive antibody test, that does not automatically mean that their level of antibodies is high enough to protect against COVID-19 infection.
The WHO recommends testing after vaccination only for people with symptoms of disease, or for people who have been contacted as part of a test and trace programme.
Why are Aboriginal and Torres Strait Islander peoples a priority group for the COVID-19 vaccine?
There is a higher risk of getting and becoming very sick from COVID-19 due to several factors. This may include a higher rate of chronic health conditions and in some cases crowded living conditions, which increase the risk of spreading the infection.
Is there advice in languages other than English?
Cancer Australia has compiled answers to questions about the safety of the COVID-19 vaccines for people affected by cancer in Australia’s ten most spoken languages other than English.
Vaccine information in other languages is available from the Department of Health here.
What are the Leukaemia Foundation doing?
We are helping to fund the SerOzNET trial which is assessing responses to COVID-19 vaccinations in adults with cancer, including blood cancers.
We are closely monitoring the situation and continuing to speak with the clinical community, many of whom are on the Blood Cancer Taskforce. We will ensure any new advice or guidance is provided to people living with blood cancer through our information channels.
For information about COVID-19 or COVID-19 vaccines, patients should call the National Coronavirus Helpline on 1800 020 080.