Last Updated 3 December 2021.
If you’re living with blood cancer, or your family member has been diagnosed, we know you’ve got questions.
The COVID-19 vaccines are free and available to everyone over 12 in Australia from 13 September 2021. Check your eligibility here.
We recently talked with experts about COVID-19 vaccinations and people living with blood cancer.
COVID-19 Vaccinations: Fact and fiction webinar
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 12 years or older and are immunocompromised or are taking immune-weakening treatments (there are no COVID-19 vaccines approved in Australia for people aged under 12 years yet).
You should also have a COVID-19 vaccine to protect yourself and others around you if you aren’t immunocompromised.
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 dose vaccinations?
ATAGI recommends a 3rd primary dose of COVID-19 vaccine in severely immunocompromised populations 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 between 2 and 6 months after your 2nd dose
What about booster doses?
ATAGI is not currently recommending booster doses for people who are severely immunocompromised and have already had a third dose.
Booster doses are available to everyone 18 years and over who have had both doses of their primary course of a COVID-19 vaccine at least 6 months ago. Two doses of COVID-19 vaccine provide very good protection, especially against severe disease.
A booster dose will make sure the protection from the first dose is even stronger and longer lasting and should help prevent the spread of the virus.
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||12+||12+||18+|
|Third dose for immunocompromised people||Yes||Yes||Not preferred |
|Booster dose||Yes||No ||Not preferred |
| AstraZeneca can be given as a booster dose in some circumstances
 Moderna is not yet approved by the TGA as a booster dose.
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.
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
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.
More information is available here.
What about children and adolescents?
There are currently no plans to vaccinate under 12s in Australia.
At present, no other country in the world is vaccinating under 12’s; however, some international trials are commencing looking at this cohort.
Here is some advice from the CDC that will help protect your under 12 now:
- Get vaccinated yourself. COVID-19 vaccines reduce the risk of people getting COVID-19 and can also reduce the risk of spreading it.
- Be sure to get everyone in your family who is 12 years or older vaccinated against COVID-19.
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. The link is 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.