Have questions about the COVID-19 vaccine? Find out the latest information about vaccine roll out and guidance.

Last updated: 22 February 2022

We’ve worked with our Waldenstrom’s Macroglobulinaemia specialists Dr Dima El-Sharkawi (Consultant Haematologist at Royal Marsden Hospital) and Dr Shirley D’Sa (lead WM clinician at UCLH) to answer some of your top questions. On this page we’ll answer your questions about:

The COVID-19 vaccine – an overview

How does the COVID-19 vaccine work?

The aim of a vaccine is to train a person’s immune system to fight a specific disease it hasn’t come into contact with before, in this case COVID-19.

With the COVID-19 vaccine, a part of the virus is injected into the body. This provokes the body’s immune system into action. It produces cells to specifically fight this new virus. When the body comes into contact with the virus again, the immune system ‘remembers’ it and has the cells ready to fight it. This helps prevent you for getting ill.

What vaccines are available in the UK?

There are currently four vaccines available in the UK, which have all been approved by the UK Medicines and Healthcare Products Regulatory Agency (MHRA). They are:

  • Pfizer – the first vaccine to have been approved in December 2020. This has two doses
  • AstraZeneca – the second to have been approved in December 2020. Also a double dose vaccine
  • Moderna – Approved in January 2021 and given in two doses
  • Janssen – Approved in May 2021. This is the only single dose vaccine available in the UK

All the vaccines give a high level of protection against COVID-19 and have been through rigorous testing to ensure they are safe.

People with compromised immune systems, like people with WM, are eligible for more vaccine doses than the general population.

What side effects are there?

You can read a list of side effects on the NHS website.

Should I get the vaccination if I’ve already had COVID-19?

Yes. It is possible to get infected with virus a second time, so getting vaccinated is always a good idea.

However, you should not get vaccinated if you have COVID-19 symptoms or have tested positive at the time of your booked appointment. This is because you could pass the virus onto others when you go into your appointment.

How do I book my vaccines?

We’ve listed the most common questions about the vaccine programme in the UK. You might also like to watch our recent webinar with Dr Dima El-Sharkawi, which you can find on our YouTube Channel.

Why am I being asked to come in for more vaccine doses?

Extra doses of the vaccine is being offered to those who are immunocompromised, which includes everyone living with WM. These extra doses aim to increase the level of protection gained from the vaccine.

What is the difference between the normal dose of the vaccine and a booster vaccination?

The booster dose (which should be your fourth Covid jab) differs slightly from the other doses as for some types of vaccine, you will only receive a half-dose.

I didn’t see an increase in my antibodies between the first and second vaccine doses, will having more doses make any difference?

Some research has shown that antibodies increase between the first and second doses. The idea behind the extra doses is to boost these even further. This means even if you still don’t have higher antibody levels, a third dose could offer you more protection.

It’s also important to remember that antibodies are only one measure of immune response, and you may still be offered some protection by the first two doses even if you have low antibody response, which is why it’s recommended that everyone with WM books in a third vaccination.

What extra doses are available to me?

As someone who is immunocompromised, you should be offered the following doses:

  • Doses 1 and 2 – Everyone in the UK has been offered two primary doses, and as someone who is immunocompromised, you should have already had these
  • Dose 3 – only available for severely immunocompromised people, 8 weeks after their 2nd dose. This was first offered in September 2021 but due to problems with the roll out, some people got it later than this
  • Dose 4/booster dose – severely immunocompromised people are eligible for this dose 3 months after their 3rd primary dose. For some vaccines, like Pfizer, you will receive the same dosage as your primary jab, but for others, like Moderna, it will be a half dose.
  • Dose 5 – the JCVI announced immunocompromised people would be eligible for fifth jab as part of a Spring booster campaign. The NHS recommend to have this 6 months after your 4th dose but appointments are available anytime from 3 months after your last dose. Because of the delay many people with WM experienced in the roll out of the 3rd and 4th doses, we recommend that you book your 5th dose as soon as you can. See the Green Book (p28) for more details. You can book your vaccine on the NHS Booking system or by calling 119.
  • Dose 6 A booster dose has been recommended for immunocompromised people in the Autumn, to counter any potential wave this winter, a season where the threat is highest. Plans have yet to be finalised for how this will be rolled out, and we’ll keep you updated when details are announced.

I haven’t been able to book my vaccine, what should I do?

You should have by now received your third dose. According to the roll out, most immunocompromised people should also have had their fourth/booster jab, but we know that due to delays this might not have happened.

If you’re having problems getting your jabs, show your GP this guidance from the JCVI which details who is eligible for the third dose. You should be able to get your vaccine at a mass vaccination centre if you present them with a letter from your GP or consultant stating that you are eligible for the extra vaccine. If you’re in England, this letter might be of help when talking to them. You will only be eligible for your 3rd dose 8 weeks after your second, and your fourth/booster dose 3 months after your third.

Guidance around the roll out of the fifth dose for immunocompromised people has yet to be published and we’ll update these pages when we know more.

You can find specific guidance for Scotland, Wales and Northern Ireland on their respective information pages.

My third dose was recorded as a booster, can I still get my fourth dose?

You will still be eligible for a 4th dose of the vaccine. We know that some centres mistakenly recorded third jabs as boosters, but this shouldn’t stop you from getting another jab. If you have been identified as severely immunocompromised, then you are eligible for a fourth dose, no matter how the third dose is recorded. Your fourth dose will simply be recorded as a second booster.

Can I get my flu jab?

Yes, you can get your flu jab at the same time as your COVID-19 vaccination. When the vaccination programme was rolled out, initial advice said to keep 7 days between the COVID-19 and flu jabs. However recent guidance confirms that there is no harm in having these vaccinations at the same time.

Vaccine efficacy and antibody testing

Is the vaccine effective in people living with WM?

Research has shown that the vaccine might not be as effective in people with blood cancer, like WM, as it is in the general population. This is because blood cancers affect the immune response and the body’s ability to create the antibodies that fight infection.

However, immune responses vary from person to person and are affected by many other factors aside from a WM diagnosis. Things like age, weight and sex can play a part in whether someone’s immune response is lower or higher than another’s.

It’s also important to note that antibodies are only one measure of immune response, which are far more difficult to measure. This means that even if your body hasn’t produced any antibodies, you may still be offered protection from the vaccine.

You can read more about immune response and the vaccine here.

Should I get my antibodies tested after I’ve been vaccinated?

Antibody tests aren’t routinely available on the NHS, so if you decide to get one done, you’ll need to pay privately. It’s a personal decision whether you do this or not, but there are few important things to think of before you pay out:

  1. Antibodies aren’t the only way to measure immune response, and low antibody levels doesn’t automatically mean you don’t have any immune response.
  2. Healthcare professionals look at individual circumstances when giving out advice, not the level of antibodies, because they do not clearly demonstrate a person’s immune response.
  3. We aren’t sure what antibody levels really mean in terms of protection against COVID-19. More research needs to be done before scientists can draw any conclusions about levels of antibodies and levels of protection against the virus.

If you do decide to get a test done, there are companies that offer them through the post. You’ll have to prick your finger for blood sample, which you send off to be analysed in a lab.

What if my antibodies haven’t changed after my vaccination? Does it mean I am not protected?

In short, we don’t know. Antibodies are only one measure of immune response. Other factors, like T-cells, are more difficult to measure and this means that even if you have low or no antibody levels, you may still be afforded some protection from the vaccine.

Vaccination of household contacts of people with WM

Anyone over the age of 12 is now eligible for their vaccines. Te JCVI have also advised offering a modified dose to 5-11 year olds, a recommendation that has been accepted by the Health Secretary.

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