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

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.

*UPDATE* People with WM will be eligible for a third full dose of the COVID-19 vaccine to further boost immunity. Read more.

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.

The third dose of the COVID-19 vaccine

Why am I being asked to come in for a third dose of the vaccine?

The third dose of the vaccine is being offered to those who are immunocompromised, which includes everyone living with WM. The third dose aims to increase the level of protection gained from the vaccine.

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

The Government has also announced a booster vaccination programme. This is for the general population and for some types of the vaccine, is only a half dose. The third dose of the vaccine is just for people who are immunocompromised, and is a full dose no matter what vaccine you are given.

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

Some research has shown that antibodies increase between the first and second doses. The idea behind the third dose 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.

When should I get the third dose of the vaccine?

The programme is already being rolled out, so you should receive a letter from your GP or hospital about arranging the vaccination. The third dose should be given at least 8 weeks after the second dose, and you may get it at either your GP surgery or hospital.

My GP hasn’t contacted me about the third dose, what should I do?

We’re hearing from the community that the roll out of the third dose hasn’t gone smoothly, and many people are reporting their GP or hospital are not aware of it. If you haven’t heard from your GP or hospital about getting the third vaccination, and think that you are eligible, you can contact them. If they’re not aware about the third dose, you might like to show them this letter which they should have received. A second letter was issued on 30 September, giving GPs and hospitals the deadline of 11 October to vaccinate immunocompromised people.

Our advice is to contact both your haematology team and your GP about booking a vaccine. Show them both the letters linked above, which state that they should have been offering the third dose since 13 September, and now have a deadline of the 11 October.

I have been offered the booster vaccination before the third dose. What should I do?

If you have been offered the Pfizer booster dose and you aren’t getting anywhere with booking in your third dose, it might be best to accept the booster. This is because the Pfizer booster and third doses do the same thing. If you are offered the Modern booster dose, you should not accept it. This is because the Moderna booster dose contains less vaccine than the full third dose.

Will I get the booster vaccination as well?

You may be offered your booster vaccination six months after your third dose, but this hasn’t been confirmed yet.

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 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 who lives with someone who is immunocompromised is eligible for two doses of the vaccine, to help lower the risk of the immunocompromised person of getting ill. A household contact is someone who shares your living accommodation on most days.

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