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COVID-19 vaccines for stem cell transplant patients

We have produced resources to help you arrange COVID-19 vaccinations for your stem cell transplant patients. These resources can be used by transplant teams and GPs.

COVID-19 vaccine primary and booster doses

The JCVI has recommended that patients who are severely immunocompromised, including certain stem cell transplant recipients, receive three primary doses of a COVID-19 vaccine followed by further booster doses three months apart. Stem cell transplant patients who do not fall within the severely immunocompromised category should receive two primary doses followed by further booster doses.

The below table summarises the current JCVI advice as it relates to stem cell transplant patients aged 5 and above. People who live with an at-risk person, should receive two primary doses. Please note, children aged 5-11 should receive paediatric doses. Further information can be found here.

 THREE primary doses and booster dosesTWO primary doses and booster doses
Patient groupPatients within 24 months of receiving an autologous or allogeneic stem cell transplant or CAR-T therapy at the time of their primary dose.

Patients at any time after transplant who had ongoing immunosuppression or graft versus host disease (GVHD) at the time of their primary dose.
Patients over 24 months of receiving an autologous or allogeneic stem cell transplant or CAR-T therapy AND who did not have immunosuppression or graft versus host disease (GVHD) at the time of their primary dose. 
TimingThird primary dose ideally at least 8 weeks after the second dose.

Booster doses no less than 3 months apart.
Booster doses no less than 3 months apart.
Choice of vaccine: primary dosesFor those aged 18+, mRNA vaccines Pfizer BioNTech (Comirnaty®) or Moderna (Spikevax®) are preferred.

For 5-17 year olds, Pfizer BioNTech (Comirnaty®) is preferred.

AstraZeneca (Vaxzevria®) vaccine is no longer routinely being used. When considered clinically necessary, Novavax (Nuvaxovid®) vaccine may be used for those aged 12+.
For those aged 18+, mRNA vaccines Pfizer BioNTech (Comirnaty®) or Moderna (Spikevax®) are preferred.

For 5-17 year olds, Pfizer BioNTech (Comirnaty®) is preferred.

AstraZeneca (Vaxzevria®) vaccine is no longer routinely being used. When considered clinically necessary, Novavax (Nuvaxovid®) vaccine may be used for those aged 12+.
Choice of vaccine: booster dosesPfizer-BioNTech (Comirnaty®) bivalent vaccine is preferred. Alternatively, individuals may be offered the Moderna (Spikevax®) bivalent vaccine.

For 5–17 year olds, the Pfizer BioNTech
(Comirnaty®) original vaccine is preferred.
Pfizer-BioNTech (Comirnaty®) bivalent vaccine is preferred. Alternatively, individuals may be offered the Moderna (Spikevax®) bivalent vaccine.

For 5–17 year olds, the Pfizer BioNTech
(Comirnaty®) orginal vaccine is preferred.
Identification and bookingAdult patients with a clinical referral letter from their doctor can book an appointment via the NHS national booking system or use the NHS online COVID vaccine walk-in finderPatients will be invited to book their booster vaccination via the National Booking System or their local GP practice.

COVID-19 vaccine: re-vaccination after transplant

Patients who receive their COVID-19 vaccination before their stem cell transplant or CAR-T therapy should be re-vaccinated with all primary doses and booster doses they are eligible for, as per JCVI advice.

The timing of re-vaccination should be in line with BSBMTCT recommendations i.e. 3-6 months after transplant or CAR-T.

You can use this template to arrange re-vaccination for your patient after their transplant or CAR-T treatment. The letter has been developed with NHS England. Clinicians based in Scotland, Wales or Northern Ireland may need to adapt it for use locally.

Links to guidance