COVID-19 vaccine and cancer – latest updates

Photo by Nataliya Vaitkevich from Pexels

Ever since the coronavirus pandemic brought the world to a standstill back in March, there’s been talk of a vaccine.

COVID-19 vaccines have been badged as our biggest opportunity to control the virus and return to normal. And for the last 10 months, researchers and scientists across the world have been racing to make that a reality.

With over 300 vaccines in development and 2 being rolled out across the UK, we want to make sure everyone has access to information about the COVID-19 vaccine and what it could mean for people with cancer, so we’ll be updating this blog post as new data and information emerges.

24 February – COVID-19 vaccine priority groups 4 and 6

There has been some confusion around what COVID-19 vaccine priority groups have meant for people with cancer. In January, we received communications from NHS England that set out that people with cancer who weren’t prioritised in group 4, such as those treated a long time previously and who were treated surgically, would be covered by priority group 6.

This information was initially published as an update on our blog post on the 28th January (which has since been amended). However, it appears that this guidance has not been communicated in any public setting, and unfortunately we have been unable to get further confirmation from NHSE that this guidance still holds true.

We’re very sorry for the confusion and frustration this has caused at this unsettling time. We encourage people to continue following the advice set out by The Joint Committee on Vaccination and Immunisation (JCVI) and the Green Book as follows:

Those who fall into group 4, and who are considered Clinically Extremely Vulnerable (CEV), include:

• People with cancer who are undergoing active chemotherapy
• People with lung cancer who are undergoing radical radiotherapy
• People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
• People having immunotherapy or other continuing antibody treatments for cancer

• People having other targeted cancer treatments that can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
• People who have had bone marrow or stem cell transplants in the last 6 months or who are still taking immunosuppression drugs

According to page 11 of the Green Book, anyone with lowered immunity due to disease or treatment who is not in group 4 will be in group 6, including:

• Patients undergoing chemotherapy leading to immunosuppression.
• Patients undergoing radical radiotherapy, solid organ transplant recipients, bone marrow or stem cell transplant recipients.
• Individuals who are receiving immunosuppressive or immunomodulating biological therapy including, but not limited to, anti-TNF, alemtuzumab, ofatumumab, rituximab, patients receiving protein kinase inhibitors or PARP inhibitors, and individuals treated with steroid sparing agents such as cyclophosphamide and mycophenolate mofetil.
• Individuals treated with or likely to be treated with systemic steroids for more than a month at a dose equivalent to prednisolone at 20mg or more per day for adults.
• Anyone with a history of haematological malignancy, including leukaemia, lymphoma, and myeloma.

Individuals who are about to receive highly immunosuppressive treatment, or those whose level of immunosuppression is about to increase may be re-prioritised and be able to have vaccination sooner, if therapy can be safely delayed or there is sufficient time before therapy starts. Those who have had cancer, or have cancer, but who are not part of group 4 or 6 will have the vaccine with their age group, depending on their circumstances.

If you have any concerns or questions about when you will be invited for a COVID-19 vaccine, please speak to your GP or cancer specialist.

18 February – Updated shielding guidance

This week the Government has updated its shielding advice, asking a further 1.7 million people to stay at home at all times and only going out to exercise or attend medical appointments. Of the people recently identified as now needing to shield, only half have been vaccinated. GPs will now urgently prioritise those who haven’t been vaccinated but who do need to shield.

The new shielding advice takes into account someone’s ethnicity, whether they live in a deprived area and their weight. As well as their age, prescribed medications and underlying health conditions. Underlying health conditions taken into consideration include:

• Lung or oral cancer
• Blood and bone marrow cancers
• If someone has received chemotherapy in the last 12 months
• Whether someone had been prescribed prednisolone or immunosuppressants 4 times or more in the last six months.

All of these measures are taken together to assess someone’s risk of becoming seriously ill if they caught COVID-19.

If you now fall into the extended shield category you will be sent a letter by the NHS informing you of your new status. This status means you are entitled to statutory sick pay, prioritisation for shopping slots online and assistance collecting medication.

16 February – Advice for people with lymphoedema or people who have received lymph node treatment following breast or skin cancer

A known side effect of the Moderna and Pfizer-BioNTech vaccines is lymph node swelling. If someone has lymphoedema in their arm or leg due to cancer treatment, it’s advised they get the vaccine in the opposite arm or thigh to their existing swelling.

The British Lymphology Society has also advised that those who have received cancer treatment that involves treating the lymph nodes directly, for example radiotherapy or surgery to the lymph nodes for breast or skin cancer, should have the vaccine in the opposite arm or leg to where they received their lymph node treatment. If they have received treatment on both sides they should receive their vaccine in the thigh. If you have any concerns, we’d recommend chatting to your vaccinating team, GP or cancer specialist.

8 February – Oxford-AstraZeneca vaccine shows 76% protection between doses

The University of Oxford has revealed that the efficacy of a single dose of the Oxford-AstraZeneca vaccine reaches 76% after 22days, and remains at this level until at least day 90. The Government has stated that leaving longer between doses than the three weeks used in clinical trials, combined with initial prioritisation of the first vaccine dose, would increase vaccine supply in the short term, and allow for more first doses to be delivered to more people earlier.

Researchers at the University of Oxford published an analysis of further data from the ongoing trials of the vaccine, in Preprints with The Lancet.

This draft write-up hasn’t yet been scrutinised by independent scientists, but is currently under review at The Lancet. The report highlights that there might be benefits to increasing the time between doses, with vaccine efficacy increasing from 54.9% with an interval of less than 6 weeks, to 82.4% when spaced 12 or more weeks apart.

The study also looks at the potential for the vaccine to reduce transmission of the virus. Analysis of COVID-19 tests taken weekly by UK participants suggests that the vaccine schedule being used in the UK (two standard doses) can reduce transmission, with a 49.5% reduction in positive tests in people who had the vaccine.

In other news, scientists have found that the Oxford-AstraZeneca vaccine offers “minimal protection” against mild cases caused by a variant of the COVID-19 virus called the South African Variant. Over 100 cases of this variant have been found in the UK. The results came from a recent study, which has not yet been peer-reviewed, involving around 2,000 people. Professor Sarah Gilbert, the lead Oxford-AstraZeneca vaccine developer, has confirmed that the vaccines should still protect against severe cases of the disease. She added that they were working on a modified version of the vaccine to be ready by the Autumn to increase protection against the South Africa variant.

5 February – UK regulator confirms COVID-19 vaccines are ‘extremely safe’

Data published by the UK’s independent drugs regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), has confirmed that both the Pfizer-BioNTech and Oxford-AstraZeneca vaccines are extremely safe.

The MHRA assessed safety reports from nearly 7 million doses of the vaccine given up to 24 January – the majority of which were the Pfizer-BioNTech jab.

Results found that approximately 22,820 suspected reactions were reported, the equivalent to approximately 3 in every 1,000 people vaccinated.

Almost all cases were mild and include sore arms, headaches and chills. These after–effects are not the disease itself, but are caused by the body’s response to the vaccine.

28 January – More clarity on priority groups for people with cancer

The Joint Committee on Vaccination and Immunisation (JCVI) has prioritised the following groups for vaccination:

1. Residents in a care home for older adults and their carers
2. All those 80 years of age and over and frontline health and social care workers
3. All those 75 years of age and over
4. All those 70 years of age and over and clinically extremely vulnerable individuals
5. All those 65 years of age and over
6. All individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
7. All those 60 years of age and over
8. All those 55 years of age and over
9. All those 50 years of age and over

But there has been a question mark over who would fall into group 4 and group 6. According to communications we received from NHS England, priority group 4 includes people who are clinically extremely vulnerable and will include people having many types of active cancer treatment as well as many in follow-up.

The communications also set out that all other cancer patients such as those treated a long time previously and who were treated surgically would be covered by priority group 6. However, this information has not yet appeared online and we’ve heard from some people with cancer and some GPs that they have not had this information. We understand that this is frustrating and have relayed this to NHS England.

If you have any questions about when you will be invited for a COVID-19 vaccine, please speak to your GP or cancer specialist.

21 January – COVID-19 vaccination centre opens at London’s Francis Crick Institute

As part of the country-wide vaccination programme, University College London Hospitals have partnered with the Francis Crick Institute to set up a new, large scale vaccination centre set to open by the end of January. Equipment and unused space within the research institute – of which Cancer Research UK is a major funder – is being used to create a vaccination centre that will be administering doses 7 days a week.

At maximum capacity, the centre has been designed to deliver just over 1,000 vaccinations per day (from 8am – 8pm). However, the number of people that can be invited will depend on the level of vaccine stocks received by the centre. Our news report has the details.

18 January – Vaccine rolled out to over-70’s and “clinically extremely vulnerable” in England

From today, those aged 70, and over and those considered “clinically extremely vulnerable”, will begin receiving invitations for a COVID-19 vaccination. People considered “clinically extremely vulnerable” are those who were asked to shield at various points during the pandemic, and include:

• People with cancer who are undergoing active chemotherapy
• People with lung cancer who are undergoing radical radiotherapy
• People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
• People having immunotherapy or other continuing antibody treatments for cancer
• People having other targeted cancer treatments that can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
• People who have had bone marrow or stem cell transplants in the last 6 months or who are still taking immunosuppression drugs

The Department of Health and Social Care have acknowledged that those in the top 2 prioritisation groups – care home residents, those over 80 years old and front-line health care workers – will remain as the top priority to receive the vaccine.

The announcement today means that areas that have already vaccinated the majority of people in the top 2 priority groups will now be able to keep up the momentum and start vaccinating additional groups.

15 January – Guidance on the COVID-19 vaccine for patients receiving Systemic Anti-Cancer Therapy

The UK Chemotherapy Board has produced a comprehensive document of FAQs on the Pfizer–BioNTech and Oxford-AstraZeneca COVID-19 vaccines for healthcare professionals treating patients on systemic anti- cancer therapies (SACT) such as chemotherapy, antibody therapy or immunotherapy.

The document outlines that all patients receiving SACT should be considered for a COVID-19 jab.

These FAQs were produced in response to questions by cancer specialists about giving the vaccine to people with cancer receiving SACT. They may be used by cancer specialists, along with any local guidelines, to help decide the best timing for giving the vaccines in people receiving SACT.

You can talk to your GP or cancer specialist when you’re offered the vaccine to discuss timings. We’ve got further information about the different vaccines, summarising the guidance from the UK Chemotherapy Board, here.

11 January – Government publishes latest vaccine delivery plan

The Government has set out its latest vaccine delivery plan to administer at least 2 million vaccinations per week, as part of the ‘largest vaccination programme in British history’.

The plan includes the commitment set out last week by Boris Johnson to offer the first vaccine dose to all those in the top 4 priority groups, as recommended by the Joint Committee of Vaccination and Immunisation (JCVI), by 15 February. This includes those considered “clinically extremely vulnerable” including people with cancer who are undergoing chemotherapy, people with cancers of the blood or bone marrow, and people with lung cancer who are undergoing radical radiotherapy. You can find a complete definition of clinically vulnerable groups, on the Government website.

8 January – Third vaccine approved for rollout across the UK

A vaccine made by Moderna – a US based biotech company – has become the third vaccine to be approved for mass rollout across the UK, although supplies are yet to arrive in the country and may not do so for several months.

This vaccine is the latest to have been approved by the Medicines and Healthcare products Regulatory Agency (MHRA). Similarly to the Pfizer-BioNTech vaccine, which was approved in December 2020, the Moderna vaccine is not a ‘live’ vaccine, but contains a molecule called mRNA, which contains genetic information that causes the body to produce tiny fragments of a molecule made by the coronavirus.

In trials with more the 30,0000 people, the Moderna vaccine was assessed to see whether it could prevent symptomatic infection and was found to have an efficacy of almost 95%. There were also no cases of severe COVID-19 in the group that had the vaccine. It is unclear at this stage what impact the vaccine might have on infection without symptoms. The Moderna vaccine can be stored at –20°C (normal freezer temperature) for up to 6 months.

7 January – Study examines immune response to COVID-19 in people with cancer

The news that 2 COVID-19 vaccines have been approved and are now being rolled out offers hope of a return to normal life in 2021. For people with cancer this could mean less anxiety about attending hospital appointments, fewer changes to treatment and shorter waiting times. At this stage, although we can’t be sure whether the vaccines will work quite as well in people having cancer treatment because of the effect that cancer treatment can have on the immune system, experience with other vaccines suggests that the COVID-19 vaccines should offer protection against COVID-19 for people with cancer.

Studies looking at how people with cancer have responded to the virus that causes COVID-19 may also provide some clues. Results just published from one of these studies – the SOAP study – suggest that patients with solid cancers have a similar immune response to the virus as people without cancer. Those with blood cancers were found to have a more variable response, with some people responding similarly to people with solid cancers, while others didn’t manage to clear the virus or develop antibodies against it. The numbers in this study weren’t big enough to determine whether patients with particular blood cancers or receiving particular treatments had a poorer response.

These findings may have implications for COVID-19 vaccination, for example it may be that some people with cancer would benefit from more frequent boosters or monitoring to check their response. The SOAP study plans to investigate this in the next phase of their project, which will look at the immune response to the vaccine in people with different type of cancer.

It’s important to remember that some protection is better than none and that people with cancer are encouraged to take the vaccine when it is offered. As with other vaccines, the timing of COVID-19 vaccination may depend on the type and timing of cancer treatment.

5 January – COVID-19 vaccine and questions about safety for people with cancer

Are these vaccines safe? And which vaccines are most appropriate for people living with cancer? These are questions we’re frequently being asked, and understandably so.

While we’re not able to comment on individual circumstances, we’ll continue to update this blog post as new findings and information are released.

To get an ‘on the ground’ view, we recently spoke to Dr Neil Smith, a GP based in Lancashire, about how he is advising his cancer patients in his clinic. “My general advice is yes, it is, safe. You’ve got to understand your individual circumstance, but for people with cancer, or for people who have previously had treatment for it, it is safe. For most people, it’s much safer to have it than not have it. And because it’s not a vaccine that uses a ‘live’ virus, it doesn’t pose a threat to somebody’s immunity, instead It helps them to produce their own immunity against the coronavirus.”

The Medicines and Healthcare products Regulatory Agency (MHRA) – the organisation which grants licenses to companies to sell their medicines in the UK – have confirmed that both the Pfizer-BioNTech vaccine, and the Oxford-AstraZeneca vaccine, are safe for rollout across the country. Whilst doses of the other vaccines have been purchased, they are yet to be approved by the MHRA.

Similarly, another government body – the Joint Committee on Vaccination and Immunisation (JCVI), which advises UK health departments on immunisation – commented that the Pfizer-BioNTech vaccine “appears to be safe and well-tolerated, and there were no clinically concerning safety observations,” and that the Oxford-AstraZeneca vaccine “appears to have a good safety profile.” These comments apply to the general population – but what about people affected by cancer?

Some people who were asked to shield during the pandemic (and who are considered “clinically extremely vulnerable”), which includes a number of cancer patients (please see the update from 28 November for the complete list), will be prioritised to receive their first dose of vaccine as soon as possible. However, the JCVI thinks that others who are considered “clinically extremely vulnerable” and who also have some degree of immunosuppression, or are immunocompromised, may not respond as strongly to the vaccine – despite this, the vaccines will, they think, still offer these people some protection. So the COVID-19 vaccines are likely to be made available to cancer patients at some point. However, these people, including those on chemotherapy, have been advised to continue to follow Government shielding advice to reduce their risk of infection, even after vaccination.

Whatever their situation, people invited for vaccination will be able to discuss their concerns with a doctor. “When people arrive at a COVID-19 vaccine centre, they’ll go through a normal consent process. And within that consent process, if there’s any specific issues, they’re often advised beforehand to contact the GP, and so a GP will be in contact with several patients wanting a bit more information,” says Smith. “But in my experience of that, it’s been a very positive conversation where I’ve been able to reassure people – ‘Yes, the vaccine for you is safe, and you should go ahead’.”

Smith is extremely hopeful for the vaccine. “It’s one of the best things I’ve seen in my 30 years of the NHS, and the main thing it does, is it makes the world a better place and makes us safer. So what I’m hoping going forwards, it’s safer for me to see patients and it’s safer for patients to feel confident they can see me to talk about cancer again, and to talk about the fears and concerns, it’s safe for me to refer them and to do investigations, and it becomes much safer for people to carry on having the cancer treatments early. The COVID-19 vaccine will help us to continue to diagnose and cure cancer and save people’s lives.”

30 December – Oxford-AstraZeneca vaccine approved for use and rollout next week

The Oxford-AstraZeneca vaccine has been approved for use in the UK. It is the second jab to be approved in the UK after the Pfizer-BioNTech vaccine was given the go-ahead earlier this month.

This vaccine contains a weakened form of a common cold virus (harmless to humans) that has been modified to include the gene for the coronavirus spike protein. Once injected, this primes the immune system to attack without exposure to the full virus. This is then followed by a second dose – up to three months later – for maximum protection.

16 December – Fifth vaccine begins clinical trials in UK

Speciality vaccine company Valneva is the latest to begin clinical trials of their COVID-19 vaccine, currently being developed in West Lothian in Scotland.

The Valneva trial will begin by testing the safety and efficacy of the vaccine on volunteers at 4 sites across the UK and is currently enrolling 150 healthy participants aged 18 to 55.

The Valneva vaccine is what’s known as an “inactivated whole virus” vaccine. While the vaccine does hold some of the same virus particles that cause COVID-19, they are weakened and made inactive so that they cannot give you the virus. But they are able to prime the immune system to be able to recognise and destroy the virus responsible for COVID-19, which may prevent you from getting sick if you’re exposed to the virus in the future.

15 December – Latest COVID-19 vaccine trial data published

Results from the clinical trial of the vaccine developed by Pfizer/BioNTech – currently being rolled out across the country – have been published in The New England Journal of Medicine, showing that the vaccine may provide protection as early as 12 days after the first dose.

The phase 3 trial involved 42,000 people, with around half receiving the vaccine and the others a dummy vaccine (placebo). 170 people developed COVID-19, with 8 cases in the vaccinated group and 162 in the placebo group, demonstrating that the vaccine has an overall efficacy of 95%.

The AstraZeneca Oxford vaccine have also been published, this time in The Lancet, with data suggesting that the vaccine is safe and offers protection against COVID-19. The results are a combination of 2 clinical trials in the UK and Brazil. When the interim trial results were released a few weeks ago, the vaccine had an efficacy between 62 and 90% depending on how doses were administered.

This paper shows that the vaccine offers protection against symptomatic COVID-19 when the 2 doses are administered with a 6-week gap between them. This could mean that this vaccine could take longer to roll out than others, with the Pfizer vaccine being given in 2 doses spaced as little as 3 weeks apart. However, it doesn’t need to be stored at –70 degrees, meaning that it might be easier (and perhaps cheaper) to deliver.

11 December – Progress of COVID-19 vaccine vs cancer research

The development of multiple COVID-19 vaccines over an extraordinary 10-month period has brought up some questions about why there haven’t been similar transformative leaps in treating cancer.

Cancer is a highly complex disease, with over 200 different types that vary in biology, genetic make-up and behaviour. Not only that, but each person’s cancer is unique with its own set of challenges, so it’s very unlikely there will ever be one single cure that can be applied to everyone.

One of the biggest challenges our researchers face is that cancer can evolve, adapt and diversify and eventually outwit the immune system. For now, COIVD-19 doesn’t appear to rapidly change its make-up like cancer. And with COVID-19, researchers have been able to define specific targets that are found on the virus, which makes it much easier to treat than cancer.

Much of the science behind the development of the recent COVID-19 vaccines have been underpinned by previous research to understand the body’s immune system for other diseases, including cancer. And the extraordinary progress of the COVID-19 vaccine is in part because scientists, governments, industry and academic institutes around the world turned their focus to this one goal. To further accelerate development, different phases of vaccine trials and production have overlapped.

Copy this link and share our graphic. Credit: Cancer Research UK.

Although progress against cancer might not look as quick or dramatic as that against COVID-19, we have made great strides. Thanks to our research, we’ve helped cancer survival double over the last 40 years.

But there’s still more to do, and the technologies and insights that have come from the COVID-19 vaccine work could help us with future advancements in cancer research. We are relentless in our ambition to beat cancer and will continue to fund ground-breaking research to find new ways to prevent, diagnose and treat cancer.

8 December – Vaccine rollout begins across the UK

90-year-old Margaret Keenan has become the first person to receive the Pfizer-BioNTech COVID-19 vaccine, as mass rollout begins across the UK. BBC News has the latest.

50 hospitals in England have been selected to receive the first doses of the vaccine and deliver the first rounds of the vaccination programme. Scotland, Wales, and Northern Ireland are also set to begin their vaccination programmes from hospitals today.

With the first 800,000 doses arriving this week, limited quantities will be available until further doses arrive. To begin, elderly people who are hospital outpatients, as well as those who are being discharged after a stay in hospital, will be among the first to be offered the vaccine. Each individual will require two jabs, administered within 21 days of each other, so the initial 800,000 doses will vaccinate 400,000 people.

Prioritisation groups are based on who has the greatest risk of becoming seriously ill or dying from the virus.

2 December – Pfizer–BioNTech vaccine approved for use in the UK and to be rolled out next week

The UK has become the first country to approve the Pfizer–BioNTech vaccine for widespread use, after the Medicines and Healthcare products Regulatory Agency (MHRA) confirmed that the vaccine is safe for rollout across the country.

The mRNA vaccine, which trials suggest offers up to 95% protection against COVID-19, should be available to those who need it most, including elderly and care home patients and staff, within the week. Protection from the vaccine should stop people from becoming ill with the virus. So far, the UK has ordered 40 million doses, enough to vaccinate 20 million people, with the first 800,000 doses arriving early next week.

The vaccine will be distributed from Pfizer centres in Germany, Belgium and the USA. Approximately 50 hospitals across the country have been prepared to deliver the first of the vaccination programme. Specialist vaccination units in spaces such as conference centres are also being set up and some GPs and pharmacists may have access to vaccines, if they have the available cold storage facilities required to store the jab.

To find out more, head to BBC News.

30 November – Final results from Moderna confirm vaccine is 94% effective

The final results from Moderna’s vaccine trials have confirmed that their vaccine showed 94% efficacy against COVID-19, and nobody who received the vaccination developed a severe case of the virus. The latest news has initiated an approval process with regulators around the world who will study the trial data for the vaccine and decide if the data on its safety and effectiveness are robust enough to be recommend for roll out.

The UK has now bought 7 million doses of the vaccine, which are expected to arrive in the UK in March. On top of that, the UK has pre-ordered 40 million of the Pfizer/BioNTech vaccine and 100 million of the AstraZeneca Oxford vaccine. Full trial data has not yet been released but you can read more about the Moderna vaccine at BBC News and The Guardian.

28 November – Extremely vulnerable given high priority for COVID-19 vaccine in UK

The provisional priority list published by Public Health England has listed people aged 18 years and over who are deemed “clinically extremely vulnerable” as the same priority as the over-70s to receive a COVID-19 vaccine.

People considered “clinically extremely vulnerable” are those who were asked to shield during the pandemic, and include:

• People with cancer who are undergoing active chemotherapy
• People with lung cancer who are undergoing radical radiotherapy
• People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
• People having immunotherapy or other continuing antibody treatments for cancer
• People having other targeted cancer treatments that can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
• People who have had bone marrow or stem cell transplants in the last 6 months or who are still taking immunosuppression drugs

Although this prioritisation list is subject to further potential changes as the vaccine is still waiting approval from the Medicines and Healthcare products Regulatory Agency (MHRA), those considered “clinically extremely vulnerable” have now been placed in priority group 4 of 9. Based on these changes, the interim guidance, advised by the Joint Committee on Vaccination and Immunisation (JCVI), says the order of priority should be:

1. Older adults in a care home and care home workers
2. All those 80 years of age and over and health and social care workers
3. All those 75 years of age and over
4. All those 70 years of age and over and the clinically extremely vulnerable individuals, excluding pregnant women and those under 18 years of age
5. All those 65 years of age and over
6. Adults aged 18 to 65 years in an at-risk group
7. All those aged 60 and over
8. All those 55 and over
9. All those aged 50 and over

23 November – Initial results of AstraZeneca-Oxford vaccine announced

The day’s big news was of results from clinical trials in Britain and Brazil of the vaccine led by drug company AstraZeneca and researchers in Oxford. The trials involved over 20,000 individuals and showed differing levels of protectivity depending on how the doses were administered (between 62 and 90%). Like all the recent results, these findings were announced in a press release and have not yet been independently verified.

The trials explicitly excluded people with a history of cancer apart from a few exceptions; those with localised prostate cancer (where the cancer is contained in the prostate and has not spread to anywhere else), non-melanoma skin cancer that has been treated, cervical carcinoma in situ (pre-cancer) that has been treated, or those with a low risk of either their cancer coming back, or spreading to other parts of the body.

So far, we haven’t seen any data about how effective the vaccine was in these people, nor how many were on the trials – we’ll be looking out for this information as it emerges.

The UK government has already pre-ordered 100 million doses of this vaccine.

23 November – Last trials of COVID-19 ‘antibody cocktail’ treatment begin

In addition to vaccine development, AstraZeneca have started large-scale trials of an “antibody cocktail” aimed at providing short-term protection to people with a weakened immune system, who would be unlikely to develop immunity after a vaccine. Antibodies form a key part of the immune system’s response to infection and it’s hoped that these antibodies developed in the lab will help the immune system to fight off the virus. AstraZeneca have described it as “almost like a passive vaccination.”

5,000 people around the world will be taking part in the trial of this treatment that scientists hope could give individuals immediate protection lasting up to 1 year. If successful, this may make up part of the UK’s wider COVID-19 treatment portfolio and be available to people whose immune systems are compromised.

23 November – Experts react to COVID-19 vaccine news

Like most of us, Cancer Research UK-funded experts have been following the news closely and have called the progress ‘exceptional’.

News of an effective COVID vaccine is great to hear. Having a vaccine will make the world safer, which means it will be safer for people with cancer too and it will become much easier for cancer treatments to continue.

We look forward to getting a better understanding of the best time to give the vaccine to cancer patients to give them the best level of protection.

– Martin Ledwick, Cancer Research UK’s head information nurse

Normal drug or vaccine development would take in the range of 5-10 years, sometimes much longer, so these developments have been extraordinary.

But experts have been keen to emphasise that the rapid turnaround of the COVID-19 vaccines isn’t because standards have dropped. In fact, the COVID-19 trials have involved more people than standard vaccine trials and have been able to draw on cutting-edge developments in technology and data analysis.

The extraordinary progress is in part because scientists, governments, industry and academic institutes around the world have turned their focus to this one goal. And to further accelerate development, different phases of vaccine trials and production have overlapped.

Copy this link and share our graphic. Credit: Cancer Research UK.

Finally, while the initial results are extremely promising, it’s early days yet. Preliminary data from one vaccine trial led by Pfizer suggested the vaccine offered 90% protection against developing COVID-19, whilst more recent data revealed the vaccine was 94% effective in over-65s. Initial reports from a second vaccine trial made by Moderna disclosed similar figures.

Experts expect more results – including important safety data – to materialise in the next 4 to 6 weeks. Vaccination will only be approved once it has passed the usual high standards set by the Medical and Healthcare products Regulatory Agency (MHRA) in the UK.

You can read more about the various COVID-19 vaccines in this piece by journalist Tom Chivers, who’s taking part in the Oxford-AstraZeneca vaccine trial.

23 November – Who’s taken part in COVID-19 vaccine trials?

We don’t have information on how many people living with cancer, or with a history of cancer, have been involved in COVID-19 vaccine trials so far. But some people with cancer have been able to take part in these trials, although who can take part varies from trial to trial.

For example, the earliest phase of the Pfizer trial involved healthy people aged 18 to 55 or 65 to 85. People with pre-existing conditions were able to take part as long as they didn’t require a significant change in therapy or hospitalisation for worsening disease in the 6 weeks prior to enrolment.

In later phases of the trial (phases 2 and 3) the lower age limit was reduced to 16 years old and individuals identified as being in a ‘high-risk’ group based on their use of public transport, being a frontline essential worker or other factors were included. Although people with cancer weren’t explicitly excluded from this list, those who are immunocompromised or receiving immunosuppressive therapy were not able to take part, and anyone taking part needed to have stable disease prior to enrolment.

For the late phase trials of the Oxford vaccine, anyone over the age of 18 who’s considered to be ‘medically stable’ – someone who’s not expected to be hospitalised or change their therapy less than 3 months before enrolment – could enrol in the trial. The criteria for the Oxford trial explicitly excludes anyone with a history of cancer, apart from a few cancer types, or those with a low risk of either their cancer coming back following curative treatment or spreading to other parts of the body.

Another vaccine that’s hit the news recently is the Moderna vaccine. Similar to the Oxford vaccine trial, medically stable people aged 18 or over were able to take part in the Moderna vaccine trials. However, those who are immunocompromised or have taken immunosuppressive treatments in the 6 months before the trial were not able to enrol.

Beyond vaccine trials, studies looking at how people with cancer’s immune systems respond to COVID-19 may also provide useful information on if the vaccine will be effective for people with specific types of cancer.

Lilly, Katie, Angs and Lyndsy