Coronavirus guidance for children with cancer
This guidance was developed by CCLG for children and young people with cancer undergoing treatment.
Guidance updated 17 November 2022 (updated sections/new sections coloured red)
This guidance is intended for children and young people on active cancer treatment up to the age of 18 and for those who have received a bone marrow transplant (BMT), also called a stem cell transplant (SCT). There is separate guidance if your child is over 19.
As the situation changes, we recommend checking with the Government advice to keep up to date with the latest guidance.
Our guidance remains the same:
- Children with cancer in the UK remain at low risk of severe SARS-CoV-2 infection
- Standard infection precautions should continue for children with cancer
- Vaccination with the autumn booster is recommended for children aged over 5 years old
- It is important that children with cancer also receive their seasonal influenza (flu) vaccine
This information is based on the UK Government and Public Health England advice and may differ from guidance issued from other countries. It will be regularly updated as and when new information is available. It has been written by experts in Childhood and Teenage cancer to reflect the particular needs of our patients. This guidance is consistent with the advice from the Royal College of Paediatrics and Child Health and has been developed with them.
We acknowledge there is a huge amount of information online and this can be overwhelming and sometimes conflicting, causing even more worry and stress. It is important that families make sure that information is filtered and gathered from reliable, easy to understand sources. CCLG’s booklet ‘Searching for information and support online’ has further information.
Update – 17 November 2022
Update on vaccination of children with cancer including information on the autumn booster vaccine
What are the current 2022 recommendations for the autumn booster COVID-19 vaccination in children over 5 years who are undergoing treatment for cancer?
This winter (2022/23), it is expected that many respiratory infections, including COVID-19 and flu, may be circulating at high levels. Therefore, children who are five years and older in clinical risk groups are recommended to receive an autumn booster of the COVID-19 vaccine. This should be given at least three months after your child’s last dose of vaccine and given between September and December 2022. More information can be found here.
Children in high-risk groups who turned five years of age after August 2022 are eligible for primary vaccination and can also receive a booster during the autumn programme, provided there is at least three months since their second (or third) primary dose.
Children with cancer between five and 15 years old who are currently eligible to receive the COVID-19 vaccine and the autumn 2022 booster include those who are immunosuppressed due to disease or treatment, including:
- those undergoing chemotherapy or radiotherapy, solid organ transplant recipients, bone marrow or stem cell transplant recipients
- those with haematological malignancy, including leukaemia and lymphoma
- those receiving immunosuppressive or immunomodulating biological therapy (usually end with –nab such as rituximab)
- those treated with or likely to be treated with high or moderate dose corticosteroids
- those receiving any dose of non-biological oral immune modulating drugs e.g. methotrexate, azathioprine, 6-mercaptopurine or mycophenolate
- those with auto-immune diseases who may require long term immunosuppressive treatments.
As with other vaccinations, we know that giving a COVID-19 vaccine during chemotherapy is likely to produce a small protective response. The timing of vaccination should fit with chemotherapy cycles as we do with seasonal influenza vaccines.
We advise you to speak with your treating team who will be able to offer advice as to the best timing for your child to receive the vaccine depending on their treatment plan.
Which vaccine will my child be offered as part of the autumn booster programme?
For information on the vaccine your child will be offered and recommended doses, visit the CCLG website.
What if my child undergoing treatment for cancer has a healthy sibling over five years old? Should the sibling receive the autumn booster vaccine?
Yes. To reduce the risk of exposure, household contacts (if aged five years and over) of individuals with immunosuppression are also eligible for primary vaccination and boosting in the 2022 autumn campaign.
Should adult household contacts of immunosuppressed children receive an autumn 2022 booster vaccine?
Yes. All persons aged five to 49 years who are household contacts of people with immunosuppression are eligible for a COVID-19 booster vaccine in autumn 2022. All adults over 50 years old are offered a booster vaccine too.
Where can I find more specific guidance regarding my child who has received or is due to receive a donor bone marrow (stem cell) transplant?
The Bone Marrow Transplant Group have been collecting data across Europe about COVID-19 in children who have had a donor bone marrow (stem cell) transplant. Specific information about transplant patients can be found here.
How do I keep myself up to date about COVID-19?
Keep checking the Public Health England website for regular updates.
What if I have some more questions?
Please speak to your child’s consultant or any member of the team in your treating centre.
This information was written by the Children’s Cancer and Leukaemia Group (CCLG)
Original version written by Dr Jessica Bate, Consultant Paediatric Oncologist, Southampton Children’s Hospital and Chair, CCLG Supportive Care Group on behalf of the CCLG Executive.
Updated version 17 March revised by Dr Jessica Bate with Dr Bob Phillips, Honorary Consultant in Paediatric Oncology, Leeds Teaching Hospitals, Prof Richard Grundy, CCLG Chairman and Ashley Gamble, CCLG CEO. This information was discussed and reviewed by a national group comprising medical representatives from all UK paediatric oncology Principal Treatment Centres, with representation from Young Lives vs Cancer and Bloodwise.
Updated version 23 March and 24 March revised by Dr Jessica Bate with Dr Bob Phillips, Prof Richard Grundy, Ashley Gamble, Dr Geoff Shenton, Consultant Paediatric Haematologist, Newcastle and Dr John Moppett, Consultant Paediatric Oncologist, Bristol.
Subsequent updates revised by Dr Jessica Bate with Dr Bob Phillips, Prof Richard Grundy, Ashley Gamble, Dr Geoff Shenton and Dr John Moppett
Other useful information
The One Cancer Voice group of charities have developed some further general guidance for cancer patients which you may find useful, although this is primarily aimed at adults with cancer. Download One Cancer Voice advice on coronavirus for people with cancer.