Revaccination after stem cell transplant – Moderna vaccine. Risk of getting the incorrect dose

I would like to make everyone aware of the risk of getting the booster dose of the Moderna vaccine instead of the primary dose. The booster dose of Moderna is half the primary dose. The booster dose of Pfeizer is the normal primary dose.

I became aware of this problem as I was advised that I could start the revaccination at a local pharmacy. Nurses and pharmacists were very helpful. It wasn’t until I was about to have the vaccination that I questioned the dose. According to the NHS vaccination record I was only eligible for a booster, not a primary vaccination. I had to leave without having had the vaccination.

As I don’t live too far from the hospital where I had the transplant and they have a walk-in vaccination center I was able to have the correct full dose of Moderna later that day. Somehow the hospital clinician was able to override the NHS vaccination record.

My concerns are:

  1. Some health professionals and stem cell patients might not be aware of the difference between the Moderna booster and primary dose.
  2. The NHS vaccination record does not allow all clinicians to record/administer revaccinations.
  3. How will my second primary and future boosters be recorded? Will it continue to be a problem to have them done locally?
  4. There are no guidelines for vaccination centers regarding revaccination of transplant patients.
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Hi @Berit a warm welcome to the forum - thank you very much for sharing your experiences with this though I’m sorry to hear that the process wasn’t simple for you.

I have spoken to our Covid-19 Policy Officer about this, and they responded explaining that we are currently asking the Dept. of Health for:
(1) Mandatory training for clinical leads at vaccination centres and pharmacies on the Green Book and National Protocol before each new roll-out (there is guidance in the Green Book about re-vaccination after stem cell transplant).
(2) Regular auditing of the assessment and consenting process at non-controlled sites (e.g., vaccination centres and pharmacies)
(3) The establishment of a freephone number whereby patients who are refused despite their eligibility can call, and the freephone NHSE call handler would speak with the clinical lead on site and point them to the relevant section of the Green Book

I also wanted to add that Anthony Nolan has been working with NHSE on this issue and produce some useful documents for people undergoing revaccination after stem cell transplant -

COVID-19 vaccines for stem cell transplant patients | Anthony Nolan

COVID-19 Vaccination After Stem Cell Transplant UPDATE 22-04-2022.pdf (anthonynolan.org)

If you want to talk through this further, we’re only a phone call or an email away on 0808 2080 888 and support@bloodcancer.org.uk

How have you been getting on since your transplant? I do hope you find this forum a useful source of support.

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Hi @Berit welcome to our forum and thanks for your post and it is very interesting.
We don’t know what we don’t know.
People giving the vaccines don’t know what they don’t know.
When I was first diagnosed the GP said to me that I had to be responsible for my diagnosis. I had no idea what she meant then but there have been so many times over the years where I have had to tell or remind other medical or dental departments about my Chronic lymphocytic leukaemia (CLL).
As a minority group of the population we so often get forgotten.
I have left @Alice_BloodCancerUK to answer your questions
Good for you getting it sorted in the end
Look after yourself and I look forward to hearing more about you.

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@Erica
100% agree with your statement, I have had to help educate my GP practice with taking in Blood Cancer Uk and Myeloma UK leaflets and stuff as most of them don’t have an understanding of it. I have had to manage my own childhood vaccination in terms of time line, booking them all in with them and ensuring I get the right dose and type, been the same principle with Covid vaccinations. This has added a different complication to my childhood vaccinations as at time I have had to split them as my consultant always told me that between any vaccination I needed to allow 10 days which seemed to be a shock to my doctors surgery. All have gone well but it takes a lot of management and organization. When I got I’ll with a chest and eye infection I had to be carefully as well to challenge the doctors giving me medication for this that they had considered it with my other medication to ensure nothing reacts.
The key I have learnt is you can’t rely on there systems being right I go to 3 different hospitals and my GP none of them update there system even in the same NHS chain so if one changes something it becomes you as the individual advising the others.
All has gone okay though.

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Dear Alice,
Thank you so much for this information. I will send the template re revaccination to my transplant team at UCLH.
Kind regards
Berit Moback

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