Covid antiviral treatments for people with blood cancer

If you have blood cancer, you may be eligible for a telephone assessment after a positive covid test. You are eligible if you:

• have had treatment in the last 12 months (not including aspirin), including people with chronic blood cancers such as CML, even if in molecular response or on TKIs, and myeloproliferative neoplasms (MPN) (including essential thrombocythaemia (ET), polycythaemia vera (PV) and myelofibrosis)
• had a stem cell transplant in the last 12 months - either a donor transplant (allogeneic) or a transplant using your own stem cells (autologous)
• have active graft vs host disease (GvHD) regardless of how long ago the transplant was
• had CAR-T therapy in the last 24 months
• have been diagnosed with CMML, MDS, myelofibrosis, myeloma (not including MGUS), or a chronic B-cell lymphoproliferative disorder (e.g. CLL, hairy cell leukaemia, follicular lymphoma, SLL, marginal zone lymphomas, MALT lymphoma, Waldenström macroglobulinaemia), regardless of treatment
• have been diagnosed with a mature T-cell malignancy (e.g. peripheral T-cell lymphomas, cutaneous T-cell lymphomas, T-cell prolymphocytic leukaemia, T-cell large granular lymphocytic leukaemia).

People with other conditions such as solid cancers, kidney disease and liver disease may also eligible for assessment.

If you are told you are not eligible for an assessment, but you think you should be, contact your hospital team straight away. Always let your hospital team and GP know if you test positive for covid.

If you test positive for covid, you can access covid treatments in these ways:

• Call NHS 111
• Contact your hospital team
• Contact your GP.

In some areas, you can refer yourself for treatment. You can find out from your local ICB. Find your local Integrated Care Board on the NHS website.

If you are able to refer yourself, make sure you have the following information ready:

• the date you tested positive
• the date your symptoms started
• your current address (including where you’re staying if you’re away from home)
• a contactable phone number
• your current medical condition(s)
• your current medications

Whoever you speak to, tell them that you:

• are immunosuppressed
• have tested positive for covid
• think you are eligible for treatment.

Normal prescription costs apply for covid treatment in England. However, if you have blood cancer, you can get a Medical Exemption Certificate, which entitles you to free prescriptions. Find out more about free prescriptions.

If you get symptoms of covid, you should take a lateral flow test as soon as possible. If it’s positive, you’ll need to report your positive test online or call 0800 008 6587.

Then contact your NHS Health Board. You can find contact numbers for each Health Board here.

Whoever you speak to, tell them you:

• are immunosuppressed
• have tested positive for covid
• think you are eligible for treatment.

For more information, go to NHS Inform.

If you get symptoms of covid, take a lateral flow test as soon as possible. If you test postive, contact your GP straight away. Tell them that you:

• have symptoms of COVID-19
• have tested positive for COVID-19
• believe you are in the highest risk group and are eligible for treatment. 

Alternatively, call NHS 111 for advice or contact your hospital team.

For more information, read the Welsh Government's information about covid treatments.

If you get symptoms of covid, you should take a lateral flow test as soon as possible. If it's positive, contact your GP. If your GP refers you for an assessment, your local Health and Social Care Trust will call you. This call may be from an unknown or withheld number.

You'll find more information on the NIDirect website.

Make sure you keep a box of rapid lateral flow tests at home. Free testing is no longer available to the general public, but if you are eligible for covid treatments, you can still get free tests.

You can also use tests you buy from a pharmacy. The results of these will be accepted.

If you get covid symptoms, take a rapid lateral flow test as soon as possible. If it’s positive, follow the instructions for how to access treatments for your country (see above). If the test is negative, but you have covid symptoms, continue to take lateral flow tests daily.

If you want to get free tests from a pharmacy (England, Wales and Northern Ireland), take a copy of a letter or email that shows you are eligible for covid treatments. This is not essential but will help confirm that you should have free tests.

A friend, relative or carer can collect tests for you. They should take a letter or email confirming your eligibility for covid treatments, plus these personal details:

• your condition or conditions
• your NHS number
• your full name
• your date of birth
• your address

Accessing free tests in England

You can pick up free rapid lateral flow tests from some pharmacies. You can check for pharmacies that offer free lateral flow tests by entering your location into this NHS pharmacy finder.

Accessing free tests in Scotland

You can order free rapid lateral flow tests from the NHS Scotland portal. You will need an existing login or you can register online or by phone.

Accessing free tests in Wales

In Wales, you can collect free rapid lateral flow tests from some pharmacies. Use the NHS Wales online search to find a pharmacy near you that provides free tests. Put in your postcode and check the box that says "Supply of COVID Lateral Flow Test Kits".

Accessing free tests in Northern Ireland

In Northern Ireland, you can collect free rapid lateral flow tests from some pharmacies.

• Make sure you have contact details for your GP and hospital team's out of hours services, in case you test positive at the weekend or any time outside their normal working hours.
• Keep a list of your medical conditions and all your medications handy - this will help you during any telephone assessments for covid treatment.
• If you are having medical care for any other health condition as well as blood cancer, speak to both your blood cancer specialist and your other specialist now. Make sure they both know that you might need their input quickly if you get covid and need antiviral or antibody treatments.
• If you have problems asking for covid treatment, contact your Integrated Health Board in England, your Health Board in Scotland, your Health Board in Wales or your Health and Social Care Trust in Northern Ireland.

Across the UK, people with blood cancer aged 18 and above who test positive for covid may be eligible for:

• Paxlovid (nirmatrelvir/ritonavir)
• Lagevrio (molnupiravir), if Paxlovid is unsuitable.

These medicines aim to prevent hospitalisation or serious illness in people who are most at risk.

If you have a positive test, you would need to have an assessment with a healthcare professional, to find out if you need treatment.

Treatments are available across the UK, although the process for how to access them varies in the different countries - see above.

These treatments have been found to be safe and effective at reducing the risk of hospitalisation and death for people with blood cancer who get covid. The treatment you have (if any) will be based on a personal assessment with a qualified healthcare professional about the different benefits and risks.

Paxlovid (nirmatrelvir and ritonavir)

• antiviral treatment (made up of nirmatrelvir and ritonavir)
• taken as tablets at home
• can be used in people aged 18+
• 88-89% relative risk reduction of hospitalisation or death
• should be given within 5 days of covid symptoms starting, but this can be extended to 7 days if needed
• more about Paxlovid

There are lots of health conditions and other medicines that can interact with Paxlovid. With some, you shouldn’t take Paxlovid at all, with others, your doctor should consider this with you before making a decision. The drugs include some cancer drugs, immunosuppressants, painkillers, drugs for infections, blood clot prevention drugs, hormonal contraceptives, and other medicines. So any decision about starting Paxlovid would need to follow a discussion about the type of blood cancer you have, other health issues and the medication you are taking.

Lagevrio (molnupiravir)

• to use if Paxlovid is unsuitable
• antiviral treatment
• taken as tablets at home
• can be used in people aged 18 and over
• should be started within 5 days of covid symptoms starting
• more about Lagevrio.

If you are thinking of travelling away from home, do discuss this with your healthcare team or doctor first. Ask them:

• What do I need to think about before travelling?
• What should I do if I test positive for covid while I'm away?

Not everyone with blood cancer needs antivirals or antibody treatments for covid, but some do. For many people, covid can seem mild at first but then get worse.

Before you go away, make sure you:

• have all of your covid vaccinations on offer (usually twice a year in spring and autumn)
• ask your hospital team what you should do if you get covid while you are away
• have contact numbers for your hospital team, including numbers for evenings and weekends
• take a recent clinic letter and any medication paperwork with you
• take lateral flow tests away with you, and test if you get symptoms
• get travel insurance if you can
• ask your hospital team for a letter to take with you, covering your current diagnosis and treatment, an overview of your condition, a medication list, your fitness to travel, and eligibility for covid treatment.

If you get covid while you are away, tell your hospital team straight away and get their advice.

You can also check the policy for covid treatments in the country you are visiting by contacting their health authority. If you have a UK European Health Insurance Card (UK EHIC) that hasn’t expired yet, or a UK Global Health Insurance Card (UK GHIC), you can access the same medical treatments as residents of the country you are in.

So if covid treatments like Paxlovid are available, and you would be eligible for it according to that country’s guidance, you might be able to access it there.

There are some people that might not be eligible for the covid treatment, according to the list above. This includes:

• people who have CML, ET, PV AND who have not had any anti-cancer treatment in the last 12 months (aspirin doesn't count as a cancer treatment), no CAR-T therapy in the last 24 months, and no active graft vs host disease (GvHD).

The full guidance on eligibility is available here.

People with these conditions are unlikely to be eligible for covid treatment. But if you are worried, it might still be worth asking for an assessment. Follow the instructions for your country above.

Antivirals work by interfering with the way the coronavirus replicates and reproduces in our body.

On their own, viruses can’t make more versions of themselves. What makes them effective, is their ability to enter our own cells and hijack a toolbox in our cells that allows them to multiply. Antivirals stop this from happening, and the less virus there is in our body, the lower the risk of more severe illness.

Paxlovid (nirmatrelvir and ritonavir) and (Lagevrio) molnupiravir are both antiviral treatments.

Research is going on into treatments that may stop vulnerable people getting covid in the first place. However, none are currently available on the NHS in the UK.

In 2022, initial studies showed that an antibody treatment called Evusheld may be effective at preventing covid. However, it was not proven to work against current and future covid variants. It therefore did not get approval for use on the NHS and is no longer available privately in the UK.

Since then, the drug company AstraZeneca has produced another antibody treatment intended to prevent covid infection in people with suppressed immune systems. This drug is called Sipavibart. Although a study showed effectiveness against some variants of covid, it has not been proven to work against newer variants. An application to have Sipavibart considered for use on the NHS was suspended in late 2024 and has not been restarted.

Blood Cancer UK are funding and coordinating research into how covid is affecting people with blood cancer, and how well the covid vaccines are working. Together with other charities, we are investing £800k in vaccine efficacy research.

We report on our own research findings, and findings from other key studies. Find out what we know so far about covid vaccine efficacy for people with different blood cancers.

Information last updated: October 2026. Next review due: April 2027