Advice for those who are severely immunosuppressed around COVID-19 vaccine doses

If you are severely immunosuppressed and have questions about the COVID-19 vaccine and which doses to have when, find out everything you need to know here.

Below are common questions and answers, featuring video clips with Dr Richard Preece, NHS North West Medical Director for COVID-19 Vaccination.


Q. Am I severely immunosuppressed (SI)?

A Your GP or hospital doctor will have informed you if you are classed as SI and you will have received a letter from the NHS advising you of this. If you are concerned that you are and may have received a letter but cannot find it, please get in touch with your GP or hospital doctor for advice.


Q. Which doses of COVID-19 vaccine should I have and when?

A. People aged 12 and over who are SI have what are known as three ‘primary’ doses, a booster dose and those eligible will be invited for a spring booster very soon. There is more information about the spring booster at the bottom of this page.

Like all people who are eligible for a COVID-19 vaccine, it is recommended that you have a first dose, followed by a second dose 8 weeks later.

For most people, a booster dose is offered 12 weeks later, but it is different for people who are severely immunosuppressed. People who are SI will be offered a third ‘primary’ dose and booster doses doing forward.

Your GP or consultant will be able to recommend when to have the third dose and the booster doses and the gap between them depending on the reasons you are classed as SI. Please get in touch with them if you are concerned or haven’t heard from them.


Q. Why do I need so many doses?

A. If you are SI, you need extra doses of the COVID-19 vaccination as you need a bit more of a nudge to your immune system. Because you have, or had, a weakened immune system at the time of your first two doses, you need the extra protection of a third primary dose, additional booster doses to ensure you have maximum protection from COVID-19.


Q Is the dosage different to those given to people who are not severely immunosuppressed?

A. No, the dosage of each jab (first, second, third and additional boosters) is the same as the dosage of vaccine for anyone who is not classed as SI.


Q. How do I show staff at vaccination sites that I am immunosuppressed and that I need these extra doses?

A. After you have had your first two doses, you can take a letter you should have received from your GP or hospital doctor to any walk-in site that is offering a third or additional booster doses for people with a weakened immune system.

People with a weakened immune system who don’t have a letter from their GP or hospital doctor inviting them for a third or booster dose can still get a third or additional booster dose vaccinations by taking alternative evidence to a walk-in vaccination site instead.  You must bring with you either:

  • a hospital letter that describes the condition or treatment that caused you to have a weakened immune system
  • a prescription or a medicine box with your name and the date showing when the medicine was prescribed.

These must show that you had a weakened immune system at the time of your first or second dose. A clinician at the site will check to make sure that you’re eligible for a third or booster dose.

A conversation at the vaccination centre with an appropriate clinician may also be sufficient to confirm that the individual is eligible.

An appropriate clinician would include healthcare professionals who are familiar with medicines and treatments that cause immunosuppression and are able to understand your medical history, however these are not at every vaccination site.

Q. Is there also a spring booster?

A. In February, it was advised that there be a spring dose of the COVID19 vaccine for:
  • adults aged 75 years and over
  • residents in care homes for older adults
  • individuals aged 12 years and over who have a weakened immune system
The NHS will contact those who are eligible to make a spring booster appointment, so people should wait until they hear from the NHS.
The NHS will prioritise those whose clinical need is greatest, as it has throughout, starting with those who have had a bigger gap since their last dose.
Everyone who is eligible will be offered a top up between three and six months over the Spring and early Summer.
Again, this is to ensure that you are as protected as possible from COVID-19.