People considered to be at increased risk from COVID-19 include those with a weakened immune system and a wider group of people such as those with an underlying health condition.

People with a weakened immune system

If you have a weakened immune system, you can get a further COVID-19 vaccination this spring. This includes if:

• You have or previously had blood cancer (such as leukaemia, lymphoma or myeloma)
• You have had an organ, bone marrow or stem cell transplant
• You have HIV (at all stages)
• You have a genetic disorder affecting the immune system
• You are having a treatment such as biological therapy, chemotherapy or radiotherapy
• You are treated with certain medicines that increase your risk of infection, including strong steroids (such as azathioprine, dexamethasone, prednisolone, ciclosporin or mycophenolate, depending on your dosage)
• You are treated with long-term immunosuppressive medicines for conditions such as lupus, rheumatoid arthritis, inflammatory bowel disease, scleroderma and psoriasis.

If you’re unsure if you have a weakened immune system, speak to your pharmacy team, GP practice or specialist for advice.

Other people at increased risk from COVID-19

If you are in one of the below groups, you are identified as at increased risk from COVID-19. You are not considered to have a weakened immune system.

You can currently only get a 1^st or 2^nd dose of the COVID-19 vaccine if you haven’t already had these vaccinations. You cannot get a further dose this spring unless you are also:

• aged 75 or over (by 30 June 2023), or
• live in a care home for older adults, or
• have a weakened immune system (see ‘People with a weakened immune system’ above).

Adults aged 16 years and over:

• a long-term lung condition, such as chronic obstructive pulmonary disease (COPD), asthma (if you need steroid tablets) or cystic fibrosis
• a long-term heart condition, such as congenital heart disease, chronic heart failure or atrial fibrillation
• long term kidney disease (CKD) stage 3, 4 or 5
• a severe liver disease, such as cirrhosis
• a long-term problem with the brain or nerves, such as epilepsy, cerebral palsy, multiple sclerosis, motor neurone disease, Huntington’s disease, myasthenia gravis, or a stroke or transient ischaemic attack
• severe or multiple learning disabilities (or being on the learning disability register), such as Down’s syndrome
• diabetes or another hormone disorder, such as Addison’s disease
• problems with the spleen, having no spleen or having a condition that can affect the spleen (such as sickle cell disease)
• being severely obese (having a body mass index (BMI) over 40 or above)
• a severe mental illness, such as schizophrenia or bipolar disorder
• being pregnant (all stages)
• living in a long-stay nursing and residential care home as a younger adult.

Children aged under 16 years:

• a long-term lung condition, such as chronic obstructive pulmonary disease (COPD), asthma (if you need steroid tablets) or cystic fibrosis
• a long-term heart condition, such as congenital heart disease or chronic heart failure
• a long-term condition of the kidney, liver or digestive system
• a long-term problem with the brain or nerves, such as epilepsy, cerebral palsy, multiple sclerosis, an inherited condition or autism
• severe or multiple learning disabilities (or being on the learning disability register), such as Down’s syndrome
• diabetes or another hormone disorder, such as Addison’s disease
• problems with the spleen, having no spleen or having a condition that can affect the spleen (such as sickle cell disease)
• a serious genetic condition that affects multiple systems in the body, such as mitochondrial disease
• being pregnant (all stages)
• living in a long-stay nursing and residential care home as a younger adult.

Please note that these are summary lists and do not cover everything. For a full list of conditions and criteria, please see Chapter 14a (tables 3 and 4) of the Green Book.

After 30 June 2023

If you are eligible for a spring vaccination, or if you haven’t had your 1^st or 2^nd dose, the last date you will be able to get vaccinated is 30 June.

After this date, you will only be eligible for a 1^st or 2^nd dose if you are at increased risk from COVID-19 and in most cases, you will have to wait until the autumn to get these vaccinations. If you develop a new health condition or start treatment that severely weakens your immune system, an exception may be made if your clinician advises you to get vaccinated sooner.