The vaccines and health conditions

There are very few people who cannot get the coronavirus vaccine.

You should not get the coronavirus vaccine if you've had a confirmed anaphylactic reaction to:

  • any of the ingredients in the vaccine
  • a previous dose of the vaccine

The coronavirus vaccine is suitable for people with disorders of the immune system.

People with underlying health conditions

The Joint Committee on Vaccination and Immunisation (JCVI) recommended that the vaccine was offered first to those at highest risk of getting coronavirus and of suffering serious complications if they get coronavirus. Health conditions that put people aged 16 years and over at higher risk include:

Chronic respiratory disease

Severe lung conditions, including:

  • asthma that requires continuous or repeated use of systemic steroids or with previous exacerbations requiring hospital admission (patients who are well controlled on asthma inhalers are not eligible in priority group 6 for coronavirus vaccination)
  • chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema bronchiectasis
  • cystic fibrosis
  • interstitial lung fibrosis
  • pneumoconiosis
  • bronchopulmonary dysplasia (BPD)
Chronic heart disease and vascular disease

Conditions such as:

  • congenital heart disease
  • hypertension with cardiac complications
  • chronic heart failure
  • individuals requiring regular medication and/or follow-up for ischaemic heart disease
  • atrial fibrillation
  • peripheral vascular disease
  • venous thromboembolism
Chronic kidney disease

Conditions such as:

  • chronic kidney disease at stage 3, 4 or 5
  • chronic kidney failure
  • nephrotic syndrome
  • kidney transplantation
Chronic liver disease

Conditions such as:

  • cirrhosis
  • biliary atresia
  • chronic hepatitis
Chronic neurological disease

Conditions such as:

  • stroke
  • transient ischaemic attack (TIA)
  • conditions in which respiratory function may be compromised due to neurological disease (e.g. polio syndrome sufferers)
  • cerebral palsy
  • severe or profound learning disabilities
  • Down’s Syndrome
  • multiple sclerosis
  • epilepsy
  • dementia
  • Parkinson’s disease
  • motor neurone disease and related or similar conditions
  • hereditary and degenerative disease of the nervous system or muscles
  • severe neurological disability
Diabetes mellitus

Any diabetes, including diet-controlled diabetes and gestational diabetes.

Immunosuppression

Conditions or treatments such as:

  • immunosuppression due to disease or treatment, including patients undergoing chemotherapy leading to immunosuppression
  • undergoing radical radiotherapy
  • solid organ transplant recipients
  • bone marrow or stem cell transplant recipients
  • HIV infection at all stages
  • multiple myeloma or genetic disorders affecting the immune system (e.g. IRAK-4, NEMO, complement disorder, SCID)
  • receiving immunosuppressive or immunomodulating biological therapy including, but not limited to anti-TNF, alemtuzumab, ofatumumab and rituximab
  • receiving protein kinase inhibitors or PARP inhibitors
    being treated with steroid-sparing agents such as cyclophosphamide and mycophenolate mofetil
  • being treated with or likely to be treated with systemic steroids for more than a month at a dose equivalent to prednisolone at 20mg or more per day for adults

This also includes:

  • anyone with a history of haematological malignancy, including leukaemia, lymphoma, and myeloma
  • anyone with systemic lupus erythematosus and rheumatoid arthritis,
  • anyone with psoriasis who may require long term immunosuppressive treatments
  • anyone with Addison’s disease
Asplenia or dysfunction of the spleen

This also includes conditions that may lead to splenic dysfunction, such as homozygous sickle cell disease, thalassemia major and coeliac syndrome.

Morbid obesity

Adults with a Body Mass Index (BMI) greater than or equal to 40.

Severe mental illness

Conditions such as schizophrenia, bipolar disorder, or any mental illness that causes severe functional impairment.

If you're taking medication

You’ll be asked some questions at your vaccination appointment to make sure that there are no reasons for you not to have the vaccine.

You'll also have an opportunity to ask any questions or discuss concerns you may have.

People with bleeding disorders or taking medication to thin their blood or reduce bleeding

People taking medication to thin the blood, such as warfarin, can safely receive the coronavirus vaccine as long as their treatment is stable.

You should let the person giving you the vaccine know what medication you are on.

Stable means you will have been taking the same dose for a while and if you are on warfarin, your:

  • INR checks are up to date
  • your latest INR level was in the right range

People with bleeding disorders should consult their specialist or their individual care plan for advice on vaccination.

Cancer treatment and the vaccine

It is recommended that all patients with cancer, including all those receiving systemic anti-cancer therapy (which includes cytotoxics, immunotherapy and targeted therapies), radiotherapy or steroids, should consider getting the coronavirus vaccine.

The Joint Committee for Vaccination and Immunisation (JCVI) consider both the Pfizer BioNTech, AstraZeneca and Moderna coronavirus vaccines to be safe for patients with suppressed immune systems.

Immunosuppression may however reduce the effectiveness of vaccines.

Patients should not assume they are immune after receiving the vaccine, and strictly adhere to measures to reduce exposure to the virus.

This same advice is given to everyone receiving the vaccine.

If you’re about to receive planned immunosuppressive therapy, your doctor may advise you to get the vaccine before starting therapy (ideally at least two weeks before), when your immune system is better able to respond.

Where possible, it is preferable for the 2 doses to be given before starting immunosuppression treatment. For this group only, it is recommended that the second dose is given either 3 or 4 weeks after the first dose, depending on the vaccine given to provide maximum benefit.