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Coronavirus and COVID-19

Guidance for high-risk groups

Some people with long-term lung conditions are at higher risk of severe illness from coronavirus. These people were in the group described as ‘clinically extremely vulnerable (CEV)’, formerly known as the ‘shielding group’. Now the shielding programme has ended, find out what to do if you were in this group.  

If you think you have developed symptoms of coronavirus, such as a fever or new continuous cough or a loss or changed sense of normal smell or taste, get advice from the NHS 111 online service or call NHS 111.

Who was considered clinically extremely vulnerable (CEV)?

People were viewed as clinically extremely vulnerable if they were at high risk of severe illness as a result of COVID-19 and were more likely to be admitted to hospital. This included some people with long-term lung conditions.

At the beginning of the pandemic, people who were considered at much higher risk from COVID-19 were asked to shield. Shielding was introduced as a method of protecting the most vulnerable people from serious illness from the virus.

Why has the shielding programme ended?

People who were in the clinically extremely vulnerable group, who were asked to shield at the start of the pandemic, are now being advised to follow the same guidance as everyone else. The government paused the shielding programme in April, and it has now been confirmed that the shielding programme is closed in England.

This means that anyone who was in the clinically extremely vulnerable group is no longer required to shield. Shielding was needed at the start of the pandemic as one of the few ways to protect those who were most vulnerable. But restricting people’s movements to protect them can also have a negative effect on some people’s mental and physical wellbeing.

If you were on the shielded patient list and live in England, you will get a letter telling you the list has closed.

Experts will continue to assess the risks from COVID-19 to the most vulnerable, but given what they know about the virus now, it is thought unlikely that people will be asked to shield again.

COVID-19 hasn’t gone away, but the situation is very different to how it was at the start of the pandemic. 

For example, there is now:

  • A vaccination programme, including a booster vaccine
  • The Test, Trace and Isolate system to help prevent transmission of the virus
  • Up-to-date expert advice on how to manage your own risk
  • Free availability of lateral flow tests
  • New drugs available to treat serious illness.

Find shielding guidance if you live in Scotland, Wales or Northern Ireland.

What can I do to stay safe?

Everyone should be doing what they can to prevent the spread of COVID-19, to help protect ourselves and those around us.

If you were previously in the clinically extremely vulnerable group (formerly known as the shielding group) you might be feeling anxious about the government ending the shielding programme in England and wondering how you can keep yourself safe.

Coronavirus vaccine and the booster

Everyone aged 12 and over who is considered at higher risk from COVID-19, or who lives with someone who is immunosuppressed can get the coronavirus vaccine.

If you are at higher risk of coronavirus, or live with someone who is immunosuppressed, and have not yet had your vaccine you should book one as soon as possible.

Third primary dose of the vaccine for immunosuppressed people

People aged 12 and above with a severely weakened immune system are also being offered a third primary dose of the COVID-19 vaccine as part of the initial vaccine programme. The British Thoracic Society (BTS) has said that this will include some people with lung conditions who are on certain steroid doses. The JCVI has full details of who is eligible.

The third dose should be given at least eight weeks after the second. However, timings may be affected if the person is on any immunosuppressive therapies.

It’s important to note that the third dose is separate to the winter booster vaccine campaign.

Booster vaccines

The government have announced a vaccine booster programme this autumn to give people at higher risk additional protection from coronavirus over the winter months.

People aged 16-49 with an underlying health condition that puts them at higher risk of severe COVID-19 (people who were in priority groups 4 or 6 for the initial vaccine programme) will be eligible for a single dose of the booster vaccine. People aged 16 or above who live with someone who is immunosuppressed will also get the booster.

People who are eligible will be invited for their booster at least six months after their second COVID-19 vaccine. Boosters will be given in the same order of priority as the initial vaccine programme (groups 1-9).

The JCVI has advised that the booster vaccine and flu vaccine can be safely given together. The NHS will contact you when it’s your turn to have the booster vaccine.

You can read more about the coronavirus vaccine on our dedicated FAQ page.

What to read next:

Last updated: Thursday 30 September 2021


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Last medically reviewed: October 2021. Due for review: October 2021

This information uses the best available medical evidence and was produced with the support of people living with lung conditions. Find out how we produce our information. If you’d like to see our references get in touch.