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Clinically extremely vulnerable

People with serious underlying health conditions who are most at risk of severe illness from coronavirus have previously been advised by the government to self-isolate (known as shielding).

Advice for residents in the shielding category

This update is for everyone who has been identified as clinically extremely vulnerable. This includes those people who have been identified by the NHS as being clinically extremely vulnerable and those identified through the Covid-19 Population Risk Assessment.

We know that the pandemic has been a difficult time for everyone and recognise that it has been particularly hard for those who have been advised to take extra precautions.

Although cases of Covid-19 are currently higher than at other points during the pandemic, they are still below the levels at which shielding was last introduced, with significantly fewer hospitalisations than seen when cases were at similar levels. Coupled with the high levels of vaccination, this means that the risk of catching Covid-19 is lower for everyone, including clinically extremely vulnerable people. This has allowed the Government to ease restrictions for everyone.

Shielding advice ended on 1 April 2021. Clinically extremely vulnerable people are now advised, as a minimum, to follow the same guidance as the general population. It is important that everyone adheres to this guidance.

The latest information that we have suggests that having two doses of a Covid-19 vaccine reduces the severity of the illness if you catch the virus. However, as you may remain at a higher risk of becoming seriously ill if you were to catch Covid-19, you may wish to think particularly carefully about additional precautions you may wish to take. There is a separate guidance page for clinically extremely vulnerable people that contains some examples of additional precautions that you might consider taking.  

Guidance on protecting people who are clinically extremely vulnerable from COVID-19 (easy read)

Guidance on protecting people who are clinically extremely vulnerable from COVID-19 (large print)

  • Everyone on the Shielded Patient List should already have been offered a Covid-19 vaccine. If you have not yet received your first dose, please contact your GP, book your vaccination appointment online or call 119.
  • If you have any questions, please call our helpline number between 9am 5pm, Monday to Friday on 020 7364 3030.
    • meet outside where possible
    • make sure the space is well ventilated if you meet inside; open windows and doors or take other action to let in plenty of fresh air
    • consider whether you and those you are meeting have been vaccinated – you might want to wait until 14 days after everyone’s second dose of a COVID-19 vaccine before being in close contact with others
    • wash your hands regularly and avoid touching your face
    • consider continuing to practice social distancing if that feels right for you and your friends
    • ask friends and family to take a lateral flow test before visiting you
    • ask home visitors to wear face coverings
  • From 19 July, there are no longer any limits on the number of people or households that you can meet with. Social distancing rules have been lifted. Things you could do to lower your risk of infection:
  • You are encouraged to go outside for exercise and can do so freely now. You can find tips and advice on staying active and eating healthily at NHS Better Health. You can find more information about local free support.
  • From 19 July, social distancing measures have ended in the workplace and it is no longer necessary for the government to instruct people to work from home. However, your employer should be able to explain to you the measures they have in place to keep you safe at work.
  • The Covid-19 Job Retention Scheme (furlough) has been extended until 30 September. You may continue to be eligible throughout this period, even when shielding is paused, providing your employer agrees. The Self-Employment Income Support Scheme (SEISS) has also been extended until 30 September.
  • From 1 April, you are no longer eligible for Statutory Sick Pay (SSP) or Employment and Support Allowance (ESA) on the basis of being advised to shield, given the lifting of shielding measures nationally. You may be eligible for SSP or ESA if you are sick or incapable of work, either due to coronavirus or other health reasons, subject to meeting the eligibility conditions.
  • Clinically extremely vulnerable pupils and students should have returned to their school or other educational setting.
  • From 19 July the legal requirement to wear a face covering has been lifted. However, the government expects and recommends that people continue to wear face coverings in enclosed and crowded areas, such as public transport.
  • You can continue to ask for short-term help from the NHS Volunteer Responder scheme with telephone support if you are feeling lonely, or for help with collecting shopping (if you are unable to use any of the online or telephone shopping options now available through most supermarkets), medication or other essential supplies that you need delivered to your home. You can ask for help by visiting NHS Volunteer Responders or calling 0808 196 3646 (8am to 8pm, 7 days a week).
  • You should continue to seek support from the NHS for your existing health conditions. You can access a range of NHS services from home (Health at Home). If you have an urgent medical need, call NHS 111 or, for a medical emergency, dial 999.
  • The measures you may have taken to respond to COVID-19 may have triggered feelings of worry, distress or loneliness. These feelings are a completely normal response to an unprecedented period of disruption. You can visit the Every Mind Matters website for advice and practical steps that you can take to support your wellbeing and manage your mental health. You can find more information about local free support.


The most effective form of protection from COVID-19, even for the most vulnerable, is vaccination. The Covid-19 vaccines are effective for the majority of clinically extremely vulnerable people and provide a significant amount of protection against the virus, including to those who are immunocompromised.

It is really important that you have both doses of the vaccine when it is offered to you. It is also important that other members of your household get vaccinated as this will lower your chances of catching COVID-19. You may be offered a booster dose over the coming months to further increase your level of protection. You should take this when it is offered to you.

There are a small number of immunocompromised or immunosuppressed people who may be less well protected by the vaccines. Those individuals should know who they are, will always have been at risk of infectious disease and, pre-pandemic, they would have had to make individual risk assessments in consultation with their GP or clinician. If this applies to you then you should get in contact with your GP or specialist to discuss this further. All vaccines offer some level of protection, so you should still get vaccinated against COVID-19 even if you are immunocompromised or immunosuppressed.

You can find more information about Covid-19 vaccines (Covid-19 vaccination: easy-read leaflets) and local vaccination sites.

Appointments at local clinics can be booked through our online system or by calling the council helpline 020 7364 3030 (Monday- Friday, 9am - 5pm).

Children and young people

All young people aged 16 and 17 years will be offered a first dose of vaccine. The timing of a second dose for these 16 to 17 year olds will be confirmed later.

The Joint Committee on Vaccination and Immunisation (JCVI) advises that the following groups of children should be offered 2 doses of the Pfizer-BioNTech vaccine:

  • 12-15-year olds with the underlying health conditions specified below:
    • Severe neuro-disabilities 
    • Down’s Syndrome
    • Underlying conditions resulting in immunosuppression 
    • Those with profound and multiple learning disabilities, severe learning disabilities or who are on the learning disability register
    • 12-15-year olds who are healthy, but are household contacts of individuals (adults or children) who are immunosuppressed

People aged 16 and 17, and children aged 12 to 15 who are eligible, will be contacted by a local NHS service such as a GP surgery to book their vaccination appointments.

You can find more information for eligible children and young people on Covid-19 vaccination.


Everyone is advised to take PCR tests if experiencing symptoms of Covid-19. Alongside this, rapid tests (lateral flow tests) should be taken regularly which can identify those carrying the virus but not showing symptoms.

You can find more information about Covid-19 testing and local Covid-19 testing options.