Thread by @petermbenglish

Can contacts of "clinically extremely vulnerable" people get Covid-19 vaccine even if they are not yet in the age group being offered the vaccine?

This question has come up recently, so I've had a look at the guidance.
1/13

There are two key pieces of guidance - an NHS letter, and accompanying operational guidance.

The letter:
england.nhs.uk/coronavirus/wp…
or via
england.nhs.uk/coronavirus/pu…
2/13

The operational guidance:
england.nhs.uk/coronavirus/wp…
or via england.nhs.uk/coronavirus/pu…
3/13

There are two key things to note - the definition of who is a contact; and the definition of "severely immunosuppressed individuals".

"Severely immunosuppressed individuals" (SII) does not include everybody who is "clinically extremely vulnerable" (CEV).
4/13

So, just because you are, or your contact is CEV, it doesn't automatically mean they are SII.
5/13

The letter is a bit vague - it's not clear that all immunosuppressive cancer immunotherapy is included, for example; but if you look at the operational guidance it would appear that it is. So refer to the guidance to check!
6/13

And note that it is only people who live with the SII who is eligible. (Image from the letter.)
7/13

Vaccination clinics are supposed to check that the SII person was sent a letter by their GP identifying them, with their address; and the household contacts will be required to present proof they live at the same address. The operational guidance provides details.
8/13

As we work down the age-groups (people who are or who turn age 32 by 1 July are now eligible) there will be smaller numbers of people who are in "grey areas".
9/13

In my opinion, pregnancy should have been added to the list of underlying conditions when further evidence appeared about a month ago.
10/13
doi.org/10.1001/jama.2…
c1dc.gov/coronavirus/20…

But although I can argue the case for this, JCVI has not added pregnancy to the list of underlying conditions. I think they're wrong 😉; but vaccination clinics have to follow rigid guidelines.

They have little or no discretion: NHS England can be very heavy-handed.
11/13

So… if you are borderline - say, a regular carer or visitor but not actually resident at the same address as a SII person AND a borderline underlying condition - they might be prepared to stretch a point.
12/13

But please don't cross with them if they don't - the implications for the healthcare worker or the people running the clinic could be very serious if NHS England decide they vaccinated somebody who wasn't strictly eligible according to rigid criteria.
13/13

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