People previously considered to be clinically extremely vulnerable will not be advised to shield again, as the government agrees to end the requirement for centralised guidance for these groups following expert clinical advice. The closure of the shielding programme follows a pause to shielding guidance in place since 1 April 2021.
This decision is based on there being far more information available on the virus and what makes individuals more or less vulnerable, the success of the COVID-19 vaccination programme and the emergence of proven treatments, such as dexamethasone and tocilizumab, to support improved outcomes in clinical care pathways.
Shielding was introduced at the beginning of the COVID-19 pandemic as one of the few interventions available to support those who were considered to be most at risk of serious illness from the virus.
While this was the right decision at the time to protect the most vulnerable during the initial waves of the virus when little was known about the virus and risk characteristics, shielding advice was extremely restrictive and for some, had a significant impact on people’s lives and their mental and physical wellbeing.
Since 19 July, the guidance for clinically extremely vulnerable people has been to follow the same advice as the rest of the population, with the suggestion of additional precautions people may wish to take. Research and evaluation for some individual clinical groups will continue.
This will move the country towards the situation pre-COVID-19, where people managed their own conditions with their health professionals, who know the needs of their individual patients best.
For some who may have a reduced immune response – for example those who are immunocompromised or have particular cancers such as blood (haematological) malignancies – and who are at risk from infectious diseases more generally, a return to routine individual advice from relevant specialists is now recommended.
Those previously on the Shielded Patient List will receive a letter from the government in the coming days to inform them of this decision.
The government will continue to assess the situation and the risks posed by COVID-19 and, based on clinical advice, will respond accordingly to keep the most vulnerable safe. Individuals should consider advice from their health professional on whether additional precautions are right for them.
People aged over 16 with underlying health conditions that put them at higher risk of severe COVID-19 will also be prioritised for booster vaccinations, as well as adult household contacts of immunosuppressed individuals. This will ensure the protection the vaccines provide will be maintained over the winter months.
Vaccinations as part of a booster programme will begin from next week and the NHS will contact people directly to let them know when it is their turn.
Chief Executive of the UK Health Security Agency, Jenny Harries, said:
Since the start of the pandemic, the NHS has administered millions of life-saving COVID-19 vaccines and treatments, which is why those who were originally considered clinically extremely vulnerable have, since step 4 (19 July), been advised to follow the same guidance as everyone else.
Because of this progress, the government does not expect to have to issue shielding advice to this large group again, but will continue to assess the risks to the most vulnerable from COVID-19.
Those patients who are at risk from infectious diseases more generally – for example patients with blood cancers – and who can also remain less protected after other vaccinations, may wish to discuss this with their specialist as part of their routine care.
I would urge everyone else to follow the guidance and continue with the precautions that make you feel safe.