Guidance

COVID-19 medical exemptions: proving you are unable to get vaccinated

How to apply for official proof that, for medical reasons, you're unable to be vaccinated or unable to be vaccinated and tested for COVID-19.

Applies to England

Why you may need to show your COVID status

The NHS COVID Pass lets individuals share their COVID-19 vaccination records or test results in a secure way.

You may need to demonstrate your COVID status to:

  • work or volunteer in a care home regulated by the Care Quality Commission (CQC) from 11 November 2021
  • be exempt from self-isolating for 10 days if you are a close contact of somebody with a confirmed case of COVID-19
  • enter venues and events in England that require the NHS COVID Pass as a condition of entry
  • be exempt from quarantine and completing a test on day 8 if you travel from a country that’s not on the red list

If you’re unable to get vaccinated against COVID-19 for medical reasons

Some individuals are unable to be vaccinated and also, in some cases, tested for medical reasons. You can apply for proof that you have a medical reason why you should not be vaccinated or why you should not be vaccinated and tested.

If you get this proof of medical exemption you’ll be able to use the NHS COVID Pass wherever you need to prove your COVID-19 status within England.

Until 24 December 2021, you can self-certify that you’re medically exempt if you work or volunteer in a care home.

Some businesses in England choose to use the NHS COVID Pass as a condition of entry. Until 24 December, businesses can decide whether to allow in people who self-declare that they’re medically exempt.

From 25 December, if you’re unable to get vaccinated, you’ll have to use the NHS COVID Pass in the same way that people who are fully vaccinated use it.

A carer can apply on your behalf.

The possible reasons for exemptions are limited. Examples that might be reasons for a medical exemption are:

  • people receiving end of life care where vaccination is not in the person’s best interests
  • people with learning disabilities or autistic individuals, or people with a combination of impairments where vaccination cannot be provided through reasonable adjustments
  • a person with severe allergies to all currently available vaccines
  • those who have had an adverse reaction to the first dose (for example, myocarditis)

Other medical conditions could also allow you to get a medical exemption.

Short-term exemptions will also be available for those with short-term medical conditions and as an option that some pregnant women may choose to take.

Pregnant women can alternatively use MAT B1 certificates to show their COVID status, if they choose to use a medical exemption. Pregnant women do not need to apply for a medical exemption NHS COVID Pass if they have a MAT B1 certificate. For pregnant women the exemption will expire 16 weeks post-partum. This will allow them to become fully vaccinated after birth.

The Royal College of Obstetricians, Royal College of Midwives and the UK Tetralogy Service consider COVID vaccination to be safe. They recommend that pregnant women get vaccinated against COVID.

The NHS COVID Pass for people who are medically exempt from vaccinations

All exemptions will be confirmed by your doctor, specialist clinician or midwife. If approved, your NHS COVID Pass can then be used to prove your status.

The domestic NHS COVID Pass will look and work the same for people with medical exemptions as it will for people who are fully vaccinated. The pass will not show that you have a medical exemption.

You will also get a confirmation letter which you should keep for your records. Use the letter to prove that you’re unable to get vaccinated if you work or volunteer in a care home or are travelling from a country that’s not on the red list. The letter will explain that you’re medically unable to get vaccinated, the pass does not.

It’s up to other countries to decide whether or not residents in England with a medical exemption qualify for relaxed border measures.

If you’ve taken part in a vaccine trial

If you’re a resident in England and have taken part, or are taking part, in COVID-19 vaccine clinical trials you can get a domestic NHS COVID Pass to use in England.

You don’t need to apply for a medical exemption. See more information on proving your COVID status after vaccine clinical trials.

How to apply for and receive your COVID Pass medical exemption

  1. Phone the NHS COVID Pass service on 119 to ask for an NHS COVID Pass medical exemptions application form.

You can also call to find out more information about COVID Pass medical exemptions.

The call handler at the NHS COVID Pass service will ask you some questions. You will need to give:

  • your name
  • your date of birth
  • your NHS number (if you know it)
  • the name of your GP and/or specialist clinician

2. If you’re eligible to apply, you’ll get an application form by post.

You should not ask your GP for an application form. If you do go to your GP before you get your application form you’ll be asked to call the NHS COVID pass service on 119.

3. Return your application form to the GP or relevant clinician stated on the form. Your application will be clinically reviewed by your doctor, specialist or midwife. Your GP, specialist or midwife may ask to speak with you if needed, but you won’t need to book this when you submit your application.

4. You’ll automatically get the results of your application by post 2 to 3 weeks after applying. You don’t need to contact your GP or the clinician reviewing your exemption unless they ask you to contact them.

5. If you get a medical exemption you can use the domestic NHS COVID Pass wherever you need to.

The pass won’t show others that you have a medical exemption, just that you have the NHS COVID Pass.

You can access your NHS COVID Pass digitally – on the NHS app or the NHS website. You can also download it as a pdf.

The paper version of the pass will be available soon.

Find out more about the NHS COVID Pass on the NHS website.

6. The clinical decision on your medical exemption is final. You can’t appeal the decision.

Receiving an exemption does not mean you are protected against COVID-19. You should self-isolate if you have any symptoms of COVID-19.

Published 1 October 2021