Adults with underlying health conditions

Last updated 1 July 2021

People aged 16-64 with certain underlying health conditions are Priority Group 6. Use our eligibility tool if you have not received your invitation.

About the Adults with Underlying Health Conditions Priority Group

Adults age 16 to 64 with specific underlying health conditions are priority group 6 in the national priority groups for COVID-19 vaccination from the UK's independent Joint Committee on Vaccination and Immunisation.

The precise definitions for the people who will be invited in these groups will be based on guidance set out in the Green Book - Immunisation Against Infectious Disease (the definitions as at 12 February are included below, but please check the Green Book for the latest details). Some people with more severe conditions may be clinically extremely vulnerable.

National guidance from the Joint Committee on Vaccination and Immunisation also recommend that certain categories of carer should also be offered vaccination alongside these groups.

Category or condition	Information from the "Green Book"	Other guidance
Chronic respiratory disease	Individuals with a severe lung condition, including those with asthma that requires continuous or repeated use of systemic steroids or with previous exacerbations requiring hospital admission, and chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema; bronchiectasis, cystic fibrosis, interstitial lung fibrosis, pneumoconiosis and bronchopulmonary dysplasia (BPD).	UK national guidance advises that the following people with asthma should be offered the COVID-19 vaccine in Priority Group 6: The following people with asthma should be offered vaccination: anyone who has ever had an emergency asthma admission or; those who have an asthma diagnosis and have had 3 prescriptions for oral steroids over a 3-month period (each prescription must fall within separate individual month windows), as an indication of repeated or continuous oral steroids. Source: NHS advice
Chronic heart disease and vascular disease	Congenital heart disease, hypertension with cardiac complications, chronic heart failure, individuals requiring regular medication and/or follow-up for ischaemic heart disease. This includes individuals with atrial fibrillation, peripheral vascular disease or a history of venous thromboembolism.
Chronic kidney disease	Chronic kidney disease at stage 3, 4 or 5, chronic kidney failure, nephrotic syndrome, kidney transplantation.
Chronic liver disease	Cirrhosis, biliary atresia, chronic hepatitis.
Chronic neurological disease:	Stroke, transient ischaemic attack (TIA). Conditions in which respiratory function may be compromised due to neurological disease (e.g. polio syndrome sufferers). This includes individuals with cerebral palsy, severe or profound learning disabilities, Down’s Syndrome, multiple sclerosis, epilepsy, dementia, Parkinson’s disease, motor neurone disease and related or similar conditions; or hereditary and degenerative disease of the nervous system or muscles; or severe neurological disability.	Welsh Government has also published updated guidance on 24 February on Covid-19 vaccinations for individuals with a learning disability or severe mental illness.
Diabetes mellitus	Any diabetes, including diet-controlled diabetes.
Immunosuppression	Immunosuppression due to disease or treatment, including patients undergoing chemotherapy leading to immunosuppression, patients undergoing radical radiotherapy, solid organ transplant recipients, bone marrow or stem cell transplant recipients, HIV infection at all stages, multiple myeloma or genetic disorders affecting the immune system (e.g. IRAK-4, NEMO, complement disorder, SCID). Individuals who are receiving immunosuppressive or immunomodulating biological therapy including, but not limited to, anti-TNF, alemtuzumab, ofatumumab, rituximab, patients receiving protein kinase inhibitors or PARP inhibitors, and individuals treated with steroid sparing agents such as cyclophosphamide and mycophenolate mofetil. Individuals treated with or likely to be treated with systemic steroids for more than a month at a dose equivalent to prednisolone at 20mg or more per day for adults. Anyone with a history of haematological malignancy, including leukaemia, lymphoma, and myeloma and those with systemic lupus erythematosus and rheumatoid arthritis, and psoriasis who may require long term immunosuppressive treatments. Most of the more severely immunosuppressed individuals in this group should already be flagged as CEV. Individuals who are not yet on the CEV list but who are about to receive highly immunosuppressive interventions or those whose level of immunosuppression is about to increase may be therefore be offered vaccine alongside the CEV group, if therapy can be safely delayed or there is sufficient time (ideally two weeks) before therapy commences. Some immunosuppressed patients may have a suboptimal immunological response to the vaccine (the Green Book provides specific guidance on Immunosuppression and HIV).
Asplenia or dysfunction of the spleen	This also includes conditions that may lead to splenic dysfunction, such as homozygous sickle cell disease, thalassemia major and coeliac syndrome.
Morbid obesity	Adults with a Body Mass Index ≥40 kg/m2.
Severe mental illness	Individuals with schizophrenia or bipolar disorder, or any mental illness that causes severe functional impairment.	Welsh Government has also published updated guidance on 24 February on Covid-19 vaccinations for individuals with a learning disability or severe mental illness.
Adult carers	Those who are eligible for a carer’s allowance, or those who are the sole or primary carer of an elderly or disabled person who is at increased risk of COVID-19 mortality and therefore clinically vulnerable.	Check our carers page for more details.
Younger adults in long-stay nursing and residential care settings	Many younger adults in residential care settings will be eligible for vaccination because they fall into one of the clinical risk groups above (for example learning disabilities). Given the likely high risk of exposure in these settings, where a high proportion of the population would be considered eligible, vaccination of the whole resident population is recommended. Younger residents in care homes for the elderly will be at high risk of exposure, and although they may be at lower risk of mortality than older residents should not be excluded from vaccination programmes.	In relation to younger adults in long-stay nursing and residential care settings, please also see Welsh Government updated guidance on 24 February on Covid-19 vaccinations for individuals with a learning disability or severe mental illness.

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Further Information

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