If you are classed as clinically extremely vulnerable (CEV), you should have been contacted by the NHS or your GP telling you that you are on the shielded patient list. It is important that you read the full government guidance for extremely vulnerable people for the nation where you live: England, Northern Ireland, Scotland or Wales.
- If you think you should be on the shielded patient list and you have not been contacted by your GP or the NHS, you should discuss it with your GP or medical team.
- If you have received a letter or text advising you that you are on the shielded patient list but you think it is an error, check the government advice on what to do.
You might be classed as clinically extremely vulnerable if you have a particular medical condition that increases your risk, or because of other factors such as your age, ethnicity, sex or weight. If this is the case, you should receive a letter telling you. The government has produced separate letters for people aged 19 to 69 and people over 70.
Your GP or specialist can add you to the shielded patient list if they think you are at high risk of serious illness if you catch coronavirus.
People who have cancer of the blood or bone marrow, such as lymphoma, leukaemia or myeloma, who are at any stage of treatment, are considered to be at high risk of severe illness from COVID-19. This means they are in the group classed as clinically extremely vulnerable. These people are on the shielded patient list.
The government guidance refers to ‘Patients at any stage of treatment’ for blood cancers, including lymphoma. This includes people before, during and after treatment.
People who are currently having treatment for any type of lymphoma.
(Patients on treatment should follow the standard neutropenic sepsis pathways and telephone for clinical advice as stated by their chemotherapy unit prior to commencing treatment.)
COVID-19 is a new illness and at present, there is limited scientific evidence to guide decisions on exactly who is at high risk of severe disease. Public Health England recommends that anybody who has had treatment for lymphoma should be on the shielded patient list but does not give a time frame for how long ago the treatment was.
A consensus of UK lymphoma specialists agree that it is sensible for people who have low-grade non-Hodgkin lymphoma to be on the shielded patient list even if they have not required treatment for many years.
If you were successfully treated for Hodgkin lymphoma or high-grade non-Hodgkin lymphoma many years ago and your lymphoma has not come back, the situation is more complicated. Your GP or specialist will consider lots of factors to help determine if you might be at high risk of serious illness due to COVID-19. This includes:
- the specific type of lymphoma you had
- how long ago you were treated
- the exact treatment you had
- any late effects of treatment you might be at risk of
- any other medical conditions you have
- your individual circumstances (for example, your living situation or your occupation).
Your GP or specialist will offer advice that is specific to you.
If you have had a splenectomy, you should be on the shielded patient list.
You should follow any specific advice your medical team gives you. The government has also produced advice for extremely vulnerable people. This varies depending on where you live. We have separate webpages covering:
- guidance on coronavirus for people with lymphoma: England
- guidance on coronavirus for people with lymphoma: Northern Ireland, Scotland and Wales
- general measures you can take to reduce the spread of COVID-19.
Shielding is a way of protecting extremely vulnerable people from COVID-19 by minimising their interaction with other people. This reduces their chance of coming into contact with the virus. Shielding is currently paused throughout the UK.
You might be advised to shield if you are clinically extremely vulnerable and the level of coronavirus in your area is high.
Shielding can only be introduced by the government, based on advice from the Chief Medical Officer. Your GP or specialist might advise you to take additional precautions to reduce your risk of being exposed to coronavirus infection, but this does not officially class as shielding. If shielding is officially advised where you live, you should get a letter from the government advising you what to do. In this case, you might be eligible for extra support from your local authority.
People classed as clinically extremely vulnerable might be advised to take extra precautions if levels of coronavirus in their area are high. This is called shielding.
Guidance on whether to shield is based on the level of coronavirus in your local area, rather than across the UK as a whole. If levels of coronavirus are particularly high in your area, you might be advised to shield. If this is the case, you should be contacted by letter or text message with further advice. Shielding advice might not be the same as it was previously.
Everybody who is clinically extremely vulnerable should be on the shielded patient list. Being on the shielded patient list doesn't necessarily mean you need to shield. However, it allows you to be contacted quickly if the advice changes. You should not be removed from the shielded patient list without your GP or medical team discussing it with you first.
Clinically extremely vulnerable people are a priority group for coronavirus vaccination.
A consensus of UK lymphoma specialists recommend that all patients with lymphoma should receive a non-replicating COVID-19 vaccine, unless there are particular reasons they can't have it (for example, if they've had serious allergic reactions in the past). The Pfizer/BioNTech vaccine, Oxford/AztraZeneca vaccine and Moderna vaccine are all non-replicating. These vaccines might not achieve full protection for people who have lowered immunity, and vaccination of close contacts when available is also likely to be beneficial.
After having the vaccine, it is important to carry on taking appropriate measures to reduce your risk of infection.
You don't need to contact your doctor or pharmacist to ask for a vaccination. You will be automatically invited for vaccination when it is your turn.
Please visit our separate webpage on the coronavirus vaccination programme for more detailed information. We also have an article addressing concerns about the COVID-19 vaccine for people affected by lymphoma.