COVID-19 and flu vaccinations, autumn/winter 2022
Since the first COVID-19 vaccine was given, it has saved lives, helped tens of thousands of people stay out of hospital, and made it safer for us to live with COVID. But the virus is still with us and is still making people very ill every day.
And, as we head into autumn and winter, flu presents further dangers. For most people flu is unpleasant, for some it can be very dangerous and even life-threatening, particularly those with certain health conditions. The flu vaccine is the best protection against getting seriously ill from flu and spreading it to other people.
Getting your flu and COVID vaccines are two of the most important things you can do to keep yourself and others around you safe this winter.
Experts advise that those at greater risk will need extra protection this winter. For Covid-19 and flu, everyone aged 50 and over, people with certain health conditions that put them at risk and frontline health and care staff will be offered a vaccine. To protect against flu, additional groups most at risk of getting seriously ill from flu or of passing it on to others, such as pregnant women, young children, primary school aged and some secondary school aged children will be offered protection. COVID-19 and flu can be serious for those these groups and getting both COVID-19 and flu at the same time increases risk.
The NHS is getting ready to offer COVID-19 vaccines over autumn to those eligible, starting with those at greatest risk. It is important people who are eligible come forward as soon as possible when it’s their turn, for extra protection ahead of winter, when viruses circulate most and can cause greatest harm. For maximum protection, your COVID vaccination must be at least three months after your previous dose.
Based on expert guidance the NHS is offering vaccination to those at greatest risk first. The NHS will let people know when it is their turn to come forward for their COVID-19 vaccine and more information is available on the NHS website. Once invited, people can book their seasonal COVID-19 vaccine using the National Booking Service or by calling 119, or can find a local vaccination walk-in site.
This year, the flu vaccine will be offered to those most at risk from flu first. From September, younger children, older people, those in clinical risk groups and pregnant women will be able to book an appointment for a flu vaccine at their GP practice or pharmacy. From mid-October 2022, people aged 50 to 64 years old that aren’t in a clinical risk group, will also be able to get a free flu vaccine. The flu vaccine is offered through schools for school-aged children and pregnant women can get their flu vaccine through their GP practice, pharmacy or maternity service.
The COVID-19 and the flu vaccine can be given on the same day and some people might get both vaccines at the same time. However, this may not always be possible, so we encourage everybody to get each vaccination as soon as they can, rather than waiting to get both at the same time.
Please help to keep yourself and those around you safe against these viruses by getting vaccinated when you are invited. You can find out more about what vaccinations you may need, and information about how to book an appointment, by visiting www.nhs.uk/flujab and www.nhs.uk/covid-vaccine.
Flu and the flu vaccine
What is flu?
Flu is caused by influenza viruses that infect the windpipe and lungs. Flu will often get better on its own, but it can make some people seriously ill. It's important to get the flu vaccine if you're advised to.
There are several symptoms of flu including a sudden high temperature, an aching body and a dry cough.
Flu is spread by coughs and sneezes. You can prevent the spread by covering your mouth and nose when you cough or sneeze, and you should wash your hands frequently or use hand gels to reduce the risk of picking up the virus.
The best way to avoid catching and spreading flu is by having the vaccination before the flu season starts.
What should I do if I think I have flu?
The best way to avoid catching and spreading flu is by having the vaccination before the flu season starts.
If you think that you have flu you should:
- rest and sleep
- keep warm
- take paracetamol or ibuprofen to lower your temperature and treat aches and pains
- drink plenty of water to avoid dehydration (your pee should be light yellow or clear)
A pharmacist can give treatment advice and recommend flu remedies.
Why should I get the flu vaccine?
It's important to get the free NHS flu vaccine if you're eligible.
The flu vaccine is a safe and effective vaccine. It can provide protection to those that are most likely to become seriously ill from flu and help reduce the spread of flu in the population.
While flu is unpleasant for most people it can be very dangerous and even life threatening for some people, particularly people with certain health conditions. For them, it can increase the risk of developing more serious illnesses such as bronchitis and pneumonia or can make existing conditions worse. In the worst cases, flu can result in a stay in hospital, or even death.
It's offered free every year to eligible groups by the NHS to help protect people at risk of getting seriously ill from flu. If you are eligible for the flu vaccine, it is important to get it every year because the viruses that cause flu change every year. This means the flu (and the vaccine) this year may be different from last year.
The best time to have the flu vaccine is in the autumn or early winter before flu starts spreading. GP surgeries and pharmacies get the flu vaccine in batches to make sure that it is widely available. If you are eligible and cannot get an appointment straight away, ask if you can book an appointment for when more vaccines are available.
If I had the flu jab last year, do I need to have it again now?
Yes, because the viruses that cause flu change every year. This means the flu (and the vaccine) this year may be different from last year. If you had the flu vaccine last year, either because you were pregnant or because you're in a clinical risk group, you need to have it again this year.
Is there anyone that shouldn’t get the flu vaccine?
Almost everybody can have the vaccine, but you should not be vaccinated if you have ever had a serious allergy to the vaccine, or any of its ingredients. If you are allergic to eggs or have a condition that weakens your immune system, you may not be able to have certain types of flu vaccine – check with your immuniser. If you have a fever, the vaccination may be delayed until you are better.
What type of flu vaccine will I be given?
There are several types of flu vaccine depending upon your age:
- most children over the age of 2 are offered a nasal spray vaccine. A small number cannot have it due to pre-existing medical conditions or treatments and are offered protection through an injected vaccine instead. The nasal spray contains small traces of porcine gelatine. For those who may not accept the use of porcine gelatine in medicines, an injectable vaccine is available.
- adults are offered an injectable vaccine. There are different types, including low-egg and egg-free ones
- adults aged 65 years and over – the most common flu vaccine contains an extra ingredient to help your immune system make a stronger response to the vaccine
If your child is aged between 6 months and 2 years old and is in a clinical risk group for flu, they will be offered an injected flu vaccine as the nasal spray is not licensed for children under the age of 2.
Will there be any side effects from the flu vaccine?
Flu vaccines have an excellent safety record. All adult flu vaccines are given by injection into the muscle of the upper arm.
Most side effects are mild and only last for a day or so, such as:
- slightly raised temperature
- muscle aches
- sore arm where the needle went in – this is more likely to happen with the vaccine for people aged 65 and over
Try these tips to help reduce the discomfort:
- continue to move your arm regularly
- take a painkiller, such as paracetamol or ibuprofen – some people, including those who are pregnant, should not take ibuprofen unless a doctor recommends it
Side effects of the children's flu vaccine
The nasal spray flu vaccine for children has an excellent safety record. Most side effects are mild and do not last long, such as:
- a runny or blocked nose
- a headache
- loss of appetite
When should I get my flu vaccine?
It is best to have the flu vaccination as soon as possible once the vaccine becomes available. The vaccine is offered in the autumn or early winter before any outbreaks of flu. Remember that you need it every year, so don’t assume you are protected because you had one last year.
The vaccine will be offered to those that are most at risk or most likely to pass on flu first and once the offer has been made to these groups by mid-October those aged 50-64 not in a clinical risk group will then be able to come forwards.
GP surgeries and pharmacies get the flu vaccine in batches to make sure that it is widely available. If you are eligible and cannot get an appointment straight away, ask if you can book an appointment for when more vaccines are available.
Where do I get the flu vaccine?
The flu vaccine is offered free on the NHS through GP practice and participating community pharmacies and through schools and community venues for school aged children. Pregnant women can visit their GP or a participating pharmacy and in addition may be able to get the vaccine through their maternity services to help protect themselves and their baby. A full list of where you can get your flu vaccine is below:
Where to have the flu vaccine
All children and adults from 6 months of age upwards in a clinical risk group
GP practice (all ages) or participating community pharmacy (age 18 years and above)
All children aged 2 or 3 years on 31 August 2022
All children from reception age (aged 4 -5) to school year 6 (aged 10-11) - regardless of educational setting
School and/or community clinics delivered by the School-age Immunisation Service.
GP practice, participating community pharmacy, or antenatal appointment
Frontline social care workers (that do not have access to employer led occupational health vaccinations)
Workplace, GP practice or participating community pharmacy
Those aged 65 years and over
GP practice, participating community pharmacy
Those in long-stay residential care homes
Adults aged 50-64 years old not in a clinical risk group and some children of secondary school age not in a clinical risk group, to be introduced later in the season.
GP practice, participating community pharmacy (50-64 years), school or community clinic upon invite from school age immunisation service (secondary school age children)
How do I book an appointment?
If you're eligible for a free flu vaccine, you can book an appointment at your GP surgery or a pharmacy that offers it on the NHS.
You may be invited to get your free vaccine by the NHS or your GP through a letter, text or email. Don’t worry if you do not receive this. If you are eligible, you do not have to wait for this before booking an appointment. The only exception is if you are aged 50 – 64 years old and are not in a clinical risk group, then you cannot book an appointment before mid-October.
If you receive an invite from the NHS and have already been vaccinated do not worry, sometimes there is a lag in the information flowing through and you do not need to do anything.
Everyone who is eligible for the free flu vaccine will be able to get it. GP surgeries and pharmacies get the flu vaccine in batches to make sure that it is widely available. If you are eligible and cannot get an appointment straight away, ask if you can book an appointment for when more vaccines are available.
How can my child get the flu vaccine?
All children in a clinical risk group can get their flu vaccine at their GP practice. If your child is in a clinical risk group, you do not need to wait for an invite from the School-aged Immunisation Service. Please contact your GP if you would like your child to receive the vaccine earlier in the season.
Children aged 2-3 years old will receive their flu vaccine at their GP practice.
Primary school children in Reception to Year 6 will receive their flu vaccine from the local School-aged Immunisation Service. This will either be in school or at a community clinic.
Some secondary school aged children will be offered a flu vaccine by the local School-aged Immunisation Service, most likely later in the season. Parents should wait to be invited and complete the necessary consent documentation accordingly.
Who can get the free NHS vaccine this year?
The flu vaccine is offered to people most at risk of getting seriously ill from flu or who are most likely to pass flu to other people at risk. It usually starts to be offered from September and it’s best to have it before flu starts to circulate in the winter. NHS flu vaccine appointments are available throughout the autumn and winter. The following people will initially be offered the flu vaccine:
- all children aged 2 or 3 years on 31 August 2022
- all primary school aged children (from Reception to Year 6)
- those aged 6 months of age upwards in a clinical risk group
- pregnant women
- those aged 65 years and over
- those in long-stay residential care homes
- carers in receipt of a carer’s allowance, or who are the main carer of an older or disabled person who may be at risk if the carer gets sick
- those that live with someone who is more likely to get infections (such as someone living with HIV, has had a transplant or is having certain treatments for cancer, lupus or rheumatoid arthritis)
- frontline health or social care workers (that do not have access to occupational health)
From mid-October 2022, people aged 50 to 64 years old that aren’t in a clinical risk group, will also start to be offered the vaccine after people most at risk have been offered it. If you are in this group, please wait until mid-October before booking an appointment with your GP practice or a local community pharmacy.
In addition some secondary school aged children will be offered a flu vaccine by the local school-aged immunisation provider service, most likely later in the season. If your child is in a clinical risk group please contact your GP if you would like your child to receive the vaccine earlier in the season.
How is it decided who is eligible to get the flu vaccine for free on the NHS each year?
The flu vaccine programme aims to reduce the number of people that get seriously ill from flu and reduce the spread of flu by vaccinating children.
The government decide which groups will be eligible for free flu vaccination each year. Their decision is based on the independent advice of experts in the Joint Committee on Vaccination and Immunisation (JCVI) who review the latest evidence and data.
Over the last two years there have been lower levels of flu circulating, which means some people will have lower levels of immunity against flu, and Australia have reported more cases of flu than average during their winter. Because of this, the government has decided that the groups that can get the free flu vaccine this year are broadly similar to those that were eligible during the pandemic. Young children and those most at risk from flu will be prioritised before the vaccine is offered to some secondary school children and 50-64s who are not already eligible in a clinical risk group.
COVID-19 and flu
The JCVI have advised that the following groups should receive a further dose of the COVID-19 vaccine this autumn to be protected against COVID-19 over the winter and the government have accepted this advice:
- Residents in a care home for older adults and staff working in care homes for older adults
- Frontline health and social care workers
- All adults aged 50 years and over
- Persons aged 5 to 49 years in a clinical risk group
- Persons aged 5 to 49 years those that live with someone who is more likely to get infections (such as someone living with HIV, has had a transplant or is having certain treatments for cancer, lupus or rheumatoid arthritis)
If you are in any of these groups, you will be invited to book your Covid vaccine this autumn.
COVID-19 vaccines and the flu vaccine can be given on the same day and for people that are eligible for both, there may be opportunities to have both together. We would encourage you to get your vaccinations as soon as possible and get fully protected rather than waiting as it may not always be possible to get them together.
The flu jab in pregnancy
Am I at risk from flu if I am pregnant?
There is good evidence that pregnant women have a higher chance of developing complications if they get flu, particularly in the later stages of pregnancy. One of the most common complications of flu is bronchitis, a chest infection that can become serious and develop into pneumonia. If you have flu while you're pregnant, it could cause your baby to be born prematurely or have a low birthweight, it increases the need for admission to intensive care for mum and baby and may even lead to stillbirth or death. If you get flu and also get COVID-19 at the same time, the symptoms are likely to be more serious.
Can I get the flu vaccine if I’m pregnant?
You should have the flu vaccine if you're pregnant to help protect you and your baby. It's safe to have the flu vaccine at any stage of pregnancy from the first few weeks up to your expected due date. Women who have had the flu vaccine while pregnant also pass some protection on to their babies, which lasts for the first few months of their lives. It's safe for women who are breastfeeding to have the vaccine.
Should I get the flu vaccine whilst I’m pregnant?
If you are pregnant, we would urge you to have the flu vaccine, whatever stage of pregnancy you’re at. It helps protect both you and your baby.
Is it safe for me to have the flu vaccine whilst I’m pregnant?
It's safe to have the flu vaccine during any stage of pregnancy, from the first few weeks up to your expected due date. Women who have had the flu vaccine while pregnant also pass some protection on to their babies, which lasts for the first few months of their lives.
Can I have the flu vaccine whilst I’m breastfeeding?
It's safe for women who are breastfeeding to have the flu vaccine if they are eligible.
How do I get the flu vaccine?
Contact your midwife, GP practice or local pharmacy to find out where you can get the flu vaccine. It's a good idea to get vaccinated as soon as possible after the vaccine becomes available in September. Do not worry if you find that you’re pregnant later in the flu season – you can have the vaccine then if you have not already had it. In some areas, midwives can give the flu vaccine at the antenatal clinic. In others, you will need an appointment at a GP practice or visit your local participating pharmacy.
Can I have the flu jab at the same time as the whooping cough (pertussis) vaccine?
Yes, you can have the flu jab at the same time as the whooping cough vaccine (pertussis vaccine), but do not delay your flu jab so you can have both at the same time. Pregnant women are at risk of severe illness from flu at any stage of pregnancy, so you need to have the flu vaccine as soon as possible. The best time to get vaccinated against whooping cough is from 16 weeks up to 32 weeks of pregnancy. If you miss having the vaccine for any reason, you can still have it up until you go into labour.
Can I get the flu and COVID-19 vaccine whilst I’m pregnant?
It’s also safe to have both the flu vaccine and the COVID-19 vaccine together, and studies show that the antibodies your own body produces in response to COVID-19 vaccination also help with the baby’s own immunity to the virus. COVID-19 vaccines and the flu vaccine can be given on the same day and for people that are eligible for both, there may be opportunities to have both together. We would encourage you to get your vaccinations as soon as possible and get fully protected rather than waiting as it may not always be possible to get them together.
Are vaccines safe?
Yes – the Medicines and Healthcare products Regulatory Agency (MHRA), the official UK regulator are globally recognised for requiring the highest standards of safety, quality and effectiveness for medicines and vaccines. Your safety will always come first and there are rigorous safety standards that have to be met through the approval process.
First of all, vaccines are tested it the laboratory and then tested in people who have volunteered to take part in studies called clinical trials. A dedicated team of scientists and clinicians thoroughly review pages of information and tables of data, looking at a range of things from the laboratory studies, clinical trials, the level of protection the vaccine provides, product stability and storage and each step of the manufacture process, as well as many other tests. They do that to ensure the safety and effectiveness of the COVID-19 vaccines is reviewed as robustly and thoroughly as possible. Hundreds of millions of people have now safely received a COVID-19 vaccine. The data from tens of thousands of participants in clinical trials show that the vaccines are safe and effective at preventing serious disease or death due to COVID-19.
Like any other vaccine or medicine, the COVID-19 vaccines are being continuously monitored for safety – the effected benefits of the vaccines far outweigh risk in the majority of patient. You and your healthcare professional can report any suspected side effects through the tried and trusted Yellow Card Scheme.
Who can get the COVID-19 Autumn booster?
In July, the Joint Committee on Vaccination and Immunisation (JCVI) recommended that a further dose of the COVID-19 vaccine should be offered to:
- residents of care homes for older adults
- front line health and social care workers
- all those aged 50 years or above
- people aged 5 to 49 years in a clinical risk group (including pregnant women) or who are household contacts of people with a weakened immune system, and
- people aged 16 to 49 years who are carers
Is the flu vaccine and COVID-19 booster mandatory for staff?
No, having the COVID-19 vaccine is not compulsory for health and care staff, but is an important protection for them and those they come into contact with. Local employers will be working hard to ensure all staff can get the COVID and flu vaccines this autumn and winter, and we are confident that most of our staff will choose to protect themselves and those around them by getting the vaccine.
Can I have my flu vaccine and COVID-19 booster in the same appointment?
Yes, if you are eligible to receive these two vaccines, you may be offered both in the same appointment. It is safe to receive both vaccines in the same appointment. But it’s important that you do not wait to try and schedule both vaccinations at the same time as this may not be possible and could delay your protection over winter. Please take up the offer of each vaccine when you are invited to, even if they are on different dates.
Why do I need an autumn booster?
More than 94% of England’s population have received at least one dose of the COVID-19 vaccine – saving lives, helping tens of thousands to stay out of hospital, and enabling us to return to lives we knew before the pandemic began.
However, the virus is still with us and is still making people very ill.
The JCVI has stated that winter will remain the season when the threat from COVID-19 is greatest for individuals and communities. Viruses, like COVID-19, spread much more easily in winter when we socialise indoors, so it’s important that everyone eligible tops up their protection with an autumn booster.
The aim is to protect the whole population and protect those at greatest risk from the virus against severe COVID-19 disease over winter.
How effective is the COVID-19 vaccine?
The COVID-19 vaccination will reduce the chance of you suffering from COVID-19.
The COVID-19 vaccines have saved more than 100,000 lives and significantly reduced hospitalisations from COVID-19. The COVID-19 vaccination programme allows us to live with this virus without restrictions on our freedoms.
With both flu and COVID-19 expected to be circulating this winter, it’s important to boost your immunity and help protect yourself and others.
Can I still catch COVID-19 after having the vaccine?
The COVID-19 vaccination will reduce the chance of you suffering from COVID-19 disease. It may take a few days for your body to build up some protection from the booster.
Like all medicines, no vaccine is 100% guarantee of not catching the virus – some people may still get COVID-19 despite getting vaccinated but this should be less severe.
Has the COVID-19 booster been given to people like me?
As with any medicine, vaccines are highly regulated products. There are checks at every stage in the development and manufacturing process, and continued monitoring once it has been authorised and is being used in the wider population.
Each of the vaccines are tested on tens of thousands of people across the world. They are tested on both men and women, on people from different ethnic backgrounds, and of all age groups.
Latest data from UKHSA show that six months after receiving a second dose, two doses provide between 55% and 70% protection from needing to be hospitalised for Covid-19. This remains around 70% six months after receiving the booster.
When will I be contacted, and how?
The NHS will prioritise protection of those at greatest risk – starting with people in the older age groups or who are clinically more vulnerable, and then inviting people in the other eligible groups. You will receive a letter, email or text from the NHS when it is your turn to come forward.
Where will I receive my vaccine?
Once invited, you can find your nearest vaccination site when you book using the National Booking Service or by calling 119. You are most likely to be offered your vaccine at a community pharmacy or at a local GP practice.
What vaccine will I be offered for my booster?
On 15 August 2022, the Medicines and Healthcare products Regulatory Agency (MHRA) granted regulatory approval for the Moderna bivalent COVID-19 vaccine. After reviewing data on booster responses from different combinations of COVID-19 vaccines, the UK, following JCVI advice, will deploy vaccines which are targeted at both Omicron and the original strain of COVID-19.
What are COVID-19 bivalent booster vaccines?
COVID-19 vaccines which target two different variants of COVID-19 are called bivalent vaccines. Bivalent vaccines broaden immunity and therefore potentially improve protection against variants of COVID-19. All vaccines used in the UK to date have been primarily targeted at the original strain of COVID-19 and have remained effective at preventing severe disease against subsequent variants.
How do we know the COVID-19 bivalent vaccines are safe?
All vaccines used in the UK must be authorised by our independent medicines’ regulator, the Medicines and Healthcare products Regulatory Agency (MHRA). Each COVID-19 vaccine candidate is assessed by teams of scientists and clinicians on a case-by-case basis and is only authorised once it has met robust standards of effectiveness, safety and quality set by MHRA. The MHRA has reviewed the available safety and efficacy data supporting Moderna’s bivalent vaccine and provided its authorisation.
Will there be any side effects from the vaccine?
Common side effects are the same for all COVID-19 vaccines used in the UK, and include:
- having a painful, heavy feeling and tenderness in the arm where you had your injection. This tends to be worst around a day or two following the vaccination
- feeling tired
- general aches, or mild flu like symptoms
You can rest and take paracetamol (follow the dose advice in the packaging) to help make you feel better. Although feeling feverish is not uncommon for 2 to 3 days, a high temperature is unusual and may indicate you have COVID-19 or another infection.
Although a fever can occur within a day or two of vaccination, if you have any other COVID-19 symptoms or your fever lasts longer, stay at home. Symptoms following vaccination normally last less than a week. If your symptoms seem to get worse or if you are concerned, you can call NHS 111.
Are there any serious side effects to having the COVID-19 vaccine?
Worldwide, there have been very rare cases of inflammation of the heart called myocarditis or pericarditis reported after some vaccinations. These cases have been seen mostly in younger men within several days after vaccination. Most of these people recovered and felt better following rest and simple treatments.
You should seek medical advice urgently if, after vaccination, you experience:
- chest pain
- shortness of breath
- feelings of having a fast-beating, fluttering, or pounding heart
Can I have the booster if I feel unwell?
If you are feeling unwell, for instance if you have a fever or have recently had a fever, it is better to leave a seven day interval between the start of your symptoms began to when you have your vaccine. You should not attend a vaccine appointment if you are self-isolating or waiting for a COVID-19 test.
If you are unwell on the day of vaccination for whatever reason, it may be appropriate to postpone vaccination until you have recovered. Those people with long term illness should present for vaccination when invited. If you are uncertain, please attend the vaccination service where healthcare professionals will be available who can advise you.
I’ve only just had my first or second COVID-19 vaccine, can I have the autumn booster jab?
No, the JCVI advises that the booster vaccine should be offered no earlier than three months after completion of the primary vaccine course.
I haven’t yet had the COVID-19 vaccination, can I still get my first jabs?
Everyone who is eligible that hasn’t already had their first or second COVID-19 vaccination will still be able to get vaccinated, even when the COVID-19 autumn booster programme begins.
I have had COVID, do I need to wait before having my booster?
If you've recently had a confirmed COVID-19 infection, you should ideally wait before getting any dose of the vaccine. You should ideally wait:
- 4 weeks (28 days) if you're aged 18 years old or over
- 12 weeks (84 days) if you’re aged 5 to 17 years
- 4 weeks (28 days) if you’re aged 12 to 17 years old and at high-risk from COVID-19
This starts from the date your symptoms started or from the date of a positive test, whichever was earlier. If you had some symptoms but you are not sure if you had COVID-19, you should still attend for vaccination once your symptoms are better and you can discuss this with a healthcare professional when you attend.
Do I need to receive the same type of vaccine or booster as my previous ones?
No, all COVID-19 vaccines authorised for use in the deployment programme are highly effective and provide a strong booster response. When you attend your appointment, the NHS will offer you a safe, effective vaccine.
How and when do I access my booster if I am a housebound individual?
If you're currently housebound and you think you’re eligible for a home vaccination, but you have not been contacted by the NHS to arrange this, contact your GP practice for support.
If the vaccine and booster jabs offer high levels of protection, why do I keep having to have more?
For the 2022 autumn booster programme, the primary objective is to boost immunity in those at higher risk from severe COVID-19 illness so that those people have optimal protection against severe COVID-19. In particular, the vaccine will help avoid those people being hospitalised or dying from COVID-19 over winter 2022/23. Throughout the pandemic, COVID-19 mortality has disproportionately affected those in older age groups, residents in care homes for older adults, and those with certain underlying health conditions, particularly those who are severely immunosuppressed. Following vaccination, these same factors continue to identify those people who are at higher risk of developing severe COVID-19.