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People at higher risk from COVID-19

COVID-19 (coronavirus) can make anyone seriously ill. But for some people, the risk is higher.

If you are at higher risk from COVID-19, follow the advice below on how to protect yourself. Use your own judgement to stay safe in public and crowded places.

People at higher risk

People over 65 are at the highest risk of serious illness from COVID-19 if they have not been vaccinated.

Serious illness means that you may need to go to hospital, an intensive care unit (ICU), or be put on a ventilator to help you breathe. There is also a risk of death.

Conditions that put you at higher risk

You are also at higher risk from COVID-19 if you have certain long-term health conditions.

Very high risk groups (extremely vulnerable)

The list of people in very high risk groups include people who:

  • have Down syndrome
  • have cancer and are being treated with (or within 6 weeks of) chemotherapy or targeted therapy, monoclonal antibodies or immunotherapies
  • have lung or head and neck cancer and are having (or within 6 weeks of) radical surgery or radiotherapy
  • are having certain complex cancer surgery, for example, surgery for lung cancer, head and neck cancer or oesophageal cancer
  • getting treatment or pending treatment for a cancer of blood or bone marrow
  • have advanced cancer or cancer that has spread to another part of the body
  • are on dialysis or have end-stage kidney disease and an eGFR less than 15
  • have a condition affecting the brains or nerves that has significantly affected your ability to breathe, meaning you require non-invasive ventilation (such as motor neurone disease or spinal muscular atrophy)
  • have unstable or severe cystic fibrosis, including people waiting for a transplant
  • have severe respiratory conditions including Alpha-1 antitrypsin deficiency, pulmonary fibrosis, lung fibrosis, interstitial lung disease and severe COPD
  • have uncontrolled diabetes
  • have had an organ transplant or are waiting for a transplant
  • have had a bone marrow or stem cell transplant in the last 12 months, or are waiting for a transplant
  • have a rare genetic condition that means you have a very high risk of getting infections (such as APECED or errors in the interferon pathway)
  • sickle cell disease
  • have been treated with drugs such as Rituximab, Cyclophosphamide, Alemtuzumab, Cladribine or Ocrelizumab in the last 6 months
  • have certain inherited metabolic disorders (such as Maple Syrup Urine Disease)
  • have obesity with a body mass index (BMI) greater than 40
High risk groups

The list of people in high risk groups includes people who:

  • have a learning disability other than Down syndrome
  • are being treated for cancer but are not very high risk
  • have been treated in the past 5 years for a cancer of the blood or bone marrow (such as leukaemia, lymphoma or myeloma)
  • have been treated in the past 1 year with immunomodulating treatment for a cancer that did not start in the blood or bone marrow
  • have chronic heart disease (such as heart failure)
  • have chronic kidney disease with an eGFR below 30ml a minute
  • have chronic liver disease (such as cirrhosis or fibrosis)
  • have a condition affecting the brain or nerves (such as Parkinson's disease or cerebral palsy) that affects their breathing or ability to protect or clear their airway
  • have clinically stable cystic fibrosis
  • have a serious lung condition but are not at very high risk, for example, severe asthma, moderate COPD, emphysema or chronic bronchitis
  • have diabetes
  • are taking medicine that makes your immune system weak (such as high doses of steroids)
  • have a condition that means you have a high risk of getting infections (such as lupus, scleroderma, or HIV when not on treatment or CD4 count <200)
  • have an inherited metabolic disorder but are not very high risk
  • have obesity with a body mass index (BMI) between 35 and 40
  • have a severe mental illness (such as schizophrenia, bipolar disorder, severe depression)

Weak immune system

Having a weak immune system (immunocompromised) also puts you at higher risk. Some of these conditions are listed above.

COVID-19 vaccines you should get if you have a weak immune system

If you have COVID-19 symptoms

Urgent advice: Phone your GP if:

you have symptoms of COVID-19 and are:

You do not need a COVID-19 test unless a GP or health professional advises one.

You should also:

  • stay at home until 48 hours after your symptoms are mostly or fully gone
  • limit contact with other people, especially other people at higher risk from COVID-19

Do these even if you are up to date with your COVID-19 vaccinations, or had COVID-19 in the past.

Treatment for COVID-19

There are medicines for early treatment of some people with COVID-19. Most people who get COVID-19 don’t need this treatment. It’s available to people who are at the highest risk of serious illness or death from COVID-19.

Treatment for people at the highest risk from COVID-19

How to protect yourself if you're at high risk

Keeping up to date with your vaccines is the most important thing you can do to avoid serious COVID-19 illness. Talk to your GP or hospital care team if you have any questions about vaccination.

Booster dose of the COVID-19 vaccine

Do

  • try to avoid crowded indoor spaces, if possible

  • wear a face mask, if you would like to

  • keep active and look after your general health - this will improve your chance of recovery if you get COVID-19

  • wash or sanitise your hands often

  • continue to use the healthcare services you need - ask or remind healthcare workers about precautions if needed

Don't

Going out

Going out is good for your health and wellbeing. The risk of catching COVID-19 is low if you keep away from other people.

You can tell people who provide services to you that you need to be extra careful to avoid COVID-19.  They will usually try to fit you in at a quiet time and can take extra care to protect you.

If you have an appointment with your GP or at a hospital or clinic, it is important to attend.

You are more likely to be exposed to COVID-19 if you are in a place where there are large numbers of people indoors.

Staying safe at home

Try to keep the number of people who come into your house to visit, work or provide healthcare to a few trustworthy people. Then you can feel safe at home and relax there. 

Check that anyone who comes to the house is well when they arrive. Make sure they have no symptoms of COVID-19.

Ask them to:

  • clean their hands when they arrive
  • keep some distance from you whenever possible

What the people you live with should do

Other people you live with can protect you by:

Telephone support

Stay in touch with friends and family. If you need help for any reason there are places you can go for help.

These include:

Page last reviewed: 19 October 2023