Vaccination information for people in Vaccination Priority Groups 4 and 6

From Lynsey Cullen, Communications Manager, Corporate Communications, Office of the Chief Executive NHSScotland, Scottish Government

First of all, if you receive an invitation to attend a COVID-19 vaccination, it is important that you attend.

Group 4:

In addition to all people in Scotland aged  70 – 74 years of age, priority group 4 includes those adults aged 16-69 who are classified as clinically extremely vulnerable (CEV).

People classified as CEV in group 4 will have received a letter from Scotland’s Chief Medical Officer to advise them that they have been added to the shielding list.

These people will have been added to the shielding list either because they have a condition included in the shielding criteria agreed by the 4 Chief Medical Officers of the UK or because they have been added  by their GP or hospital clinician based on their clinical judgement.

Although everyone (with the exception of carers and younger adults in long-stay nursing and residential care settings)  within groups 4 and 6 will fall into the disease categories listed in the table further down the page, those in group 4 have been invited for their vaccination first because they have had more recent treatment and/or a more advanced condition, which makes them at highest risk of severe illness from COVID-19.

People who were on the shielding list by 1 February 2021 should have already been invited to their vaccination. Those people added to the shielding list after this date should await their invite in the near future.

Group 6:

All individuals aged 16 to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality, who are not on the shielding list are being offered the vaccine as part of group 6. These people are being identified by a modified version of the flu vaccine list.

The table below lists the health conditions which may mean people aged 16 and over are at higher risk of serious disease and mortality from COVID-19, meaning they should take their vaccination when it is offered to them. People under 16 are not currently being invited for vaccinations.

Chronic respiratory diseaseSevere lung conditions, including:   asthma that requires continuous or repeated use of systemic steroids or with previous exacerbations requiring hospital admission (patients who are well controlled on asthma inhalers are not eligible in priority group 6 for coronavirus vaccination)chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema bronchiectasiscystic fibrosisinterstitial lung fibrosispneumoconiosisbronchopulmonary dysplasia (BPD)  
Chronic heart disease and vascular diseaseConditions such as:   congenital heart diseasehypertension with cardiac complicationschronic heart failureindividuals requiring regular medication and/or follow-up for ischaemic heart diseaseatrial fibrillationperipheral vascular diseasevenous thromboembolism  
Chronic kidney diseaseConditions such as:   chronic kidney disease at stage 3, 4 or 5chronic kidney failurenephrotic syndromekidney transplantation  
Chronic liver diseaseConditions such as:   cirrhosisbiliary atresiachronic hepatitis  
Chronic neurological diseaseConditions such as: stroke transient ischaemic attack (TIA) conditions in which respiratory function may be compromised due to neurological disease (e.g. polio syndrome sufferers) cerebral palsy learning disabilities Down’s Syndrome multiple sclerosis epilepsy dementia Parkinson’s disease motor neurone disease and related or similar conditions hereditary and degenerative disease of the nervous system or muscles severe neurological disability  
Diabetes mellitusAny diabetes, including diet-controlled diabetes.
ImmunosuppressionConditions or treatments such as: immunosuppression due to disease or treatment, including patients undergoing chemotherapy leading to immunosuppression 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) receiving immunosuppressive or immunomodulating biological therapy including, but not limited to anti-TNF, alemtuzumab, ofatumumab and rituximab receiving protein kinase inhibitors or PARP inhibitors
being treated with steroid-sparing agents such as cyclophosphamide and mycophenolate mofetil being 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 This also includes: anyone with a history of haematological malignancy, including leukaemia, lymphoma, and myeloma anyone with systemic lupus erythematosus and rheumatoid arthritis, anyone with psoriasis who may require long term immunosuppressive treatments  
Asplenia or dysfunction of the spleenThis also includes conditions that may lead to splenic dysfunction, such as homozygous sickle cell disease, thalassemia major and coeliac syndrome.
Morbid obesityAdults with a Body Mass Index (BMI) greater than or equal to 40.
Severe mental illnessConditions such as schizophrenia, bipolar disorder, or any mental illness that causes severe functional impairment.

Also included within priority group 6 are the following:

Younger adults in long-stay nursing and residential care settings:

Many younger adults in residential care settings will be eligible for the coronavirus vaccine because they fall into one of the clinical risk groups (for example learning disabilities). Given the likely high risk of exposure in these settings, vaccination of the whole resident population is recommended.

Younger residents in care homes for the elderly will also be at a higher risk of exposure. Although they may be at lower risk of mortality than older residents, they will have been offered the coronavirus vaccine at the same time as other residents in care homes for older people.

Unpaid carers:

Unpaid carers aged 16 to 64 are now beginning to be offered vaccination alongside adults with eligible at-risk health conditions (priority group 6). Those unpaid carers aged 65 and over should have been offered the vaccine earlier in priority groups 2 to 5.

The Scottish Government is using the definition for an unpaid carer as set out in the Carers (Scotland) Act 2016 however for the purposes of vaccinations this will not cover those who provide only remote care.

Some NHS boards are now beginning to call forward a limited number of carers identified through GP systems and social security data of those on relevant benefits, as vaccine supply allows. Carers do not have to do anything at this time if they have not received their appointment letter, are not on benefits or if they are not registered with their GP as a carer.

Further information will be available shortly about the forthcoming self-referral system for carers in Scotland which we expect to launch in early March.  A dedicated national marketing campaign will be launched alongside the self-referral system to raise awareness and encourage carers to come forward.

Priority group 6 includes a large number of people. It will take some time to invite everyone, so please wait to be invited for your vaccination over the coming weeks.

To keep updated on who is currently being vaccinated and for other COVID-19 vaccine information, please visit www.nhsinform.scot/covid19vaccine. If you think you should have been invited to your vaccination by now, you can access the missing invites form at www.nhsinform.scot/covid-19-vaccine/invitations-and-appointments/missing-appointment-details. Your enquiry will then be looked into. You will receive a communication within a couple of days.

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