GP mythbuster 89: Immunising people with an underlying medical condition

Page last updated: 23 December 2022
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Coronavirus (COVID-19) vaccines

Gov.uk COVID-19 vaccine information states:

  • people who are at high risk from coronavirus (clinically extremely vulnerable) and
  • people who are at moderate risk from coronavirus (clinically vulnerable)

are entitled to the COVID-19 vaccine.

The Joint Committee on Vaccination and Immunisation (JCVI) has produced guidance on groups who should be prioritised for vaccination.

The Enhanced Service Specification COVID-19 vaccination programme 2020/21 states that patients not registered with a GP or those without an NHS number are still eligible to be vaccinated. They will not be charged. COVID-19 vaccines offered by the NHS will be freely available to everyone, regardless immigration status. A patient is not does not need to prove their entitlement to free NHS treatment when accessing COVID-19 vaccination services.

Professional guidance

Public Health England (PHE) immunisation schedules for the UK population. They are based on recommendations of the Joint Committee of Vaccination and Immunisation. There are specific recommendations for immunisation of people with an underlying medical condition.

PHE and the Department of Health and Social Care update The Green Book regularly. It includes chapters on principles of immunisation and on each vaccine-preventable infection. Chapter 7 deals with immunisations for people with an underlying condition.

The Patient Group Direction (PGD) provides guidance on eligible groups for each vaccine. This includes vaccination of people with asplenia and sickle cell disease. It also includes conditions such as diabetes and chronic respiratory disease.

GP practices must explain the benefits clearly when offering vaccination to patients. They need systems to identify relevant patients. Practices should make sure these patients are vaccinated following current recommendations. Search the clinical records system regularly for patients who may be eligible for vaccines due to a new diagnosis or treatment. Relevant diagnoses in incoming clinical correspondence should be coded appropriately. This makes sure data retrieval is accurate.

When we inspect

We use these Regulations when we review if the practice is safe, effective, responsive, caring and well led. When we inspect, we look at the safety of immunising people with an underlying medical condition. This relates to:

GP practices need to take extra care that immunisations they carry out are right for people with an underlying medical condition.

We consider how GP practices support the immunisation programme. We consider whether staff providing immunisations are trained and competent to do so. This relates to key lines of enquiry (KLOE):

We expect GP practices to:

  • have a reliable system for adding appropriate clinical codes to patient records. For example from correspondence when a new relevant diagnosis is made
  • carry out regular searches using clinical codes. This is to make sure vaccination and boosters have been offered to relevant patients
  • follow PHE guidance on ordering, storing and handling vaccinations
  • make sure nurses who are not qualified as independent prescribers are using Patient Group Directives (PGDs) and ensure they use them appropriately.

All immunisers must:

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