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Important COVID risk and vaccine updates

This guidance was updated on 12 May 2021; click here to see the latest version

Tuesday 16 March 2021

Getting a COVID vaccine

Most COVID vaccines will be arranged via primary care. For people not registered with a GP, or who have not disclosed their HIV status, HIV clinics in Wales, Scotland, Northern Ireland and England can refer directly to vaccine hubs. It may take a while for individual clinics to get the necessary pathways arranged, and numbers may be limited, but patients should contact their clinic for more information if they are unable to access the vaccine through their GP. Some HIV services are offering vaccines within the HIV clinic so people should be advised to check with their local service.

Currently in the Republic of Ireland vaccines can only be accessed via GPs. We will update this information as required and a summary of current practice in each country is in the table below (Appendix 1.)

Central vaccine databases will not include medical information, just basic details and the date a vaccine is given.

People without an NHS number should be able to access vaccines.


Shielding

An additional 1.7 million people in England have been added to the ‘clinically extremely vulnerable’ list for COVID-19 based on a new risk calculator called QCovid. QCovid is based on a combination of factors which include ethnicity, housing, obesity and specific health conditions. This affects many people, both with and without HIV. If you have HIV and you have been added to the Shielded Patient list it may be for non-HIV reasons or it may be wrong. You can be taken off that list by your GP and we are investigating if HIV clinics can do the same.

If you have been told that you are in this group it means that you are on the Shielding List and so you are in priority group 4 for COVID vaccination. You are also eligible for additional support - see the Shielding Support Website: https://www.gov.uk/coronavirus-shielding-support. You can find your local council’s details at https://www.gov.uk/coronavirus-local-help.

Last year there were cases where people who were NOT high risk were advised to shield because it has been based on inaccurate information. NHS Digital and DHSC are aware of some of the issues that caused this and are continually updating the ways they assess risk. Anyone who was removed from the ‘extremely clinically vulnerable’ list last year (also called ‘the shielding list’) will not have been included in the QCovid risk assessments – here the advice is for a GP or secondary care service to recalculate someone’s risk and information about how to access, and register to use, the tool is here: https://digital.nhs.uk/coronavirus/risk-assessment/clinical-tool

QCovid flags someone as ‘clinically extremely vulnerable’ if their risk of dying from COVID is at least 10 times higher than it would be for someone of the same age without additional risk factors. HIV is considered in the calculation but HIV alone would not be enough to put someone in the higher risk group. An important issue to consider is relative versus absolute risk: a 10 x higher risk of severe COVID (relative risk) sounds very alarming BUT if the actual risk of getting severe COVID is 1 in 20,000 (absolute risk) that translates to 1 in 2,000 which is still a LOW RISK. The risk of getting COVID will also depend on how common COVID is in the population, whether you follow social distancing guidance and hygiene recommendations like washing your hands, and vaccination. Current risk calculations will evolve over time to reflect this.

We continue to advise that people living with HIV who are at increased risk of COVID should shield. The BHIVA & THT advice about risk remains unchanged and can be found here:

https://www.bhiva.org/SARS-CoV-2-vaccine-advice-for-adults-living-with-HIV-update

with Plain English version here:

https://www.bhiva.org/SARS-CoV-2-vaccine-advice-for-adults-living-with-HIV-plain-english-version-update

For now, if you think you have received shielding advice by mistake, try to speak to your GP or your clinician so they can review the decision with you.


For further information, please contact bhiva@bhiva.org or for media enquiries, please contact Jo Josh at jo@commsbiz.com or +44 (0) 7306 391875


Appendix 1

Regional delivery of COVID-19 vaccination to people living with HIV