Coronavirus (Covid-19) - latest information and advice for patients Last updated 24/09/2021 Contents: Shielding advice Vaccination information Latest information for patients National restrictions Travel Stress and anxiety Research from NHS Blood and Transplant Latest NHS information and advice Support for the extremely vulnerable Further general advice CORONAVIRUS - SHIELDING/UNSHIELDING - LATEST INFORMATION AND ADVICE FOR PATIENTS Shielding programme ends for the most vulnerable – 15/09/2021People previously considered to be clinically extremely vulnerable will not be advised to shield again. The Government have announced that the shielding programme in England is closed. The closure of the shielding programme follows a pause to shielding guidance in place since 1 April 2021. The Government has decided that centralised guidance for this group should be replaced by individualised advice from the person’s clinician.Those previously on the Shielded Patient List will receive a letter from the Government in the coming days to inform them of this decision. The Government will continue to assess the situation and risks posed by Covid-19 and, based on clinical advice, will respond accordingly to keep the most vulnerable safe. For more information visit here.Please check our Vaccination information section on the COVID web page for more on Covid-19 third dose vaccinations. The guidance on shielding and protecting people who are clinically extremely vulnerable from Covid-19 can be found on the links below: England Scotland Wales Northern Ireland NKF has produced a lanyard for people to wear when out in public, to remind other to social distance. We have had lots of great feedback about the lanyard and we have sold 16,000 to date.The NKF has worked with a coalition of over 20 charities in the #SafeAtWork coalition and this letter can be downloaded here and shared with employers to help discussions about a safe return to the workplace. Due to the restrictions easing on July 19th, what's next for kidney patients? Find some top tips from kidney patient and professional groups here UK Kidney Association statement on the care of adult clinically extremely vulnerable kidney patients after easing of COVID-19 restrictions on 19th July Summary of key messages COVID-19 vaccination offers the best available protection to clinically extremely vulnerable (CEV) kidney patients and should be recommended to all kidney patients. Some kidney patients may not have achieved full protection from vaccination with 2 doses of an MHRA approved COVID-19 vaccine. We recommend that all CEV kidney patients (those at Chronic Kidney Disease (CKD) Stage 5, on dialysis, with a kidney transplant or who are on significant immunosuppression for autoimmune kidney disease) continue to follow enhanced precautions, following the lifting of wider restrictions on 19 July. Healthcare facilities should maintain full protective environments in kidney dialysis units and kidney outpatient areas and should continue to provide COVID-19 protected “green” pathways for kidney dialysis patients, transplant recipients and patients who are on or have recently received significant immunosuppression for autoimmune kidney disease. This should include the provision of COVID-19 safe hospital transport for CEV kidney patients. The full document is available on the COVID-19 pages of the UKKA website. Please call our freephone helpline if you would like to chat to one of our advisers about your concerns - 0800 169 09 36 We know patients are very concerned about Coronavirus (Covid-19). The NKF are working with the National Renal Guidance Group for Covid-19. This is a group of specialist clinicians, partners and patient charities, who are providing the latest clinical and patient guidance during these very worrying times. The NKF have written to all NHS Trust chief executives, to highlight the importance of in-centre dialysis patients wearing appropriate face masks. These are for use when travelling to and from dialysis, throughout the prescribed dialysis treatment, and in waiting and assessment areas being used both before and after treatment. Vaccination information SEE HERE FOR A NEW GUIDE BY THE KIDNEY CHARITIES TOGETHER GROUP, DETAILING HOW THE COVID-19 VACCINE HELPS TO PROTECT, AND WHY YOU SHOULDN’T INTERPRET THE RESULTS OF AN ANTIBODY TEST AS AN INDICATION OF PROTECTION FROM INFECTION ANTIBODYPDF.PDF – 15/09/2021FIRST DOSE VACCINATIONS FOR YOUNG PEOPLE ENGLAND Young people aged 12 to 15 will be offered a first dose of a COVID-19 vaccine.16 and 17 year olds can now get their first dose of a COVID-19 vaccine.Find out who can get the COVID-19 vaccine here VACCINATIONS FOR YOUNG PEOPLE SCOTLAND 12 to 15 year olds can now be offered the Pfizer/BioNTech vaccine.16 and 17 year olds can now get their first dose of a COVID-19 vaccine.Find out who can get the COVID-19 vaccine here VACCINATIONS FOR YOUNG PEOPLE WALES 16 and 17 year olds can now get their first dose of a COVID-19 vaccine. Find out who can get the vaccine in Wales and where to book on the Public Health Wales website. VACCINATIONS FOR YOUNG PEOPLE NORTHERN IRELAND 16 and 17 year olds can now get their first dose of a COVID-19 vaccine. Find out if you’re eligible and how to book on nidirect. THIRD VACCINE DOSE FOR VULNERABLE PEOPLE ENGLAND People over 50, care home residents, health and social care workers, and those aged 16 to 49 years with severely weakened immune systems and adult household contacts of immunosuppressed individuals will be offered a third COVID-19 vaccine dose.KIDNEY PATIENTS WHO ARE ELIGIBLE FOR THE THIRD PRIMARY OR BOOSTER COVID-19 VACCINATION - 24/09/2021The UKKA have provided an update on recommendations for third or booster COVID-19 vaccines. The clarification on kidney patients who are eligible for the third primary or booster COVID-19 vaccination is now available and can be found here THIRD VACCINE DOSE FOR IMMUNOSUPPRESSED PEOPLE WALES Adults and children aged 12 and over with a severely weakened immune system will now be offered a third COVID-19 vaccine dose. The NHS will contact you directly to arrange an appointment. The difference between a Covid-19 booster vaccination and the third dose primary Covid-19 vaccine: Third dose primary Covid-19 vaccineThe third dose is for people who may not have had a sufficient immune response to the first two doses of a Covid-19 vaccination. This is likely to happen in people that are immunosuppressed or have other health conditions affecting their response to the vaccine. This dose is recommended to form part of a standard course and is not deemed to be an “additional” or a “booster” dose, but a necessary dose to help increase these people’s immunity closer to levels others would already have from their first two doses. Booster vaccineThe booster vaccine is for people whose initial immune response to their first two doses is likely to have weakened over time. Boosters are given when immunity gradually wanes to provide further protection against the Covid-19 virus. National Kidney Federation (NKF) Response to JCVI Covid-19 3rd Dose Announcement - 03/09/2021The NKF welcome the recent announcement by the Joint Committee on Vaccination and Immunisation (JCVI) who have issued advice on the third dose of an mRNA Covid-19 vaccine for the severely immunosuppressed aged 12 and over which includes all kidney transplant patients.The response has been announced after scientific data has shown that kidney patients and others who are receiving immunosuppressed treatment may not mount a full response to two vaccinations and therefore may be less protected than the wider population.Immunosuppression varies widely in severity and duration. Many people who are immunosuppressed have lower levels of antibodies after Coronavirus (COVID-19) vaccination. People with severe immunosuppression are more likely to be severely ill if they do catch COVID-19.At the NKF we are keen in ensuring kidney patients and health professionals are aware of the third vaccination dose and that kidney transplant patients see the importance and are encouraged to take a third vaccine as it may increase their protection.Although this is positive news that extra protection is being put in place for all kidney transplant patients, the NKF are concerned that data for other groups of kidney patients, such as those who are receiving haemodialysis, peritoneal dialysis and patients who have Stage 5 chronic kidney disease who are not yet receiving dialysis, also have a low response to two doses of the vaccination.Safety still remains a concern for many kidney patients and we are dedicated to continue working with partners in protecting clinically extremely vulnerable patients. View JCVI's full statement on third dose vaccination for the severely immunosuppressed here. Kidney charities together joint response to Lancet publication 12/8/21: New research published in The Lancet has shown that, unlike the general population, many people who have kidney failure and who are on haemodialysis have a poor antibody response to two doses of covid19 vaccine. The research also shows that the antibodies are less effective against the delta variant; and that people on haemodialysis have a better response to an mRNA vaccine (such as Pfizer) than an adenovirus vaccine (such as AstraZeneca). This adds to the existing research from the UK and elsewhere showing that many people who are on immunosuppressants to prevent kidney transplant rejection, or for treatment of kidney disease, are not adequately protected by two doses of the covid19 vaccine. Therefore, this leaves many thousands of kidney patients who have had two doses of vaccines without as much protection from covid19 as the rest of the population. That is why we, as the Kidney Charities Together Group*, are jointly calling on the JCVI to urgently prioritise the roll out of a third dose to kidney patients who are on haemodialysis, or who have had a transplant, or who are taking immunosuppressants due to a particular kidney condition. We need clear information and guidance, an update to the interim advice issued in June and clarity on when and how these individuals can receive their third dose. As restrictions lift and guidance changes across the UK many thousands of people are anxious because despite having shielded and having had two doses of their vaccines they still don’t know if they have enough protection to return to ‘normal.’ More needs to be done to ensure their safety so that they can enjoy the same freedoms as the rest of the population.UKKA have provided a position statement relating to the SARS-Cov-2 COVID-19 third dose of vaccine for Clinically Extremely Vulnerable adult kidney patients. Following a request from the Department of Health and Social Care (DHSC) for advice on a possible extension of the COVID-19 vaccination programme, the JCVI has looked at the available evidence around vaccinating children and young people under the age of 18. From 16 August - If you’re fully vaccinated or under 18, you will not need to self-isolate following close contact with someone who has COVID-19. You’ll still need to take a PCR test and self-isolate if it’s positive. Public Health England have released results of a vaccination study for people who are in at-risk groups. Within these clinical risk groups, there will be people with more severe forms of illness – particularly in the immunosuppressed group – who may not respond as well to the vaccines, and they recommend they seek advice from their specialists. England People aged 18 and over in England are being invited to receive the Covid-19 vaccination. NHS England has released the locations of vaccination centres throughout the country. Scotland Anyone aged over 16 in Scotland is being offered the Covid-19 vaccine.Public Health Scotland has created a resource centre where you can find information about the Covid-19 vaccination, including where they'll be administered. Wales Everyone over the age of 16 in Wales is now being vaccinated. The Welsh government has revealed the locations of vaccination centres across the country. Northern Ireland The Northern Ireland vaccination programme has been opened to all people aged 18 and over.Anyone aged 18 or over, can receive the COVID-19 vaccination at mobile walk-in vaccination clinics or community pharmacies across Northern Ireland. Those unedr 18 years of age can receive a vaccine at a mobile clinic. Find out more on who can get a COVID-19 vaccine here. The JCVI has recommended that anyone under the age of 40 should receive an alternative to the AstraZeneca vaccine. An Oxford study showed a 65% fall in Covid-19 infections after the first dose of the AstraZeneca or Pfizer-BioNTech vaccines. The JCVI has issued its final guidance on phase 2 of the Covid-19 vaccination programme. The first dose of the Moderna vaccine was administered in Wales on Wednesday 7th April. The Medicines & Healthcare products Regulatory Agency has produced an information leaflet on the Moderna vaccination. The NKF have partnered with Kidney Research UK to fund a study to discover how well Covid-19 vaccinations work in people who go to hospital for dialysis. The NKF, along with other kidney charities, released a Covid-19 vaccination information for patients guide, which includes some common questions people have asked, with answers from kidney specialists. The Medicines and Healthcare products Regulatory Agency (MHRA) has approved three Covid-19 vaccinations. The first vaccine to be approved has been developed by Pfizer-BioNTech and has been rolled out to elderly people in care homes and care home staff. The second vaccine has been developed by Oxford-AstraZeneca and roll-out started in the UK on Monday 4th January. Dialysis patient Brian Pinker was the first person to receive the vaccination. The third vaccine has been produced by Moderna. The first dose was administered in Wales on 7th April. The renal community provided key messages about the Covid-19 vaccination for people with CKD. The renal community released a joint-statement regarding the Covid-19 vaccination for adult patients with kidney disease. Vaccination webinar 29th June 2021 NKF partnered with Kidney Care UK, Kidney Research UK, Polycystic Kidney Disease Charity and UK Kidney Association to deliver a webinar regarding the developments in our knowledge about the Covid vaccines and how people with suppressed immune systems are responding, as well as a discussion about how to return to normal activities and cope with anxiety as restrictions ease. We were joined by four kidney doctors, Dr Rebecca Suckling from Epsom and St Helier NHS Trust, Dr Andrew Frankel, Dr Steve McAdoo, and Dr Michelle Willicombe from Imperial College Healthcare NHS Trust. You can view the webinar here: Latest information for patients We are working with our colleagues to ensure the latest and most up to date information is available to patients.Updated COVID-19 guidance for children with kidney disease on dialysis, and immunosuppression (including kidney transplants) -Updated 3rd August 2021 bapncovidadviceforchildrenandyoungpeopleaugust2021.pdfKQuIP COVID HD Ensuring Patient Safety - Coronavirus test information for kidney patients can be found here Read information about how you can reduce your risk of contracting Covid-19. This information is also available in Plain English. The Kidney Quality Improvement Partnership (KQuIP) has produced an animated video about receiving haemodialysis during the pandemic. National restrictions throughout the UK AUTUMN AND WINTER PLAN 2021 ENGLAND The government has set out its COVID-19 autumn and winter plan.England from 19th July - England has moved to Step 4 of the roadmap. Everyone should be cautious while managing the risks as cases of COVID-19 remain high. Restrictions in England can be found here Wales from 7 August - Wales moves to alert level 0. There are no legal limites on the number of people who can meet, including in private homes, public places or at events. In addition all businesses and premises may be open. Regulations in Wales can be found here Scotland - There are no limits on the number of people or households you can meet at home and in public places, and you no longer need to stay 2 metres apart from others. Scotland’s guidance can be found here Northern Ireland - Up to 15 people from no more than four households can meet in a private home and stay overnight. Children aged 12 and under are not counted in the total. Regulations for Northern Ireland can be found here Travel England - Travel information for people in England. Scotland - Quarantine rules and information on the process for people entering Scotland. Wales - Travel information for people in Wales. Northern Ireland - Travel advice for people in Northern Ireland. Dialysis Away From Base (DAFB) - A joint statement from professional and patient societies can be read here Research and studies on coronavirus Stress and Anxiety We have put together some information to help you cope with stress and anxiety during these uncertain times. Research updates from NHS Blood and Transplant News about the work they are doing to reduce the impact of coronavirus The latest NHS information and advice about coronavirus (Covid-19) here Support for the extremely vulnerable Get coronavirus support as an extremely vulnerable person - Register if you have a medical condition that makes you extremely vulnerable to coronavirus. For example, you’ll be able to ask for help getting deliveries of essential supplies like food In England In Scotland In Wales In Northern Ireland Further general advice If you think you have coronavirus symptoms you can use the NHS 111 assessment. Further general information and daily updates can be found on the GOV.UK. Information and guidance for renal professionals.