Coronavirus (Covid-19) - latest information and advice for patients Last updated 20/10/2021Please see below generalised Covid-19 Government guidance. We regularly update the page in response to any further announcements or developments. 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 have received a letter from the Government 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.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 Please check our Vaccination information section on the COVID web page for more on Covid-19 third dose vaccinations. NKF has produced a lanyard for people to wear when out in public, to remind others to social distance. We have had lots of great feedback about the lanyard and we have sold 16,000 to date.Back by popular demand are our NKF facemasks. To pre-order your facemask please visit here or call 01909 478166 where you can place your order and we can take payment by card. 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. 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 Boosters Programme Information 11/10/2021 According to the Department of Health and Social Care it has been estimated that over 24 million infections and more than 250,000 hospitalisations have been prevented as a result of the Covid-19 vaccination programme so far. The Covid-19 vaccine booster programme has started to maintain the protection of the most vulnerable from COVID-19 before winter. The Covid vaccine booster programme will happen around the same time as the annual flu vaccination programme, which started in September. Many people eligible for a Covid-19 booster will also be offered a free flu vaccination and it is important that these individuals get an appointment as soon as they are offered. The JCVI have advised that it is safe and effective to get the Covid-19 booster and flu vaccines at the same time. Where possible, the NHS will try to schedule these appointments together, however those offered appointments should take them up without delay to ensure they get the protection they need. Covid-19 booster and flu vaccinations are available at vaccination centres, GPs or community pharmacists. Those eligible will receive their booster from 6 months after their second dose of a Covid-19 vaccine and they will be contacted by the NHS when it is their turn. Those eligible for NHS influenza vaccination in 2021/22 are:all children aged two to fifteen (but not sixteen years or older) on 31 August 2021 (i.e. all children up to year 11 of secondary school) those aged six months to under 50 years in clinical risk groups chronic (long-term) respiratory disease, such as asthma (requires continuous or repeated use of inhaled or systemic steroids or with previous exacerbations requiring hospital admission), chronic obstructive pulmonary disease (COPD) or bronchitis chronic heart disease, such as heart failure chronic kidney disease at stage 3, 4 or 5 chronic liver disease chronic neurological disease, such as Parkinson’s disease or motor neurone disease learning disability diabetes splenic dysfunction or asplenia a weakened immune system due to disease (such as HIV/AIDS) or treatment (such as cancer treatment) morbidly obese (defined as BMI of 40 and above) pregnant women those aged 50 years and over those in long-stay residential care homes carers close contacts of immunocompromised individuals health and social care staff employed by: a registered residential care/ nursing home registered domiciliary care provider a voluntary managed hospice provider Direct Payment (personal budgets) and/or Personal Health Budgets, such as Personal Assistants. There will be no offer of flu vaccination to the household contacts of the shielded, as people are no longer being asked to shield. However, all household contacts of the immunocompromised will continue to be offered flu vaccination, which has been a longstanding commitment in the programme.Over 35 million people will be eligible for a flu vaccination this season. This is for England only. This includes the expansion of the programme to those aged 50 to under 65 years old and all school aged children. Frequently Asked Questions (FAQs) Regarding the JCVI Guidance on COVID-19 Vaccinations Below we have gathered some frequently asked questions and current recommendations relating to the Covid-19 third primary dose vaccination and the ‘booster’ vaccination. Am I eligible for a third primary dose or a booster vaccination?The Joint Committee on Vaccination and Immunisation (JCVI) originally published guidance on (1st September 2021) on third doses of COVID-19 vaccinations for individuals aged 12 years and over who were severely immunosuppressed at the time of their first or second dose. Vaccinating individuals for example that have leukaemia, advanced HIV or are receiving or have received immunosuppressive therapy for a solid organ transplant in the previous six months. These patients may not mount a full response to vaccination and therefore may be less protected than the wider population.It has been advised that the eligibility for a third primary dose vaccination as part of a primary course is based on the individual with severe immunosuppression clinical needs, informed by the timing of their specific therapeutic interventions and personal care plan. This will specifically include kidney transplant patients who will be eligible for a third primary dose vaccination.Individuals who will be eligible for the booster vaccination will include individuals with less serious immunosuppression, pending further guidance from the JCVI.If I am eligible for a third primary dose or booster, when should I receive a letter for my appointment?Please wait to hear from your health professional on whether you are eligible to receive the third primary dose or booster. Contact should be made by the patient’s consultant or general practitioner and will be communicated by letter by Monday 11th October. Individuals who are eligible for the third primary dose should receive their next vaccination after at least 8 weeks after their second dose to enable a better immune response to be generated.Individuals who are eligible for the booster vaccination should receive their next vaccination after at least 6 months after their second dose.NHS England have confirmed that they will be communicating to people via letters and/or texts to people who are eligible for a third primary dose. These will confirm eligibility and you should be able to use these communications to book your appointment.No online booking system will be in place for the third dose vaccinations.What is the difference between a Covid-19 third primary dose vaccination and a booster vaccination?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.We encourage everyone who is offered a third vaccine or booster to take up the additional protection that it offers.What vaccine types are available who receive the third dose or booster?The JCVI have advised that either the Moderna or Pfizer-BioNTech Covid-19 vaccines will be administered as the third dose and booster.However the AstraZeneca vaccine may still be offered on a case by case basis depending on the individual and following the decision by a health professional.How will my vaccination be recorded on the system?If the third primary dose is recorded as a booster dose in the point of care system, records will be amended through a national process to ensure that the third primary dose is accurately recorded as such. This will ensure distinction is made between a third primary dose and a booster dose and that individuals are invited for any subsequent doses that are recommended.Is there a letter I can show my consultant, GP or other health professional which shows to invite severely immunosuppressed people for their third Covid-19 vaccination?Here is the latest communication which was released on Thursday 30th September 2021. The JCVI states within the letter: "The specialist involved should advise on whether the patient fulfils the eligibility criteria and on the timing of any third primary dose. In general, vaccines administered during periods of minimum immunosuppression (where possible) are more likely to generate better immune responses. The third primary dose should ideally be given at least 8 weeks after the second dose, with special attention paid to current or planned immunosuppressive therapies guided by the following principles: where possible, the third primary dose should be delayed until 2 weeks after the period of immunosuppression, in addition to the time period for clearance of the therapeutic agent if not possible, consideration should be given to vaccination during a treatment ‘holiday’ or at a nadir of immunosuppression between doses of treatment”. SEE HERE FOR A 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 – 15/09/2021 FIRST 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. If you will turn 18 within 3 months, you can also get a 2nd dose.Find out who can get the COVID-19 vaccine here VACCINATIONS FOR PEOPLE AGED 18 AND OVERYou can get your 1st and 2nd dose a Covid-19 vaccine if you're aged 18 or over (or will turn 18 within 3 months).Find out who can get the COVID-19 vaccine here VACCINATIONS FOR YOUNG PEOPLE SCOTLANDNHS Scotland are now offering the Coronavirus vaccine to all children and young people aged 12 to 17 years.Find out who can get the COVID-19 vaccine here VACCINATIONS FOR YOUNG PEOPLE WALESAll children and young people aged 12 - 17 are eligible to receive the COVID-19 vaccination. This includes children and young people aged 12 - 15 years being offered their first dose of Pfizer vaccine. It is anticipated a second dose will be offered later to increase the level of protection and contribute towards longer term protection.Young people aged 16 and 17 should also be offered their first dose of Pfizer vaccine. It is anticipated a second dose will be offered later to increase the level of protection and contribute towards longer term protection.Find out who can get the vaccine in Wales here VACCINATIONS FOR YOUNG PEOPLE NORTHERN IRELAND 12 - 15 year olds are being offered the first dose of the Pfizer Covid-19 vaccine. Find out more here 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. 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. 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 12 and over 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 All adults aged 16 and over have now been offered the vaccine in Wales, including some 12-15 year olds with a severe condition that puts them at increased risk from Covid-19. 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 12 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 under 18 years of age can receive a vaccine at a mobile clinic. Children aged 12 to 15 years will be offered the vaccine at school. 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 first dose of the Moderna vaccine was administered in Wales on Wednesday 7th April 2021. 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 2021. 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 2021. 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.NHS Blood and Transplant have recently had some queries about whether having – or not having – the Covid vaccination affects a person’s ability to donate or receive a transplant. You can donate or receive a transplant whether you’ve had the Covid-19 vaccination or not, as long as you’re eligible. – 14th October 2021 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. Guidance in England has been provided on how to stay safe and help prevent the spread of Coronavirus here Wales from 7 August - Wales moved to alert level 0 on 7th August 2021. There are no legal limits 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. From 14th October, the limit allowing p to 15 people from no more than four households to meet in a private home will be removed.Restrictions will remain in place to prevent gatherings of 30 people or more in domestic settings. 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.