Treatments for coronavirus (COVID-19)

Down’s syndrome 

All patients with Down’s syndrome 

Sickle cell disease 

All patients with a diagnosis of sickle cell disease 

Patients with a solid cancer 

• Active metastatic cancer and active solid cancers (at any stage)  
• All patients receiving chemotherapy within the last 3 months  
• Patients receiving group B or C chemotherapy 3-12 months prior  
• Patients receiving radiotherapy within the last 6 months  

Patients with a haematologic malignancy 

• Allogeneic haematopoietic stem cell transplant (HSCT) recipients in the last 12 months or active graft vs host disease (GVHD) regardless of time from transplant 
• Autologous HSCT recipients in the last 12 months 
• Individuals with haematological malignancies who have 
  • received chimaeric antigen receptor (CAR)-T cell therapy in the last 24 months, or 
  • anti-CD20 monoclonal antibody therapy in the last 12 months 
• Individuals with chronic B-cell lymphoproliferative disorders receiving systemic treatment or radiotherapy within the last 3 months 
• Individuals with chronic B-cell lymphoproliferative disorders with hypogammaglobulinaemia or reduced peripheral B cell counts 
• Individuals with acute leukaemias and clinically aggressive lymphomas who are receiving chemotherapy or within 3 months of completion at the time of vaccination 
• Individuals with haematological malignancies who have received anti-CD38 monoclonal antibody or B-cell maturation agent (BCMA) targeted therapy in the last 6 months 
• Individuals with chronic B-cell lymphoproliferative disorders not otherwise described above 

Patients with renal disease 

• Renal transplant recipients (including those with failed transplants within the past 12 months), particularly those who: 
  • Received B cell depleting therapy within the past 12 months (including alemtuzumab, rituximab [anti-CD20], anti-thymocyte globulin) 
  • Have an additional substantial risk factor which would in isolation make them eligible for nMABs or oral antivirals 
  • Not been vaccinated prior to transplantation 
• Non-transplant patients who have received a comparable level of immunosuppression 
• Patients with chronic kidney stage (CKD) 4 or 5 (an eGFR less than 30 ml/min/1.73m2) without immunosuppression 

Patients with liver disease 

• Patients with cirrhosis Child’s-Pugh class B and C (decompensated liver disease). 
• Patients with a liver transplant 
• Liver patients on immune suppressive therapy (including patients with and without liver cirrhosis) 
• Patients with cirrhosis Child’s-Pugh class A who are not on immune suppressive therapy (compensated liver disease) 

Patients with immune-mediated inflammatory disorders (IMID) 

• IMID treated with rituximab or other B cell depleting therapy in the last 12 months 
• IMID with active/unstable disease on corticosteroids, cyclophosphamide, tacrolimus, cyclosporin or mycophenolate. 
• IMID with stable disease on either corticosteroids, cyclophosphamide, tacrolimus, cyclosporin or mycophenolate. 
• IMID patients with active/unstable disease including those on biological monotherapy and on combination biologicals with thiopurine or methotrexate 

Primary immune deficiencies 

• Common variable immunodeficiency (CVID) 
• Undefined primary antibody deficiency on immunoglobulin (or eligible for Ig) 
• Hyper-IgM syndromes 
• Good’s syndrome (thymoma plus B-cell deficiency) 
• Severe Combined Immunodeficiency (SCID) 
• Autoimmune polyglandular syndromes/autoimmune polyendocrinopathy, candidiasis, ectodermal dystrophy (APECED syndrome) 
• Primary immunodeficiency associated with impaired type I interferon signalling 
• X-linked agammaglobulinaemia (and other primary agammaglobulinaemias) 

HIV/AIDs 

• Patients with high levels of immune suppression, have uncontrolled/untreated HIV (high viral load) or present acutely with an AIDS defining diagnosis 
• On treatment for HIV with CD4 <350 cells/mm3 and stable on HIV treatment or CD4>350 cells/mm3 and additional risk factors (e.g. age, diabetes, obesity, cardiovascular, liver or renal disease, homeless, those with alcohol-dependence) 

Solid organ transplant recipients 

All recipients of solid organ transplants not otherwise specified above 

Rare neurological conditions 

• Multiple sclerosis 
• Motor neurone disease 
• Myasthenia gravis 
• Huntington’s disease