How individuals can evidence medical exemption from COVID-19 vaccination – guidance now available

On Friday 1 October, the Department of Health and Social Care published long-awaited guidance on how individuals can evidence medical exemption from COVID vaccination (and testing). These exemption rules will apply where an individual may have to demonstrate their COVID status.

Most importantly, this will apply to those working in care homes (or whose role requires them to enter care homes), but it will also apply in other situations, such as:

  • where an individual is required to show their NHS COVID Pass as a condition of entry to certain venues and events (businesses may choose to do this already, but it is also one of the potential measures which may be implemented if the government needs to adopt Plan B of their Winter Plan)
  • where an individual is medically exempt from vaccination and therefore does not need to comply with close contact self-isolation rules
When will medication exemption apply?

There is no definitive list of conditions set out.

The guide states:

"The possible reasons for exemptions are limited. Examples that might be reasons for a medical exemption are:

  • people receiving end of life care where vaccination is not in the person’s best interests
  • people with learning disabilities or autistic individuals, or people with a combination of impairments where vaccination cannot be provided through reasonable adjustments
  • a person with severe allergies to all currently available vaccines
  • those who have had an adverse reaction to the first dose (for example, myocarditis)

Other medical conditions could also allow you to get a medical exemption”.

Short-term exemption

The guidance confirms that short-term exemptions are available for those “with short-term medical conditions”. Pregnant individuals can also choose to take up this time-limited exemption.


If a pregnant individual chooses to take up the short-term medical exemption, this will expire 16 weeks post-partum. The guide says that, as an alternative to applying for a medical exemption NHS COVID Pass, a pregnant individual can demonstrate their exemption by using their MAT B1 certificate. Where a MAT B1 certificate is used as evidence of exemption, this exemption will also expire 16 weeks post-partum.

How can an individual apply for COVID Pass medical exemption?

  1. The individual should phone the NHS COVID Pass service on 119 and ask for an NHS COVID Pass medical exemptions application form (they are not available from GPs).  During the call they’ll be asked to provide:
  • their name
  • their date of birth
  • their NHS number (if they know it)
  • the name of their GP and/or specialist clinician
  1. The guide says, “if you’re eligible to apply, you’ll get an application form by post.” (It’s unclear as to how this eligibility will be established as the guidance does not refer to the individual being asked to give medical information.)
  2. They should return their application form to the GP or relevant clinician stated on the form and it will be clinically reviewed by their doctor, specialist or midwife. The guide says that the clinician may need to speak with them, but it’s not necessary to book an appointment when the form is submitted.
  3. They will receive the results of the application by post two to three weeks after applying.
  4. The clinical decision on the medical exemption application is final and there is no right of appeal.

If medical exemption is granted, they can use the domestic NHS COVID Pass wherever they need to. It will look and work the same for people with medical exemptions as it will for people who are fully vaccinated. It will therefore not show others that they have a medical exemption, just that they have the NHS COVID Pass.

How can you evidence exemption?

Individuals can download the pass as a PDF or access it via the NHS app or the NHS website. The guide says that a paper version of the pass will be available soon.

Impact for care homes

The temporary self-certified exemption scheme launched on 15 September stated that self-certified exemption would last for 12 weeks after the launch of the full exemption scheme, which would presumably mean that it will come to an end on 23 December.

The government have not yet updated their operational guidance on the compulsory vaccination rules to reflect the launch of the exemption scheme.

When this is done, it will be interesting to see to what extent they’ll advise care businesses to enquire beyond the production of the NHS COVID Pass (which we are told will look the same for those who are vaccinated and those who are medically exempt), given that the guidance specifically recommends that care businesses carry out risk assessments for those who are exempt and therefore unvaccinated.

How Citation can help

We understand that this can be a complicated issue to handle as an employer, especially those in the care industry. If you’re a care business owner with questions or concerns over how this will affect your business or how best to act going forwards, you can speak to one of our experts by calling 0345 844 4848.

Pop in your details and we'll call you straight back

We'll get back to you as soon as we can.

Copy link
Powered by Social Snap