The NHS COVID Pass for people who are medically exempt from vaccinations

All exemptions will be assessed by your doctor, specialist clinician or midwife. The outcome will be sent directly back to you. If approved, your domestic NHS COVID Pass can then be used to prove your status.

The domestic NHS COVID Pass will look and work the same for people with medical exemptions as it will for people who are fully vaccinated. The pass will not show that you have a medical exemption.

You’ll also get a confirmation letter which you should keep for your records. You can use the letter to prove that you’re unable to get vaccinated if you work or volunteer in a care home or are travelling from a country that’s not on the red list. The letter will say that you’re medically unable to get vaccinated. The letter does not explain the reason you’re unable to vaccinate.

It’s up to other countries to decide whether or not residents in England with a medical exemption can follow the same rules for travel as those who are fully vaccinated.

Reasons you could get a medical exemption

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, autism or a combination of impairments which mean that vaccination and testing result in distress and who cannot be vaccinated through reasonable adjustments such as an accessible environment
  • 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.

You can also get a temporary exemption which will allow you to use the COVID Pass if you have a short-term medical condition or are pregnant and choose to take this option.

How to apply for and receive your COVID Pass when you’re unable to be vaccinated

A carer can apply on your behalf.

  1. Phone the NHS COVID Pass service on 119 to ask for an NHS COVID Pass medical exemptions application form.

You can also call to find out more information about NHS COVID Pass medical exemptions.

The call handler at the NHS COVID Pass service will ask you some questions. You will need to give:

  • your name
  • your date of birth
  • your NHS number (if you know it)
  • the name of your GP and/or specialist clinician
  1. If you’re eligible to apply, you’ll get an application form by post.

You should not ask your GP for an application form. If you do go to your GP before you get your application form you’ll be asked to call the NHS COVID Pass service on 119.

  1. Return your application form to the GP or relevant clinician stated on the form.

Your application will be clinically reviewed by your doctor, specialist or midwife. Your GP, specialist or midwife may ask to speak with you if needed, but you won’t need to book this when you submit your application.

  1. You’ll automatically get the results of your application by post once your application has been processed.

You don’t need to contact your GP or the clinician reviewing your exemption unless they ask you to contact them.

  1. If you get a medical exemption you can use the domestic NHS COVID Pass wherever you need to.

The pass won’t show others that you have a medical exemption, just that you have the NHS COVID Pass.

You can access your NHS COVID Pass digitally – on the NHS app or the NHS website.

You can also download it as a pdf.

To request a paper version of your pass, call 119.

Find out more about the NHS COVID Pass on the NHS website.

  1. The clinical decision on your medical exemption is final. You can’t appeal the decision.

Receiving an exemption does not mean you are protected against COVID-19. You should self-isolate if you have any symptoms of COVID-19.

Other ways to show your exempt COVID status

If you work or volunteer in a care home

If you work or volunteer in a care home, you can temporarily self-certify that you’re medically exempt from vaccination. This means that, for a short time, you can tell your employer yourself that you’re unable to vaccinate, without getting a doctor to say it, and you can keep working.

You must complete the self-certification form and show it to your employer by 24 December 2021. You can then use it until 31 March 2022.

From 1 April 2022, you’ll need to use the NHS COVID Pass to prove your COVID-19 vaccination status.

If you’re pregnant

Pregnant women can get the COVID-19 vaccination.

If you choose not to vaccinate, you can use your MAT B1 certificate to show your COVID status - you don’t have to use the COVID Pass.

Alternatively, you can apply for a short-term medical exemption so that you can use the COVID Pass.

Whether you use the MAT B1 certificate or the COVID Pass, your medical exemption will expire 16 weeks after you give birth. This will allow you to become fully vaccinated after birth.

The Royal College of Obstetricians, Royal College of Midwives and the UK Tetralogy Service consider COVID vaccination to be safe. They recommend that pregnant women get vaccinated against COVID.

If you’ve taken part in a vaccine trial

If you’re a resident in England and have taken part, or are taking part, in COVID-19 vaccine clinical trials you can get a domestic NHS COVID Pass to use in England and a travel NHS COVID Pass to use abroad.

You don’t need to apply for a medical exemption. See more information on proving your COVID status after vaccine clinical trials.