The Department for Health & Social Care has issued temporary guidance which will allow employees and workers in the care sector to self-certify that they have a medical exemption from the Covid-19 vaccine. This is likely to make it easier for care homes to remain open with a full complement of staff, but has only delayed the challenges that will still be faced later in the year.

The deadline by which care home workers would be required to have their first dose of an authorised vaccine is 16 September 2021, which would allow sufficient time for the second dose by the 11 November 2021 implementation date. 

A letter has been issued to care providers detailing examples of the permitted exemptions which include individuals:

  • Receiving end of life care where vaccination is not in the individual’s interests. 
  • With learning disabilities or autistic individuals, or with a combination of impairments which result in the same distress, who find vaccination and testing distressing because of their condition and cannot be achieved through reasonable adjustments such as provision of an accessible environment. 
  • With medical contraindications to the vaccines such as severe allergy to all COVID-19 vaccines or their constituents. 
  • Who have had adverse reactions to the first dose (e.g. myocarditis).  

Short-terms exemptions also include those on certain medications or who are pregnant, which, in a largely female dominated workforce may provide some additional relief to both providers and workers. 

The guidance is temporary, pending the launch of a new NHS Covid pass (the details of which have not been provided). 

There remain questions about how care home providers should police the self-certification process, which will rely on trust in employees making an honest declaration as to their health and exemption status. It is also unclear whether a self-certification will be sufficient to absolve care homes of any failures to implement the requirements of the mandatory vaccine regulations.

It is notable that the medical exemption self-certification letter (which is available here) includes an acknowledgment that providing false information may result in disciplinary action against the worker.

If you have any questions arising from the medical exemption self-certification process, please contact Kevin Poulter at