Vaccine exemption guidance

With today (16 September) marking the last day for staff working in CQC registered care homes in England to have their first vaccine if they want to be fully vaccinated by 11 November, the Department of Health and Social Care has published details on the medical exemptions process, which explains that temporary exemptions on a self-certified basis will be introduced for an interim period.

The letter from Claire Armstrong, on the exemptions process for the vaccination as a condition of deployment regulations explains that on a temporary basis, people working or volunteering in care homes who have a medical reason why they are unable to have a Covid-19 vaccine will be able to self-certify that they meet the medical exemption criteria using one of the template forms attached to her letter.

Care home workers with a medical exemption will need to complete this self-certification form which includes a non-exhaustive list of medical exemptions. It also provides that time-limited exemptions will also be available for those with short-term medical conditions and for pregnant women should they choose to take it. It is worth noting that the DHSC's position on pregnancy has changed since the publication of the operational guidance.

Staff are required to certify that they meet the medical criteria for exemption “in this guidance” but the hyperlink to the further information on who is medically exempt from vaccination is missing from the form. We are therefore not clear what is meant by “in this guidance”. Interestingly staff are not required to state what exemption they are relying on.

However the form does include information on the exemptions for conditions listed in section 4.4 (special warnings and precautions for use) in the Summary of Product Characteristics for each of the approved COVID-19 vaccines (PfizerAstraZeneca and Moderna) that may also be considered for the purposes of the self-certification process.

The self-certification form also includes a health warning that providing false information may result in disciplinary action.

For those staff vaccinated abroad with both approved and non-approved vaccines, there will also be a temporary self-certification process. You can view the self-certification form for people vaccinated abroad here.

It seems that the temporary self-certification process has been introduced for a short period prior to the launch of the new NHS Covid Pass system which is due to go live “imminently” although no date is confirmed.

The letter says that once the NHS Covid Pass system is launched, care home workers will need to apply for a formal medical exemption through that process. This temporary self-certification will expire 12 weeks after the NHS Covid Pass system is launched.

We will update readers once the DHSC has updated its operational guidance to reflect the temporary exemption system outlined in Claire Armstrong's letter together with further details on the current exemption list. 

If you have any questions, please do not hesitate to contact Joanna BurrowsFiona Goodman or Amanda Narkiewicz.

Our content explained

Every piece of content we create is correct on the date it’s published but please don’t rely on it as legal advice. If you’d like to speak to us about your own legal requirements, please contact one of our expert lawyers.

Posted by


Mills & Reeve Sites navigation
A tabbed collection of Mills & Reeve sites.
My Mills & Reeve navigation
Subscribe to, or manage your My Mills & Reeve account.
My M&R


Register for My M&R to stay up-to-date with legal news and events, create brochures and bookmark pages.

Existing clients

Log in to your client extranet for free matter information, know-how and documents.


Mills & Reeve system for employees.