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Vulnerable groups

This guidance may change and people are advised to check often to keep up with the latest advice.

This guidance is for everyone who has been identified as having a long-term clinical condition or being clinically extremely vulnerable.

Reviewed 12 April 2021

This guidance may change and people are advised to check often to keep up with the latest advice. 

If you are at high risk from coronavirus (clinically extremely vulnerable), you will previously have received a letter from Manx Care or from your GP or consultant telling you this. You may have been advised to shield in the past.

The Isle of Man Government's priority is to protect the health of the Island's community and help everyone to stay safe.

Following the outbreak of COVID-19, Public Health advised those individuals who are clinically extremely vulnerable people (categories are outlined below) to stay at home as much as possible and to avoid any face-to-face contact. This is because they are at a high risk of severe illness from coronavirus.

As of 3 March 2021, the Isle of Man Government introduced new restrictions as a result of COVID-19 transmission in the community. As restrictions are being eased, from 12 April, those who are clinically extremely vulnerable are no longer being advised to shield.

Social distancing and face covering measures are still in place and we recommend you adhere to good hygiene practice.

If you have any concerns about what this could mean for any medical or health condition you have, you may wish to discuss this with your doctor, consultant or other healthcare provider.

The advice remains to work from home wherever possible. If you cannot work from home, you should discuss your safe return to work with regards to COVID-19 with your employer.

The vaccine is likely to make an important contribution towards protecting you from COVID-19. Clinically extremely vulnerable people are expected to receive a vaccination against COVID-19 before the general population. Manx Care will ensure that you can receive the vaccine as safely as possible, as well as any care and support needed. Even if you have had both doses of the vaccine, you should continue to wear a face covering and follow 2 metre social distancing rules as well as practicing good hand hygiene.

Frequently asked questions

Am I classed as extremely vulnerable?

People falling into the clinically extremely vulnerable group include:

  • solid organ transplant recipients 
  • people with specific cancers: 
    • people with cancer who are undergoing active chemotherapy  
    • people with lung cancer who are undergoing radical radiotherapy  
    • people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment  
    • people having immunotherapy or other continuing antibody treatments for cancer  
    • people having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors  
    • people who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs  
  • people with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD  
  • people with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell)  
  • people on immunosuppression therapies sufficient to significantly increase risk of infection  
  • women who are pregnant with significant heart disease, congenital or acquired  
  • adults with Down’s syndrome  
  • adults on dialysis or with chronic kidney disease (stage 5)  
  • other people who have also been classed as clinically extremely vulnerable, based on clinical judgement and an assessment of their needs. GPs and hospital clinicians have been provided with guidance to support these decisions  

What if I have another condition not listed above?

People with long-term clinical conditions will not get a letter from the Manx Care but will still need to adhere to good hygiene practicePeople in this category include:  

  • a blood cancer (such as leukaemia, lymphoma or myeloma)  
  • diabetes  
  • dementia  
  • a heart problem  
  • a chest complaint or breathing difficulties, including bronchitis, emphysema or severe asthma  
  • a kidney disease  
  • a liver disease  
  • lowered immunity due to disease or treatment (such as HIV infection, steroid medication, chemotherapy or radiotherapy)  
  • rheumatoid arthritis, lupus or psoriasis  
  • have had an organ transplant  
  • had a stroke or a transient ischaemic attack (TIA)  
  • a neurological or muscle wasting condition 
  • a severe or profound learning disability  
  • problems with your spleen – for example, sickle cell disease or if you have had your spleen removed  
  • are seriously overweight (a body mass index (BMI) of 40 or above)  
  • a severe mental illness.  

What steps can I take to protect myself?

There is a vaccine to protect against seasonal flu and the best way to avoid catching and spreading flu is by having the flu vaccination before the flu season starts. The flu vaccine is still available; and it is recommended that those in the vulnerable and extremely vulnerable groups have the flu vaccine this year. The flu vaccine won’t protect you from COVID-19 but it will reduce your risk of becoming ill with flu and potentially needing hospital treatment. 

Manx Care has begun offering the vaccine against COVID-19 to first phase priority groups. 

See  COVID-19 vaccination for the Isle of Man 

I am pregnant and worried about coronavirus - what should I do? 

If you are pregnant, you may be concerned about how the virus will affect you and your baby. There is no evidence to suggest that pregnant women are more likely to get ill from coronavirus but it is recommended that you adhere to good hygiene practice.

There may be some changes to your regular appointments and when you go into labour. For full details visit COVID-19 and Pregnancy .

Can I still breastfeed while infected? 

There is currently no evidence to suggest that the virus can be transmitted through breast milk. Infection can be spread to the baby in the same way as to anyone in close contact with you. The current evidence is that children with coronavirus get much less severe symptoms than adults. The benefits of breastfeeding outweigh any potential risks of transmission of the virus through breast milk or by being in close contact; however, this will be an individual decision and can be discussed with your midwife, health visitor or GP by telephone. 

If you or a family member are feeding with formula or expressed milk, you should sterilise the equipment carefully before each use. You should not share bottles or a breast pump with someone else. 

I look after someone who is vulnerable, what should I do?

If you are caring for someone who is vulnerable, there are some simple steps that you can take to protect them and to reduce their risk at the current time. Follow all guidance on non essential mixing, 2 meters distancing and wearing a face covering.

Ensure you follow advice on good hygiene such as:

  • wash your hands on arrival and often, using soap and water for at least 20 seconds or use hand sanitiser
  • cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
  • put used tissues in the bin immediately and wash your hands afterwards
  • do not visit if you are unwell and make alternative arrangements for their care
  • provide information on who they should call if they feel unwell, how to use the COVID-19 111 helpline service and leave the number prominently displayed
  • find out about different sources of support that could be used and further advice on creating a contingency plan available from Carers UK

Please note it is important to look after your own well-being and physical health during this time.

See self-isolation frequently asked questions for information on caring for someone in self-isolation

How do I look after my mental wellbeing?

As we move into the new normal, social isolation, reduction in physical activity, unpredictability and changes in routine can all contribute to increasing stress. Many people including those without existing mental health needs may feel anxious about this impact including support with daily living, ongoing care arrangements with health providers, support with medication and changes in their daily routines. 

If you are receiving services for your mental health, learning disability or autism and are worried about the lasting impact of isolation COVID-19 please contact your keyworker/care coordinator or provider to review your care plan. If you have additional needs please contact your key worker or care coordinator to develop a safety or crisis plan. 

Understandably, you may find that distancing can be boring or frustrating. You may find your mood and feelings are affected and you may feel low, worried or have problems sleeping.

As we move into the new normal, it may be that you have fallen into unhealthy patterns of behaviour which in turn can make you feel worse. There are simple things you can do that may help to stay mentally and physically active during this time, such as:

  1. Look for ideas of exercises you can do at home 
  2. Spend time doing things you enjoy – this might include reading, cooking, other indoor hobbies or listening to favourite radio programmes or watching TV
  3. Try to eat healthy, well-balanced meals, drink enough water, exercise regularly, and try to avoid smoking, alcohol and drugs
  4. Try spending time with the windows open to let in the fresh air, arranging space to sit and see a nice view (if possible) and get some natural sunlight, or get out into any private space, keeping at least 2 metres away from your neighbours.
  5. Spend time with friends and family outdoors. You can now meet up with people from another household, provided that you follow social distancing rules and wear a face covering.

Constantly watching the news can make you feel more worried. If you think it is affecting you, try to limit the time you spend watching, reading, or listening to media coverage of the outbreak. It may help to only check the news at set times or limiting this to a couple of times a day.

Try to focus on the things you can control, such as your behaviour, who you speak to and who you get information from.

There are a range of resources and local contacts that can help at

What steps can I take to stay connected with family and friends during this time? 

You can now meet up with friends and family outdoors in line with current guidance. Visit Gatherings, Events and Movement for more info. Let people know how you would like to stay in touch and build that into your routine. This is also important in looking after your mental wellbeing and you may find it helpful to talk to them about how you are feeling if you want to. 

Remember it is okay to share your concerns with others you trust and in doing so you may end up providing support to them too. 

How do I stay up to date?

As we move into the new normal, things will continue to change as more is known about this new virus. You can keep up to date with all the latest changes on this website, via the regular news briefings on Manx Radio or 3FM or by calling the COVID-19 telephone helpline (686262).