PHE COVID-19 Vaccination Programme Information for Healthcare Professionals provides advice on groups as summarised below.
Individuals who are currently unwell and experiencing COVID-19
This group should not be vaccinated until they have fully recovered.
This is to avoid wrongly attributing any new symptom or the progression of symptoms to the vaccine. Ideally vaccination should be deferred until at least four weeks after onset of symptoms or, for those who are asymptomatic, four weeks from the first PCR positive specimen.
Scheduling of second dose
Updated Green book guidance recommends that the second dose of both Pfizer BioNTech and AstraZeneca vaccines should be routinely scheduled between four and 12 weeks after the first dose. If an interval longer than the recommended interval is left between doses, the second dose should still be given (preferably using the same vaccine as was given for the first dose if possible). The course does not need to be restarted.
Individuals with prolonged COVID-19 symptoms (“long COVID”)
This group can be vaccinated; however, if the individual is seriously debilitated, still under active investigation, or has evidence of recent deterioration, deferral of vaccination may be considered, to avoid incorrect attribution of any change in the person’s underlying condition to the vaccine.
Individuals with COVID-19 past history or detectable COVID-19 antibodies
This group can be vaccinated.
There is no evidence from clinical trials of any safety concerns in vaccinating such individuals. This is because it is not known how long antibodies made in response to natural infection persist and whether immunisation could offer more protection. If antibodies have already been made to the disease following natural infection, receiving COVID-19 vaccine would be expected to boost any pre-existing antibodies.