Covid vaccine autumn boosters and ME/CFS – MEA writes to the Chief Medical Officer

On 16th August I wrote to Professor Chris Whitty, the Chief Medical Officer, to seek clarification as to whether people with ME/CFS will be regarded as being clinically vulnerable in relation to eligibility for a Covid vaccine booster this autumn.

This letter also explained all the reasons why people with ME/CFS are likely to experience an exacerbation or relapse of their ME/CFS if they catch COVID-19 and should therefore be regarded as being clinically vulnerable.

A copy of this letter can be found here.

I received a reply from the Private Secretary to the CMO on 6th September

Dear Dr Shepherd,

Thank you for your email to the Chief Medical Officer. I shared your email with my vaccine policy colleagues who have provided the below:

The primary purpose of the COVID-19 vaccination programme is to provide protection from serious illness for those at higher risk of severe COVID-19. This has been the case throughout the programme, and remains so this autumn. The vaccines provide good protection against severe disease from variants strains, including Omicron, but protection against infection and mild disease is lower and more short-lived.

The JCVI take into account a wide range of data and analysis covering the risk from COVID-19 to groups- e.g. age or condition. They always welcome new data, and take that into account when updating their advice, which they review regularly.

The symptoms of ME/CFS are diverse, and can be very debilitating. The examples given in the Green Book are not exhaustive, and, within these groups, a prescriber should apply clinical judgment to take into account the risk of COVID-19 exacerbating any underlying disease that a patient may have, as well as the risk of serious illness from COVID-19 itself. Those who are unsure if they should be considered for vaccination due to a medical condition not listed in the Green Book should contact their GP and/or consultant to discuss their particular situation.

I hope this is helpful

Following which I requested further clarification

Thank you for this reply.

The first two paragraphs make perfect sense.

But I would be grateful if you could confirm that I am correct in concluding from para 3 that:

If a doctor uses their clinical judgement to conclude that someone with ME/CFS is clinically vulnerable in relation to COVID-19 – as their underlying health condition is likely to be significantly exacerbated – then the person with ME/CFS would be eligible to have a COVID-19 booster


Charles Shepherd

To which I have received this further reply today:

Dear Dr Shepherd,

Yes, it is my understanding that in specific instances, where a doctor has assessed a patient, and determined that individual is of the same risk from COVID as those conditions explicitly listed in the Green Book, that they can prescribe the vaccine. The would apply to ME/CFS in the same way it applies to all conditions not specifically listed in the Green Book.

My conclusion to this exchange of correspondence with the CMO is that doctors are therefore allowed to use their clinical judgement when it comes to organising Covid booster vaccines for people with ME/CFS..

So if your doctor accepts that you are clinically vulnerable in relation to COVID-19 you will be eligible to have a vaccine booster – if you choose to do so.

Dr Charles Shepherd
Hon Medical Adviser, MEA

September 7th 2022

Dr Charles Shepherd,
Trustee and
Hon. Medical Adviser
to the ME Association.
Member of the 2018-2021 NICE Guideline Committee.
Member of the 2002 Independent Working Group on ME/CFS.

Dr Charles Shepherd
Shopping Basket