Clinical Immunology/Immunodeficiency

Information for patients 

COVID - 19/ Coronavirus 

Bristol, South Gloucestershire and North Somerset are currently under the toughest Tier 3 restrictions with regards to COVID-19. Please review the updated governmental advice carefully. 

 

Precautions

In general, it is advised that all patients with immune deficiency take special care in reducing their contacts, working from home, and cleaning hands/home/workspaces regularly in order to prevent them from being exposed to coronavirus. Schools, colleges and universities are to remain open. The recent governmental announcements have not included a recommendation of a return to shielding for those labelled as 'clinically extremely vulnerable'. If we consider a patient to be in the 'clinically extremely vulnerable' group, then we will have written to them previously during the first COVID-19 wave. In this letter or email we indicated a recommendation to shield and that these patients were in UK PIN group 1 (a clinically extremely vulnerable patient group).

Our services are now open again and are operating at a reduced capacity in a COVID-secure environment. Consultations are being performed by telephone or video call as far as possible.

Patients should please contact the department on 0117 4148392 or 0117 4148393, or at allergyandimmunology@nbt.nhs.uk if they feel that their immunology/immunodeficiency problem requires urgent attention or if you have queries about the new lockdown or new guidance.

If you want to find out more information about COVID-19 then the PID UK, UK PIN and British government websites (links below) may be helpful in accessing up-to-date information.

If patients develop symptoms of COVID-19 (high temperatures above 37.8 degrees C, a new continuous cough, or change in sense of taste or smell) then, as with other patients, they should stay at home and seek a COVID-19 nose/throat swab test. If positive, patients should self-isolate for 10 days from onset of symptoms. Other members of their household should isolate for 14 days from the date of the positive test. If patients have symptoms of COVID-19 (as above) and are due to come to the hospital (for an immunoglobulin infusion or other reason) then they should please contact the hospital for consideration of rescheduling their appointment.

Government advice on Coronavirus, extreme vulnerability and shielding can be found at https://www.gov.uk/coronavirus.

PID UK (Primary Immunodeficiency UK) is a patient organisation that has produced patient information leaflets on Coronavirus for both primary and secondary immunodeficiency.

The UK PIN (UK Primary Immunodeficiency Network) is an organisation of specialist doctors in Clinical Immunology in the UK. They have produced expert guidance on patients with both primary and secondary immunodeficiency as to who is more at risk from COVID-19.

The British Association of Dermatologists has produced guidance for patients on immunosuppressive medications, as to who is more at risk from COVID-19. 

Vaccine

Useful information with regards to the new COVID-19 vaccine can be found from the government here and on the PID UK website.

JCVI advises that persons aged less than 70 years who are clinically extremely vulnerable should be offered the vaccine alongside those aged 70 to 74 years of age. The priority list currently is as follows:

  1. residents in a care home for older adults and their carers
  2. all those 80 years of age and over and frontline health and social care workers
  3. all those 75 years of age and over
  4. all those 70 years of age and over and clinically extremely vulnerable individuals
  5. all those 65 years of age and over
  6. all individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
  7. all those 60 years of age and over
  8. all those 55 years of age and over
  9. all those 50 years of age and over

Please note that according to recent advice, any person with a history of anaphylaxis to a vaccine, medicine or food should not receive the Pfizer/BioNTech vaccine.

 

Information for GPs - Clinical Immunology/Immunodeficiency Service

We run regular Adult Immunology/Immunodeficiency (and Allergy) clinics on Tuesday mornings, Thursday afternoons, and all day Friday reviewing patients referred (see Patient Referral Pathways) to our service with suspected or confirmed immune deficiency. Criteria and advice for whom to refer can be found on the Remedy website.

Our service provides replacement antibody therapy (immunoglobulin) to patients with confirmed antibody deficiency. This can be given in hospital (as a day case) or at home.

For patients with recurrent infections please try to confirm the nature of the infection before referral. For example, by sending relevant microbiological cultures, viral swab tests, taking the patient’s temperature, inflammatory markers, radiology etc.
 
Last updated: 14/12/2020