Coronavirus (COVID-19) advice for people on the Highest Risk List: evidence review

This report presents key evidence underpinning our advice to people on Scotland's highest risk (formerly shielding) list.

Findings of the review

10. It is clear from the review that the Highest Risk List is not serving the same purpose as when it was created in March 2020. Highest risk individuals have been advised to follow the same advice as the general population since August 2021 (with the exception of attending work in level 4), and no additional clinical advice has been given by the Scottish Government since this date.

10.1 There is strong evidence to show that vaccines are offering significant protection to people on the Highest Risk List, including people who are immune-suppressed or immune-compromised from becoming severely ill or dying.

10.2 There has been a significant reduction in the number of deaths from COVID-19 across all groups within the Highest Risk List, since the roll-out of Scotland's vaccination programme.

10.3 The majority of those previously identified as highest risk do not face the same level of risk of severe illness or death from COVID-19 following the vaccination roll-out and introduction of therapeutic treatments.

10.4 Retiring of the Highest Risk List requires consideration of how we identify highest risk individuals quickly for access to therapies, treatments, priority vaccination or advice when needed and based on eligibility criteria in the future.

10.5 If a variant of concern were to arise, or the threat level was to rise significantly and tailored non-pharmaceutical advice was required, the Highest Risk List in its current form raises a risk of inaccuracy and would not be appropriate in identifying highest risk individuals due to it not being clinically revalidated following changes in risk factors.



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