If you have adrenal insufficiency, including Addison’s, you are no more likely to catch coronavirus (COVID-19) than anyone else. However people with adrenal insufficiency, including Addison’s, are more vulnerable to becoming severely unwell, triggering an adrenal crisis, if they do get coronavirus, but the way it affects you can vary from person to person.

On this page:

• Vaccines & Boosters
• Managing Your Medication
• Unwell with COVID - Dosing Guidance
• Preparing for Emergencies
• Keeping Informed
• Employment
• Recovering from COVID-19
• Children and Schools

Our trustee medics and Clinical Advisory Panel alongside Society for Endocrinology, will continue to review our guidance. 

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Vaccines & Boosters

During the peak of the pandemic, those with Addison's and adrenal insufficiency were eligible for the free COVID vaccines and boosters, alongside other chronic conditions such as diabetes. You can read more about this in our News item here. Vaccines and boosters are effective ways to prevent infection and we encouraged those eligible to get vaccines and boosters when offered. 

From Autumn 2025, only the following groups of people will be offered a COVID-19 vaccination in the UK: 

• adults aged 75 years and over
• residents in a care home for older adults 
• individuals aged 6 months and over who are immunosuppressed.

The Joint Committee on Vaccination and Immunisation (JCVI), which advises the government on vaccines, explains that since the pandemic began, vaccines and boosters have built strong protection across the population to the virus that causes COVID-19.  The rates of serious illness and hospitalisation from coronavirus have significantly reduced, despite some groups of people being at higher risk of more severe infection. Therefore due to the high population immunity to COVID-19, the eligibility for free NHS COVID boosters has been changed.

This means that all children and adults in the UK living with long-term health conditions, including Addison’s and adrenal insufficiency, who do not fall into one of the three groups listed above, will no longer be offered a free NHS COVID-19 vaccination.

For more information see the NHS website: COVID-19 vaccine - NHS

Steroids taken for adrenal insufficiency are replacement doses and increasing the dose during illness is to try and mimic your body's natural physiological response. In the correctly tailored dosages, they should not suppress your immune system or make you more susceptible to infection. Learn more on our medication page. However if you feel you should qualify for the immunosuppressed group to the level of steroids you take, please contact your healthcare team.

This does not affect flu jab eligibility and people living with adrenal insufficiency, including Addison’s, will still be offered a winter flu jab as normal.

Private COVID booster vaccines remain available

COVID booster vaccines are available privately from most local pharmacies as well as larger pharmacies such as Boots and are safe to have at the same time as your flu jab, although it is advised to have them in different arms. If you are worried you may like to consider paying for a private COVID booster vaccine.

Our guide to Vaccines and Adrenal Insufficiency

Learn more about the COVID vaccine as well as flu, pneumonia and other vaccines. You can also explore personal stories from people in our community who have kindly shared their experiences of receiving the COVID vaccinations and booster jabs.

Vaccines & Adrenal Insufficiency

Emotional support

You might be feeling worried and anxious about coronavirus. Please visit our webpage to help you cope with stress and other emotions. You can also connect with others on our online forum, where members share their experiences and advice, and you can ask any unanswered questions. You can also visit our sanctuary of support page to help if you feel lost, concerned, puzzled or poorly. 

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Managing your Medication

Unwell with COVID

Larger than usual steroid doses are required when unwell with COVID. Together with the Society of Endocrinology and our Addison's Clinical Advisory panel, dosing requirements have been advised. The below advice is in accordance with the Society for Endocrinology advice statement.

Many people will be able to self-manage their COVID illness at home, with an increased dose of hydrocortisone and regular fluid intake and paracetamol. However, people should not hesitate to contact medical services or seek hospital admission if the situation deteriorates and they feel increasingly unwell despite these measures.

Patients on hydrocortisone

• Please increase hydrocortisone to 20 mg four times daily every 6 hours
• Patients who usually take Plenadren should switch to the regular, immediate release hydrocortisone preparation and take 20 mg orally every 6 hours

Patients on prednisolone

• Patients on 5-15 mg prednisolone daily should take 10 mg prednisolone every 12 hours; patients on oral prednisolone >15 mg should continue their usual dose but take it split into two equal doses of at least 10 mg every 12 hours.

If on fludrocortisone, continue taking your usual daily dose.

General advice:

• Seek medical advice by calling 111 or accessing the NHS coronavirus online information
• Drink plenty of fluid and make sure you are passing urine regularly. You may need to wake in the night to keep drinking whilst fevers are high. If your urine is very dark, try to drink more fluids
• Take paracetamol 1000 mg every six hours

Tapering

Three months reserve supply of essential steroid medication

Make sure you have a good supply of medication in case you need to increase your dosing suddenly in reaction to COVID. The provision of a reserve supply of steroid medication is standard practice for the prevention of an acute adrenal crisis. It is the advice given in the NICE Guidance: Adrenal insufficiency: identification and management.

If you need to discuss with your GP adjusting your repeat prescription length, please visit our GP page and click on "3 months reserve supply of essential steroid medicine", for resources to support you and your GP. Do not be discouraged if you are initially told this won't be possible by your GP. Please follow the steps on our GP page, and politely ask again.

GP page

Please note: The ADSHG cannot become involved in individual disputes, but our resources can be downloaded to raise awareness amongst medics.

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Preparing for Emergencies

Get your emergency kit and emergency letter ready

Make sure you have an emergency injection kit that it is up-to-date, includes instructions and that you have practised the self-injection using our videos. Make sure you have a copy of the adrenal crisis emergency letter complete with your details.

Steroid Emergency Cards

Keep a copy of both the NHS Steroid Emergency Card and ADSHG charity Adrenal Crisis Emergency wallet card, filled in with your details, in your wallet or purse. 

Steroid emergency cards

Be Prepared - Resources to help you

Prepare in case you need to be admitted to hospital

Put together a hospital folder with your key information in and/or ADSHG leaflets, NHS steroid emergency card, spare medication and a list of your current medication. This can then be picked up and taken there easily by you, your carer or patient advocate. 

Get familiar with how to get medical help in an emergency

If you need to contact NHS 111 or call 999 in an emergency, be sure to mention 'steroid-dependent' and 'adrenal crisis' when explaining your health status. Make sure your Summary Care Record is up-to-date.

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Keeping Informed

Make sure you have ADSHG publications printed, filled in and stored in an easy to find location. Talk to your family about the support and/or treatment you need - make a plan. You could use our Medical Summary, so others can easily access a summary of your health if needed to pass on to others.

Read the latest information from the NHS. Misinformation can be troubling and misleading, so verify the things you are hearing, reading or sharing.

NHS COVID-19

Tailored information for British Sign Language users

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Managing Employment

You may be concerned about returning to face-to-face working. If you are employed, talk to your employer about their plans and your needs. As the Citizens Advice bureau advises: "Talk to your employer if you think there’s more they could do to keep you safe. Try to be constructive and explain what you need to happen so that you’ll feel safe when working."

Please note: The ADSHG cannot become involved in individual disputes, but our resources can be downloaded to raise awareness amongst employers, those in HR or occupational health or healthcare professionals involved in supporting you. Please visit our employment page for more support.

Employment and adrenal insufficiency

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Long COVID and recovering from COVID

Recovery from COVID can sometimes be a long haul, so you might benefit from being referred to a COVID follow-up clinic if you are having persistent problems. You may also like to see your endocrinologist for an up-to-date assessment. There will be no 'one size fits all' approach, so contact your healthcare team, who know your circumstances, and find out the best strategy for you.

NHS: Long COVID

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Children and Schools

If you are worried about COVID and your child in school, speak to the school and to your child’s endocrine team about your concerns. Encourage regular hand washing with your child, to prevent the virus from spreading between children, school and your home.

Here are some key reminders for young people, parents and schools:

Medication - resupply the school with an in-date hydrocortisone emergency injection kit and medications as prescribed and following your child’s Individual Healthcare Plan (IHP).

Individual Health Care Plan - Individual Health Care Plans (IHPs), are called different things depending on the nation you live in. But these plans are used to make sure your child’s Addison’s or adrenal insufficiency is managed properly during school time. Make sure your child’s IHP is up-to-date and includes a copy of the latest letter from the medical professional coordinating your child’s care. A sample IHP template is included in our booklet "When a student has Addison's: a guide for schools and parents."

Be Prepared - if your child is old enough, you can support them in making sure they know how to use their emergency injection kit. Read more about kits on our website and watch our Emergency Injection videos on YouTube about how to correctly use an emergency injection kit.

Children & Young Adults

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