Update: Omicron & Covid sick day rules + vaccine booster

We wanted to share an update on the sick day rules for covid and on the Spring vaccine booster roll out.


Sick Day Rules

If an adrenal insufficiency patient has a positive test for coronavirus, but symptoms feel more like a heavy cold (feeling weak, tired, headache) then they need to double their usual dose of hydrocortisone if required for several days. Paracetamol should be taken too.  


It’s important to recognise if symptoms are worsening, particularly paying attention to your temperature. A bit extra hydrocortisone will do little harm, but not having it may mean hospitalisation, and of course, adrenal crisis.


If symptoms increase

The symptoms for a likely coronavirus infection are:

fever >38°C, a dry cough, sore throat, loss of sense of smell or taste, aches and pains, and fatigue.

In patients with a suspected (or confirmed) coronavirus infection, we recommend:

  • Hydrocortisone - increase hydrocortisone to 20 mg four times daily every 6 hours
  • Plenadren - switch to the regular, immediate release hydrocortisone preparation and take 20 mg orally every 6 hours
  • Prednisolone - patients who take 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.


More on sick day rules

Society of Endocrinology covid statement


Spring 4th booster update

People aged 75 years and older, residents in care homes for older people, and those with weakened immune systems will be offered a spring booster of coronavirus (COVID-19) vaccine.

There are 3 types of booster for the coronavirus (COVID-19) vaccine:

  • A 1st booster dose of the COVID-19 vaccine is available for everyone aged 16 and over, and some children aged 12 to 15, who have had a 2nd dose of the vaccine at least 3 months ago.
  • A booster dose (4th dose) of the COVID-19 vaccine is available for anyone who had a severely weakened immune system when they had their first 2 doses and who had a 3rd dose of the vaccine at least 3 months ago.
  • A spring booster of the COVID-19 vaccine is available to people aged 75 and over, people who live in a care home for older people, or people aged 12 and over who have a weakened immune system.

Those taking hydrocortisone for replacement (adrenal insufficiency) aren’t immune suppressed.

Immune suppressed means for those taking high doses of prednisolone for other conditions (e.g. asthma, arthritis) or a blood cancer (such as leukaemia or lymphoma), a treatment such as immunotherapy, chemotherapy or radiotherapy, or an organ or bone marrow transplant.