When Ella Halpern-Matthews was removed from the NHS COVID-19 vaccine eligibility list earlier this year, she didn’t expect that decision to have such profound consequences. The 27-year-old historian from Kent has a long history of respiratory illness, having been asthmatic since birth and undergone major surgery to remove half a lung due to congenital cystic adenomatoid malformation.
Despite taking all possible precautions—wearing high-quality masks, avoiding crowded places, and maintaining a cautious lifestyle—she has caught COVID-19 three times in just six months. Her story underscores a growing concern among medically vulnerable people who have been excluded from the most recent vaccine rollout in England and raises questions about whether the UK’s current vaccination policy adequately protects those at high risk of serious illness.
Ella Halpern-Matthews’s case has also reignited debate around the broader accessibility and affordability of vaccines, with critics suggesting that the NHS’s updated criteria have left behind people who remain medically fragile even if they no longer meet the narrow definition of “immunosuppressed.” For Ella, the consequences are not just physical but deeply social and emotional. “If I want to protect my health, I’m essentially forced to be a hermit and forgo community and life in public,” she said, describing a reality that has become painfully isolating.
A Life of Chronic Vulnerability and Constant Precaution
From the moment Ella Halpern-Matthews was born, respiratory illness has shaped her life. She has lived with asthma since infancy and later underwent a major operation to remove half of one lung to treat cystic adenomatoid malformation, a rare congenital condition that predisposes her to chronic chest infections. Such infections are not only frequent but also severe, often leaving her bedridden for weeks. While most people recover from a cold or flu in days, even a mild respiratory infection can become a serious threat for her.
Because of this vulnerability, Ella was among those prioritised for early COVID-19 vaccinations during the pandemic. Between 2021 and 2023, she received eight doses of the vaccine under NHS care, which allowed her some measure of security in navigating daily life. But since spring 2025, the NHS’s updated eligibility guidelines have excluded people like her who are not currently taking immunosuppressant medication, even if their conditions still make them extremely susceptible to complications from the virus.
This change has left Ella without access to free booster vaccines, at a time when she continues to face elevated risk. Since her last NHS booster in 2024, she has tested positive for COVID-19 three separate times, each infection taking a significant toll on her health. “Beyond the physical and mental exhaustion of infection,” she explained, “it’s been extremely difficult navigating the UK social scene, because no one wants to talk about COVID, no one tests when they’re sick, and people don’t like to cancel plans when they’re unwell.”
Despite her careful efforts—avoiding poorly ventilated spaces, wearing FFP2 masks, and limiting social interactions—Ella feels the odds are stacked against her. She describes living in a world that has largely moved on from pandemic precautions while she remains stuck in survival mode. Her experience highlights a broader tension between public fatigue over COVID-19 and the ongoing vulnerability of individuals for whom the virus remains a life-threatening danger.
NHS Policy Shifts and the Debate Over Eligibility
Under the current guidelines in England, the autumn 2025 COVID-19 vaccination campaign is restricted to adults aged 75 and over, residents of older adult care homes, and those who are immunosuppressed. These parameters are defined by The Green Book, the official NHS immunisation guide. The updated policy represents a major shift from autumn 2024, when eligibility still included adults aged 65 to 74 and those six months or older in clinical risk groups.
For people like Ella, who once qualified under the broader criteria, the change has been devastating. She previously fell into the immunosuppressed category due to her chronic lung condition and overall vulnerability. However, the NHS now limits that category to those currently taking immunosuppressant medication, excluding individuals whose conditions are severe but not treated with such drugs.
The Joint Committee on Vaccination and Immunisation (JCVI), which advises the UK government on immunisation policy, maintains that The Green Book’s list of immunosuppressed individuals “is not exhaustive” and allows clinicians to exercise discretion based on medical judgment. But Ella’s case suggests that, in practice, this flexibility rarely extends to patients outside the narrow formal criteria. NHS Kent and Medway, her local provider, stated that it could not comment on individual cases but confirmed it follows national guidance.
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This rigid interpretation has prompted growing criticism from healthcare experts and patient advocates, who warn that thousands of medically vulnerable people may now lack protection. Leyla Hannbeck, chief executive of the Independent Pharmacies Association (IPA), described the NHS’s vaccine booking and eligibility system as “chaos.”
According to Hannbeck, pharmacists have faced confusion and even aggression from patients trying to book COVID-19 jabs they thought they qualified for. “The NHS booking system this year is poor and has confused everyone,” she said. “It allows age group 65 to 74 patients to book an appointment and self-declare themselves as immunosuppressed, even if they aren’t, and the definition of immunosuppressed is not clear to them.”
The IPA raised concerns in August when the JCVI announced the exclusion of patients aged 65 to 74 who are not immunosuppressed, calling the move “particularly worrying” given the rise of new COVID variants and the expected surge in winter respiratory viruses. “Instead of increasing public protection by vaccinating a bigger cohort, they decided to limit it,” Hannbeck said, warning that reduced coverage could put additional strain on both hospitals and pharmacies during the winter months.
Last winter, the NHS delivered nearly 10 million COVID-19 vaccinations, including more than 250,000 to care home residents. This year’s reduced rollout is expected to cover a fraction of that number, leaving millions of people without access to a free booster. Critics argue that the government’s decision prioritises cost-saving measures over public health outcomes, particularly as data continues to show that vaccination remains the most effective defence against severe illness, hospitalisation, and long COVID.
A Personal Fight for Access and Awareness
Unable to access the vaccine through the NHS, Ella has turned to crowdfunding to pay for a private booster. Private COVID-19 vaccinations in the UK range between £75 and £120 at independent pharmacies—an unaffordable expense for many people, including Ella, who admits she is “broke.” She said, “Honestly, if I could afford to pay out of pocket, I would. But also, I guess some of it is about raising awareness of just how dire the situation is here.”
Her comparison with vaccine access in Europe is striking. “You can get the COVID vaccine in France for under €10. You can get it across the EU for less. If I were to pay for the Eurostar and do a day trip to France and get it, it could cost me less than a private jab here in the UK on my preferred proverbial doorstep.” The disparity, she argues, exposes the emergence of a “two-tier health system” in Britain—one where those who can afford private healthcare can easily protect themselves, while others must either forgo vaccination or resort to crowdfunding.
For Ella, this situation feels both unjust and dangerous. “This is a really clear example of the two-tier health system we have now, where people who can afford private healthcare can just go and do all this themselves, and have a private GP and are able to access all these essential life-saving medicines.”
Her struggle for access has also had a profound emotional dimension. Once socially active, Ella now finds herself increasingly isolated. She avoids events, gatherings, and even family celebrations out of fear of infection. “If I want to protect my health, I’m essentially forced to be a hermit,” she said, reflecting on the loneliness of her situation. The loss of community has been one of the hardest consequences to bear. “I’ve had to have frank, difficult conversations with friends and loved ones about testing and mask-wearing. I’m now actively seeking out new Covid-conscious friends.”
Her experience resonates with many immunocompromised and medically vulnerable people across the UK who feel forgotten by the government’s shifting priorities. As pandemic fatigue has set in, public discussion of COVID-19 has largely disappeared, and preventive measures such as masking and testing have become rare. For individuals like Ella, however, the virus remains a daily threat that continues to shape every decision.
Public health advocates argue that the government’s retreat from broad vaccination coverage risks undoing much of the progress made since 2021. With new variants continuing to emerge, even healthy individuals face a renewed risk of infection and transmission, while those already vulnerable bear the brunt of reduced protection. As Dr. Stephen Griffin, a virologist at the University of Leeds, has warned in past interviews, narrowing eligibility “risks leaving behind precisely those who have the most to lose.”
Ella’s story has captured growing media attention not only because of her personal suffering but also because it illustrates a systemic problem. The NHS’s definition of “immunosuppressed” may satisfy bureaucratic efficiency, but it fails to reflect the complex realities of chronic illness and vulnerability. Her call is simple: treat the COVID vaccine with the same accessibility and priority as the annual flu jab, making it free and available to all who are medically at risk, regardless of medication status.
In the end, Ella’s case is not an isolated anomaly but part of a broader debate over how societies should adapt to living with COVID in the long term. Should vaccination be viewed as a universal public health service, or as an optional benefit for select groups? For Ella, the answer is clear. Vaccines remain a vital lifeline—one she believes should never depend on the ability to pay or on narrowly defined eligibility criteria.
Her plea is both personal and political: a reminder that even in the post-pandemic era, COVID-19 is far from over for everyone. While the majority of the population may now treat it as a passing inconvenience, for those with chronic conditions, it continues to represent a daily threat. In Ella Halpern-Matthews’s words, the issue is not just about access to a vaccine but about the right to live safely and participate fully in society without fear of illness or exclusion.