Around 1.7 million more people will be added to the shielding list in England, after being found to be at potential serious risk from COVID-19.
They have been identified by a new algorithm that looks at multiple factors, and will be sent a letter from the NHS in the coming days.
Some will have already been offered a coronavirus jab but the around 800,000 who have not will be bumped up the vaccine priority list.
The shielding list was expanded after scientists at Oxford University developed a new tool that assesses whether someone is at risk of severe disease or death from COVID-19.
It looks at multiple factors including age, ethnicity, body mass index, other health conditions and also postcode, which is indicative of levels of deprivation.
The additional 1.7 million will bring the number of people on the list to almost four million – all of whom are being advised to shield until 31 March.
Dr Jenny Harries, one of England’s deputy chief medical officers, said those joining the shielding list will get the same support available to those who are “clinically extremely vulnerable”, including medicine deliveries, priority slots for supermarkets and statutory sick pay.
She told a briefing for journalists: “As we learn more about COVID-19, we’re continuously reviewing the evidence… it was very clear that not all of those individuals who were at risk were identified by the binary approach.”
Dr Harries added the approach is “risk averse” to “protect as many people as possible”.
She explained: “The letter will note that this is more likely to be an overestimate of risk in a way which hopefully handles any of their anxiety.
“And it makes it absolutely clear that it is a choice for them if they choose to follow shielding advice or not – that has always been the case.
“What it does also do – which I hope will benefit them, which is why people will hopefully be grateful to receive this – is it will prioritise them for vaccination.
“In addition to that it means they have advice and support and that is important not just now, but should there be any changes in the pandemic in forthcoming months – for example, perhaps in vaccinations perhaps in the autumn as we go forward, then clearly they will be identified within that group as well so there are current and longer term benefits.”
But the MS Society said the sudden announcement eleven months into the pandemic would “come as a huge shock” to people.
A spokesperson added: “Being added to the list will have greater implications for someone’s life far beyond their place in the vaccine priority list – from going to work to being able to access food and medication.
“The government must prioritise communicating these latest developments clearly and ensure comprehensive support is in place for all those who suddenly find they must make potentially drastic changes to their life.”
And disability charity Sense said many of the people added to the shielding list “will already have been effectively shielding since the start of the pandemic, without sufficient recognition”.
It comes after ministers revealed they hope all adults in the top nine priority vaccine groups will be offered a jab by the end of April, and all remaining adults by autumn.