Queen Elizabeth II missed her traditional New Year's Day church service because she is still recovering from what a Buckingham Palace spokesman told CNN is a "heavy cold."
It is unusual for the 90-year-old monarch not to attend the service, which has long been part of her New Year's Day routine.
Elizabeth also missed Christmas church service last week. She and her husband, Prince Philip, who is 95, have been sick for most of the holiday season.
The illnesses caused them to delay their trip to their country home, Sandringham House, just before Christmas, according to CNN. Prince Philip recovered enough before Christmas to attend church.
This year marked the first time since 1998 the Queen missed a Christmas Day church service, CNN reports.
Despite being relatively healthy in recent years, the Queen recently announced she'd be relinquishing some of her duties to other members of the royal family.
"Her Majesty is currently Patron of more than 600 organisations and has enjoyed a close and active association with a great number of them throughout her reign," a press release from Buckingham Palace explained. "Her Majesty will continue to serve as Patron to hundreds of charities and institutions but will now share this work with her family."
Prince Philip similarly reduced his schedule but still managed to attend more than 100 public events in the last year.
Twitter hoax falsely claimed Queen Elizabeth II had died
Earlier this week a fake news story claiming Queen Elizabeth II had died sparked an online frenzy. The tweet came from an account with the handle @BBCNewsUKI, which graphics made it appear to be from the BBC.
The story was, of course, fake and the same Twitter account followed that tweet with a much less BBC-like message: "Love a Tuesday off if the queens dead, announce it before it's too late.”
The fake BBC account was suspended by Twitter, according to the Washington Post.
The Associated Press contributed to this report.