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The Queen will not attend the traditional Easter Sunday service at St George's Chapel in Windsor, Buckingham Palace has said.
The Queen, who is due to celebrate her 96th birthday next week, has been experiencing mobility issues.
Her Majesty also withdrew from the Maundy Day church service on Thursday, described as one of her most "rewarding duties as a sovereign", in a break with tradition that has left her "deeply disappointed".
Prince Charles and Camilla represented the monarch at the Maundy service for the first time, as the heir to the throne observed the ancient tradition of distributing money to community stalwarts.
He honoured people who have provided Christian service to the elderly, worked tirelessly during the pandemic or offered comfort to those in need.
The Bishop of Worcester, Dr John Inge, speaking in his role as Lord High Almoner, said the Queen had a copy of the order of service and a list of Maundy money recipients and details about them.
"She's close by and would want me to extend to you her greetings," he told the congregation before the service began.
Earlier, the Clarence House Twitter feed shared a video of the Queen's first Maundy service in 1952, the first public engagement in her reign.
A post said: "Representing Her Majesty The Queen, The Prince of Wales and The Duchess of Cornwall will attend the Royal Maundy Service at St George's Chapel in Windsor today.
"Maundy Thursday commemorates the Last Supper of Jesus Christ with the Apostles."
The Queen appeared tearful as she made her first appearance in months at a Service of Thanksgiving for the Duke of Edinburgh, her late husband, at the end of March.
It was Her Majesty's first major official engagement since she travelled to Cardiff to deliver a speech at the Welsh Senedd on 14 October.
The Queen travelled from Windsor Castle to the Westminster Abbey service in a car with Prince Andrew, his first public appearance since he settled the sex abuse claim brought against him by Virginia Giuffre, before he escorted his mother to her seat.
She and other members of the Royal Family paid tribute to the Duke of Edinburgh on the first anniversary of his death on Saturday.