Updated

A bad cold kept Queen Elizabeth II from attending the traditional Christmas morning church service near her Sandringham estate in rural Norfolk, England, raising some concerns about her health.

It's extremely rare for Elizabeth, now 90, to miss the service, which is a cornerstone of the royal family's Christmas celebrations and brings the monarch into contact with locals who gather outside for a glimpse of her.

"The Queen continues to recover from a heavy cold and will stay indoors to assist with her recovery," Buckingham Palace said. "Her Majesty will participate in the royal family Christmas celebrations during the day."

Those festivities included a gala lunch. In past years, the royal family would often go for extended walks in the countryside.

Elizabeth has been in generally good health and has maintained an active schedule in the last year despite traveling less often than in the past. Recently she stepped down as patron for about 20 charities and groups to lighten her work load.

Her husband, 95-year-old Prince Philip, has also cut back on his public schedule and his charitable works in the last few years. He was also suffering from a severe cold earlier in the week, the palace said.

Philip did attend the Sunday morning Christmas service, waving to well-wishers on his way out of the church in a car.

Prince Harry spent time talking to locals after the church service and stopped to pet a dog. There was no sign of his girlfriend, American actress Meghan Markle, who recently visited him in London.

Elizabeth and Philip were joined in Sandringham by other senior royals including Prince Charles. Prince William and his wife Kate, along with their two children, Prince George and Princess Charlotte, were celebrating Christmas with Kate's parents at their home in Bucklebury, a village west of London.

The queen used her annual pre-recorded Christmas Day message to praise British Olympic and Paralympic athletes and others who inspired her. The traditional message of goodwill was televised throughout Britain and much of the Commonwealth.

The broadcast included video of her 90th birthday celebrations and a gigantic street party attended by charity workers from across Britain. The soft-spoken queen praised ordinary people for pitching in to do good works.

"To be inspirational, you don't have to save lives or win medals. I often draw strength from meeting ordinary people doing extraordinary things — volunteers, carers, community organizers and good neighbors. Unsung heroes whose quiet dedication makes them special," she said.

She also praised the charitable foundations started by Philip and Charles some 60 and 40 years ago, respectively.