Continuing to protect vulnerable populations during COVID-19
As we near the third year of the COVID-19 pandemic, substantial progress has been made in understanding the SARS-CoV-2 virus and finding ways to detect, prevent and treat COVID-19. Yet, as the virus continues to mutate and spread, infections and hospitalisations have remained elevated in many parts of the world.1 While life is returning to a greater sense of normalcy for many people who are vaccinated and boosted, millions of people around the world who are not adequately protected by COVID-19 vaccination remain at risk for both contracting the virus and for poor outcomes from severe disease if they do become infected.2-6
Continuing protection for these populations is needed including before infection and after, if they were to become infected.7
Who is at high risk for serious COVID-19 infection?
Vaccines remain the most important way to prevent infections as well as severe illness.8 However, the immunocompromised may be left without long-lasting protection despite being fully vaccinated because a healthy immune system is needed for vaccines to work to their full potential.7,9 If infected, these individuals may stay sicker longer, which may, separately, also lead to the rise of new variants.10
Those who are immunocompromised (see figure below) are especially at risk for being hospitalised or dying from COVID-19 infections.9 Recent studies found:
- Immunocompromised patients accounted for 12% of all adult COVID-19 hospitalisations and had increased odds of ICU admissions and death compared to non-immunocompromised patients in the US.11
- More than half of vaccinated blood cancer patients with a breakthrough COVID-19 infection were hospitalised (n=35/54).12
- Solid organ transplant recipients who were hospitalised for COVID-19 were almost twice as likely to die as non-transplant patients. Also, those with a prior organ transplant were more likely to require ventilation during hospitalisation for COVID-19.13
People at high-risk for serious outcomes from COVID-19
Beyond the immunocompromised, other people may be at high risk for severe COVID-19 due to their age or other chronic conditions or disease. The likelihood of severe illness from an infection increases with age, with adults over 65 at highest risk.9 In addition, chronic conditions such as obesity, diabetes, heart disease and lung disease may increase the risk of serious illness from the virus.9
What are the priorities in protecting vulnerable populations?
Preventing COVID-19 and providing long-lasting protection is the ultimate goal for vulnerable populations such as the immunocompromised, especially as the virus continues to evolve.
For those who do become infected, the priority is to protect those at higher risk from progressing from milder disease to severe disease, or from needing to be hospitalised and to provide protection against future infection. As the SARS-CoV-2 virus continues to evolve, it is equally important that available therapies are able to neutralise new variants. Another critical consideration in this group of elderly and vulnerable patients is the need for therapies that do not interact with medicines they already take.14–16
The best way to treat COVID-19 is to prevent it in the first place. The patients we do see at our ICUs are the immunocompromised who haven’t responded to the vaccine, don’t clear the virus and get ill. Then, they may get several medications that are also unable to clear the virus and it’s highly problematic.
The road ahead for protection of vulnerable populations
As SARS-CoV-2 continues to spread around the world, public health authorities recommend prevention as the best strategy for individuals to reduce their risk of COVID-related disease. While it is difficult to predict what’s next for the pandemic, the current data show the newer Omicron variants, including BA.4 and BA.5, are responsible for increased hospitalisations and those trends are expected to continue putting more emphasis on current vaccines and therapies to provide long-term protection.1,17
We are dedicated to ongoing research and innovation to protect as many people as possible, particularly medically vulnerable populations who may feel overlooked and need more protection.
