People with Down syndrome are most at risk of death after receiving two Covid vaccines, study finds

People with Down syndrome, sickle cell anemia and kidney transplant patients are most at risk of dying from the coronavirus after receiving two vaccines, experts have found.

The results of a tool developed by British researchers concluded that people with certain conditions are up to 12 times more likely to be hospitalized or die from the virus after being bitten, compared to healthy people.

And the likelihood of hospitalization and death from Covid also increased as people got older, while men and those of Indian and Pakistani descent were at greater risk.

A person’s overall risk of having serious health problems after receiving a double injection is still very low, with vaccines already having tens of thousands of lives.

But the study confirms that those who were already at risk before being vaccinated are still more likely to be hospitalized or die if they catch it, compared to healthy people with double shots.

The researchers said the calculator can help the government make policy decisions, such as who should receive additional Covid vaccines.

And doctors can use it to make clinical decisions, such as who should receive the new monoclonal antibody treatment.

Experts studied 6.9 million adults who had received one or two Covid vaccines as of mid-June.

The study aimed to determine which groups were most at risk of hospitalization and death after being vaccinated.

The research, conducted by experts from the universities of Oxford, Nottingham and Edinburgh, has been published in the British Medical Journal.

Some 1,929 hospitalizations and 2,031 deaths among all participants were recorded.

But only 71 admissions (3.7 percent) and 81 deaths (four percent) occurred two weeks or later after the second dose.

This data was used to create a risk algorithm of an individual’s likelihood of needing hospital care or dying from the virus after vaccination.

It was based on age, gender, ethnicity, deprivation, body mass index and underlying health conditions, as well as the background infection rate of Covid.

Researchers have found that people with Down syndrome are 12.7 times more likely to die from the virus than healthy adults.

While kidney transplant patients are 8.1 times more at risk and those with sickle cell disease are 7.7 times more at risk.

Other risk groups include chemotherapy patients (4.3 times), people with HIV / AIDS (3.3 times), residents of nursing homes (4.1 times) and people with neurological disorders. (2.6 times).

The virus is also more likely to affect people who have recently had a bone marrow transplant or who have had a previous solid organ transplant (2.5 times), people with dementia (2.2 times) and the disease. Parkinson’s disease (2.2 times).

Other conditions at increased risk include chronic kidney disease, blood cancer, epilepsy, chronic obstructive pulmonary disease, coronary heart disease, stroke, atrial fibrillation, heart failure, thromboembolism, peripheral vascular disease and type 2 diabetes.

But the threat posed by the virus to people with these conditions depends on their severity.

For example, people with stage five kidney disease – which means they need a transplant – were 8.1 times more likely to die from Covid after the vaccination than people with a double bite without the vaccine. sickness.

But people with stage three kidney disease were only 1.23 times more at risk.

Additionally, researchers found that the likelihood of death increased with age and levels of deprivation.

Men are also at greater risk, as are those of Indian and Pakistani ethnicity.

The researchers said the increased likelihood of these groups being admitted to hospital followed “a similar pattern.”

Experts tested their calculator on a dataset of Covid patients who were not included in the study and found it to be 78.7% accurate in identifying coronavirus deaths.

The tool was published by researchers online, but is only available to those who use it for academic purposes.

Britons will need to consult their GP to find out how much risk they are based on their health profile.

Professor Julia Hippisley-Cox, an expert in clinical epidemiology and general medicine at the University of Oxford, co-author of the article, said: “The UK was the first place to implement a program vaccine and has some of the best clinical research data in the world. ‘

Professor Aziz Sheikh, a primary care research and development expert at the University of Edinburgh and other study co-authors, said ministers could use the calculator to determine which groups under 50 should be offered a booster vaccine.

And GPs could use it to determine whether their patients need to protect themselves, while doctors could use it to determine which patients are receiving treatment with monoclonal antibodies.

This therapy can reduce the risk of death by a fifth in critically ill patients whose immune systems cannot fight the virus on its own, but costs around £ 1,000 to £ 2,000 per patient, which means it is unlikely to be widely used.

Professor Sheikh said some of the most at-risk patients remained more vulnerable to the virus after receiving a double bite because they were unable to develop the same type of immune response as healthy people.

And the higher risk for people with Down syndrome may be due to “difficulty following behavioral advice,” but more research is needed to determine if other factors are at play.

Commenting on the variation between ethnic groups, he said: “I think that the fact that some of the ethnic variation is decreasing suggests that this is largely due to the fact that it is a social model – perhaps to because of occupational risk considerations.

“I think with the two remaining subgroups it’s speculative, but these groups – Indians and Pakistanis – tend to have slightly larger household sizes and so there can be that kind of transmission. within the current household. ”

Dr Peter English, former chair of the BMA Public Health Medicine Committee and not involved in the study, said the tool can help identify people who might benefit from additional measures to protect them from contamination with the virus, or reduce their risk of serious illness after being infected.

He said, “We cannot give everyone who is exposed antivirals or monoclonal antibody therapy to prevent the disease from developing into the severe autoimmune stage.

“But we might consider such treatments for some; and the tool can also help policymakers decide, for example, who to prioritize for earlier and more frequent vaccination or vaccination with new anti-variant vaccines.

The calculator can also help people make better decisions about whether to protect themselves, take public transport or meet people indoors, if they know their risk is higher, the Dr English.