HEALTH
People with chronic conditions among most at risk from Covid even after jabs

People living with chronic conditions such as Down’s syndrome and dementia remain among the most vulnerable to Covid-19 even after vaccination, research has found.

The study, based on data from more than 6.9 million vaccinated adults, 5.2 million of whom had received both doses, found that being vaccinated offers powerful protection against hospitalisation for almost all groups. However, a risk calculator based on the data shows that some groups remain at particular risk and may benefit from booster vaccine doses and treatments such as monoclonal antibodies.

The research found that people with Down’s syndrome had a roughly 13-fold increased risk of death from Covid-19 compared with the general population, even after vaccination, while those with dementia and Parkinson’s disease had a twofold increase. Some of the increase in risk is thought to be down to exposure due to people having contact with carers, for instance.

Carol Coupland, professor of medical statistics in primary care at the University of Nottingham and senior researcher at the University of Oxford, said: “Overall the risks are much smaller than before vaccination, but it hasn’t completely removed the differences between these groups.”

Aziz Sheikh, professor of primary care research and development and director of the Usher Institute at the University of Edinburgh, said that for some groups the increased risk was due to increased exposure to Covid-19, but that it was possible those with Down’s syndrome had an additional underlying vulnerability. “People need to look into this group as it remains a pretty major risk group,” he said.

The study found that older members of the population and men are at greater risk as well as those from Indian and Pakistani backgrounds. Also at greater risk are those from a deprived background, the immunosuppressed and residents in a care home.

© Getty The findings, published in the British Medical Journal, will be used in an updated version of an NHS risk prediction tool, currently used by GPs to calculate patients’ risk during consultations. The scientists, led by a team at the University of Oxford, will also make the tool available online for academics, but say this version will not be accompanied by clinical guidance.

The new algorithm predicts those most at risk of serious Covid-19 outcomes from 14 or more days after second vaccination dose, when substantial immunity is expected to have developed.

Researchers hope the new tool will allow those who perceive risk to be high to make more informed decisions regarding shielding and potentially inform policy and clinical decisions on booster vaccine doses and monoclonal antibodies.

© Getty The scientists used national datasets from general practice, vaccination, PCR testing, death registries and hospital admissions data. This sample included 2,031 Covid-19 deaths and 1,929 Covid-19 related hospital admissions, of which 81 deaths and 71 admissions occurred 14 or more days after the second vaccine dose. Based on this, the researchers developed scores to calculate people’s risk of hospital admission or death from Covid-19 after one, or two vaccination doses.

The study did not take into account factors that could have affected exposure to Covid-19, such as occupation and the number of people sharing a home.

Prof Hippisley-Cox said: “Individual risk will always depend on individual choices as well as the current prevalence of the disease, however we hope that this new tool will help shared decision making and more personalised risk assessment.”

Source: Theguardian.com

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