Global patient groups call on governments and health system leaders to address the unmet need of people who are immunocompromised, for whom the COVID-19 pandemic presents a continued health risk.
Immunocompromised patients are at increased risk of COVID-19
The COVID-19 pandemic has upended lives around the world, but there is a community of patients – those with compromised immune systems – who are at increased risk of COVID-19 compared to the rest of the population and whose needs remain unmet.
Approximately 2% of the global population is considered to be immunocompromised and at an increased risk of an inadequate response to a COVID-19 vaccine.[i],[ii] More than 40% of those hospitalised with breakthrough infections after vaccination are in people who are immunocompromised, along with a increased risk of inpatient mortality compared to the general population.1,[iii]
COVID-19 pandemic has not ended for immunocompromised patients
The current strategies adopted to support people from COVID-19 are broad but tend to focus on the average, healthy citizen. Whilst this approach benefits most and is enabling countries to start to return to normal ways of working and living, learning to live with COVID-19; immunocompromised patients are being left behind.
As these patients do not mount an optimal immune response, they are more likely to develop severe life-threatening disease and may suffer prolonged infection, which might lead to new emerging variants.[iv] For them, there is no end to the pandemic in sight.
Continued impact of COVID-19 on quality of life for immunocompromised patients
Immunocompromised patients are enduring prolonged suffering and are anxious about the continued risk posed by possible exposure to COVID-19.[v],[vi],[vii]
For over two years, this patient community has been isolated from friends, family and society with detrimental impacts. This has included children being unable to attend school or socialize, with impacts on their emotional development. A survey of blood cancer patients found almost 90% of respondents said their mental health had been impacted by the COVID-19 pandemic.[viii]
Those immunocompromised people who are unable to work from home, such as delivery drivers or those working in hospitality, are now facing increased anxiety in the workplace, due to many COVID-19 regulations and restrictions being removed.5,6 A survey of kidney patients highlighted that 54% of respondents felt concerned about returning to their workplace, but felt they have no other choice.5 Following the withdrawal of financial support for shielding in most countries, many immuncompromised people feel they have no choice but to return to work. This lack of prioritisation is further exacerbating existing health inequalities.
Specific measures to support the immunocompromised community
The COVID-19 pandemic has added considerable pressure to healthcare systems worldwide. But it is critical additional measures to support immunocompromised patients which should be prioritised. This is because of the higher risk of both hospitalization and severe, life threatening disease from COVID-19 among the immunocompromised patient community.3 This is particularly important now as the rest of the population are returning to normal ways of working and living.
Greater visibility of immunocompromised patients and the health inequalities faced by this community is needed in health policy and messaging to raise public awareness of the support still required by this group of people.
This includes communicating specific information around the safety measures that should be maintained by this community, including continued mask wearing, access to free COVID-19 testing, access to additional therapeutic options and providing advice and support for continued self-isolation.
Employers need to continue to also take responsibility for the health and safety of their immuncompromised employees, including appropriate safety measures to help reduce risk of exposure to the virus. These measures are vital to enable people who are immunocompromised to return to, and continue fully working in, the workplace.
Now
is the time to act, to address the unmet needs of the immunocompromised
community. We are calling on governments to take urgent action to support this
vulnerable community and ensure that their needs are prioritised.
[i] Oliver, S MD. Data and clinical considerations for additional doses in immunocompromised people. ACIP Meeting July 22, 2021. Available at: https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-07/07-COVID-Oliver-508.pdf
[ii] AstraZeneca Data on File (REF-129335)
[iii] Shields A M et al. Outcomes following SARS-CoV-2 infection in patients with primary and secondary immunodeficiency in the UK. Clinical and Experimental Immunology 2022. Available at: https://academic.oup.com/cei/advance-article/doi/10.1093/cei/uxac008/6515671
[iv] E Khatamzas, A Rehn, M Muenchhoff, J Hellmuth et al. Emergence of multiple SARS-CoV-2 mutations in an immunocompromised host, 2021. Available at: https://www.medrxiv.org/content/10.1101/2021.01.10.20248871v1
[v] Kidney Care UK, Lifting lockdown – the impact of COVID-19 for kidney patients as the pandemic eases, 2021, available at: https://www.kidneycareuk.org/documents/554/Kidney_Care_UK_patient_survey_report_March_2021.pdf
[vi] Renaloo. Hope, fragility, worries: the experience of the Covid epidemic by 2300 patients with kidney failure, dialysis and transplants. 2022. Available at: https://renaloo.com/espoir-fragilite-inquietudes-resultats-de-notre-enquete-sur-le-vecu-de-lepidemie-covid-par-2300-patients-insuffisants-renaux-dialyses-et-greffes/
[vii] COPAC. 62% of patients with inflammatory rheumatic diseases face major problems during the pandemic. 2020. Available at:
62% dintre pacienții cu boli reumatismale inflamatorii se confruntă cu mari probleme pe perioada pandemiei
[viii] Blood Cancer UK. The impact of Covid-19 on people with blood cancer. 2021, available at: https://media.bloodcancer.org.uk/documents/Blood_Cancer_UKs_Covid-19-Survey-Report-February-2021.pdf