For patients with high-risk disease states, the last thing that they wanted to see is the COVID-19 pandemic. Any patient with kidney disease, HIV, liver disease, or any of the other often debilitating disorders, COVID-19 presented their worst fear. Many of these patients have been panicking as they already have compromised immune systems and have talked with their physicians on the potential fallout of getting COVID-19. In addition, these are the same groups that are remaining in quarantine, staying away from family and friends to avoid exposure to the virus. The CDC (Center for Disease Control) did not include high-risk medical patients in the first priority group for the COVID-19 vaccines, however they are in the second group. The problem has been that high-risk patients are fearful of taking the vaccine. As with anything relating to high-risk patients, the answer to this depends upon the patient themselves. However, given that more people with high-risk medical disorders are dying when they get COVID-19, the vaccine presents a better alternative. The CDC is recommending that every individual that is listed as high-risk confer with their physician and/or specialist to confirm that they should get the vaccine.
High-Risk and Increased-Risk Medical Conditions
The medical and science community is continually learning new things about COVID-19. One of the major topics has been those that have suffered extreme medical problems and even death when they contract COVID-19. The CDC list of the top high-risk conditions include, but is not limited to:
- Cancer
- Chronic kidney disease
- COPD (chronic obstructive pulmonary disease)
- Down Syndrome
- Immunocompromised state (weakened immune system) from solid organ transplant
- Obesity (body mass index [BMI] of 30 kg/m2 or higher but < 40 kg/m2)
- Severe Obesity (BMI ≥ 40 kg/m2)
- Pregnancy
- Sickle cell disease
- Smoking
- Type 2 diabetes mellitus
Increased-risk medical conditions are those that could experience severe illness if they contract COVID-19. The CDC list for increased-risk conditions includes but is not limited to:
- Asthma (moderate-to-severe)
- Cerebrovascular disease (affects blood vessels and blood supply to the brain)
- Cystic fibrosis
- Hypertension or high blood pressure
- Immunocompromised state (weakened immune system) from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines
- Neurologic conditions, such as dementia
- Liver disease
- Overweight (BMI > 25 kg/m2, but < 30 kg/m2)
- Pulmonary fibrosis (having damaged or scarred lung tissues)
- Thalassemia (a type of blood disorder)
- Type 1 diabetes mellitus
The evidence in creating these lists is constantly evolving and is updated on their page. It should be noted that the original clinical trials for the COVID-19 vaccines were done with patients that didn’t suffer from underlying medical conditions. However, the Moderna, Pfizer, and Oxford/AstraZeneca vaccines did include a small number of people with HIV. Both vaccines seemed to have positive results for the HIV patients given the vaccines. HIV patients have also been recruited to be part of the clinical study for the Johnson&Johnson vaccine. The COVID-19 vaccines were also tested in clinical trials on individuals that had liver disease, heart disease, high blood pressure, diabetes, lung disease, and asthma with results showing that they are safe to give to the patients with these health conditions. The National Kidney Foundation has an informative page for kidney patients which helps to assure patients and encourage them to get the COVID-19 vaccines.
How the COVID-19 Vaccines Affect the Body
The key aspect of any vaccine is to work with the body’s immune system to develop antibodies for a specific virus. Patients with a compromised immune system worry that their body’s will simply not be up to the task of creating the antibodies.When viruses or germs invade our bodies they attack and multiply to cause an infection. The immune system uses our red blood cells in combination with the white or immune cells to fight the infection. We have a variety of white blood cells with different jobs:
- Macrophages are the white blood cells that eat and digest dead or dying cells and germs. When they accomplish their function they leave pieces of the germ that invaded behind called antigens. The body can identify the antigens as bad and will cause antibodies to attack them.
- B-lymphocytes are the white blood cells that are defensive. They create the antibodies that attack the bits of the virus that the macrophages leave behind.
- T-lymphocytes are a secondary form of white blood cell used as a defense. These attack the body’s cells that have already been infected.
The vaccines for COVID-19 assist the body by leaving it with a supply of T-lymphocytes and B-lymphocytes as part of its “memory” so that it can fight against the virus if it invades. Creating these takes a few weeks after the initial vaccination and sometimes the process of boosting the immunity can cause symptoms. Most of these symptoms are mild and are the sign that the body is creating the needed immunity. Symptoms typically go away in a matter of a few days to a few weeks. All patients with a high-risk or increased-risk medical condition should consult with their physicians as to their individual situation, but thus far, all research is showing that the COVID-19 vaccines are safe for people dealing with a variety of medical and health issues.