The High-Risk People Who Really Need the COVID Vaccine

The High-Risk People Who Really Need the COVID Vaccine

If you’re living with chronic lung disease, hypertension, or diabetes, getting the coronavirus shot is especially important


The pandemic has been a scary time for us all, but for the 60 percent of American adults with a chronic illness, the stakes can feel even higher. “If you have any kind of chronic condition and you get COVID, you’re at a higher risk of not recovering well from it,” says Cathleen Morrow, M.D., chair of community and family medicine at Dartmouth-Hitchcock Medical Center in New Hampshire.

This is exactly why it’s important for people with underlying health conditions to get their shots as soon as possible—and why they’re near the front of the vaccine line. “For most people, the risks of getting the vaccine are very small compared to the risks of COVID. And for patients with conditions like hypertension, diabetes or lung disease, the risk-benefit ratio is even more clear. It just doesn’t make any sense not to get the shot,” Dr. Morrow says.

In the meantime, get the specifics on why COVID-19 is particularly dangerous if you’ve got COPD, diabetes, or hypertension—and learn how to stay safe.

When You Have COPD or Asthma

Why COVID-19 Can Be So Serious: First, some good news for people with asthma: There’s no conclusive evidence that they’ll have a worse COVID-19 illness than someone without asthma. Experts had assumed that asthma patients might be at greater risk, given that they have reduced lung function and COVID-19 is a respiratory disease. But studies haven’t borne this out. In a statement published on its website, the American Academy of Allergy, Asthma & Immunology notes that “although the Centers for Disease Control and Prevention states that patients with moderate-severe asthma could be at greater risk for more severe disease, there are no published data to support this determination at this time.”

However, that same statement goes on to say that chronic obstructive pulmonary disease (COPD) “is a well-established risk for severe COVID-19.” COPD is an umbrella term for lung diseases like emphysema and chronic bronchitis, which block airflow and make it hard to breathe. “If you have significant COPD, you already know what it’s like to be short of breath. It’s called ‘air hunger,’ and it’s one of the most uncomfortable and scary experiences a person can have," says Dr. Morrow. Plus, research shows that the lungs of people with COPD are more susceptible to a severe COVID-19 illness. That's why COVID-19 patients with COPD are about two and a half times more likely to end up in the ICU and be put on a ventilator.

How to Stay Safe Beyond the Shot: Take your meds to keep your condition under control. A huge bonus: There’s evidence that steroid inhalers could offer some protection against COVID-19.

When You Have Diabetes

Why COVID Can Be So Serious: Whether it’s type 1, type 2, or gestational diabetes, “the nature of diabetes is that you don’t fight infection as well,” Dr. Morrow explains. “When people have chronically high sugars, their white blood cells — which attack invading germs — don’t work as efficiently as they do in people without diabetes.” This helps explain why diabetes patients who get COVID-19 tend to have severe cases. In fact, about 40 percent of Americans who have died from COVID-19 also had diabetes.

How to Stay Safe Beyond the Shot: “The better your diabetes is controlled, the better your white blood cells work,” says Dr. Morrow. Check your blood glucose often and keep in close touch with your health care provider, who can increase your insulin as needed, she says. You should also eat balanced meals, drink water instead of sweetened beverages, prioritize sleep and find ways to reduce stress. And if you’re not physically active, talk to your provider about a fitness plan.

When You Have High Blood Pressure

Why COVID Can Be So Serious: It’s well known that high blood pressure, also known as hypertension, makes your heart work harder and damages your arteries. This happens slowly, over years, and the damage throughout your body can lead to chronic inflammation.

All that inflammation, in turn, raises your risk of having severe COVID-19 illness—possibly because your immune system overreacts to the virus. This kicks off a dangerous runaway response that can lead to tissue damage, and it may be why COVID-19 patients with high blood pressure are more likely to suffer from pneumonia and organ failure.

How to Stay Safe Beyond the Shot: Stay in touch with your provider to make sure your blood pressure is in check. “Don’t delay getting the medical care you need because you’re scared of going to the office,” says Dr. Morrow, who suggests looking into telehealth appointments. Lifestyle changes can also help lower your blood pressure and reduce chronic inflammation. These include maintaining a healthy weight, eating a heart-healthy diet, getting regular exercise, and reducing stress. Deep breathing, yoga, and making time for hobbies can help.

The information in this story is accurate as of press time and posting. To limit the spread of the coronavirus, it’s important to continue practicing social distancing (keeping at least 6 feet away from people outside your household) and washing your hands frequently. You should also be appropriately masked any time you’ll be in public. According to the CDC’s latest guidance, this means layering a disposable surgical mask underneath a snug-fitting cloth mask or placing a mask fitter over your cloth mask to ensure a tight fit. Because the situation surrounding COVID-19 continues to evolve, we encourage readers to follow the news and recommendations for their own communities by using the resources from the CDCWHO, and their local public health department.

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