After more than three years, much of the world has moved on from COVID-19. Government and healthcare organisations have reduced their sense of urgency, and much of the general public has started to fully embrace a return to pre-pandemic life.
However, the burden on immunocompromised (IC) individuals is still significant and will likely continue into the 2023-2024 winter season.1 Many who are immunocompromised cannot mount an adequate response to COVID-19 vaccination, and therefore remain at higher risk for severe COVID-19, hospitalisation and death than the general population.2,3
Protection is essential for the IC who remain vulnerable to COVID-19
Vaccines require a healthy immune system and help jumpstart the body’s natural ability to produce infection-fighting cells.4 Thus, individuals with compromised immune systems, such as people with cancer, organ transplant recipients, or people taking immunosuppressive medicines, may not be well protected against COVID-19, even when vaccinated. In fact, more than one in 10 IC patients do not develop the antibodies needed for protection even after five or more COVID-19 vaccinations.5 As a result, the immunocompromised remain at higher risk for infection and serious outcomes.3
With the rapid evolution of Omicron variants that reduced or removed authorised therapies for COVID-19 prevention, many IC individuals are left without active or passive protection while potential new therapies are being studied.6,7
Vaccination alone is often not enough to protect immunocompromised individuals from potential devastating consequences of COVID-19. We must work together to find solutions so that this vulnerable population can move on from the pandemic.
Health and economic burdens continue for the immunocompromised
New real-word evidence from large-scale studies in England and the US highlights the substantial and disproportionate burden still facing immunocompromised individuals from COVID-19, even when fully vaccinated against the virus. These studies showed that:
- Despite representing a small percentage of the general population, immunocompromised individuals accounted for a disproportionally large percentage of severe COVID-19 outcomes.8,9
- The risk of hospitalisation, ICU admissions and death was disproportionately higher than the general population across all immunocompromised individuals, regardless of the primary condition.8,9
- The cost of taking steps to protect immunocompromised IC patients may be lower than the high costs associated with poor COVID-19-related outcomes.8,9
Beyond infection risk: Disruption to care for primary condition and quality of life
When the pandemic started I had to take precautions since I had been diagnosed with cancer. What affected me the most was that I could not go to my medical appointments, and I had to stop my treatment overnight.
Without protection, many in the IC community continue to limit contact with others and often aren’t able to return to their everyday lives.10 These individuals may choose not to attend important medical appointments because they no longer feel that hospitals or GP surgeries are safe due to a lack of mask-wearing or social-distancing precautions. More so, infection or fear of infection could mean being unable to receive cancer treatments, being removed from a transplant waiting list or experiencing a worsening of their condition. These treatment delays or interruptions risk poorer outcomes and wasted healthcare resources for their primary condition.11–14
“[New therapies] aren’t cheap, but neither is time in the ICU. And for a healthcare provider, it doesn’t make a lot of sense to spend countless thousands on a transplant or cancer treatment and then see the patient returned to intensive care or worse.
Interviews with IC patients about their current experience also reveals the continued impact COVID-19 has on their everyday lives.
- Up to 79% continue to practice COVID-19 avoidance and protective behaviours (such as wearing a mask) while healthy patients have returned to ‘normal life.15
- 43% report difficulty accessing healthcare or a lack of proper healthcare support.15
COVID-19 continues to cause widespread disruption around the world
In May 2023, the World Health Organization declared COVID-19 no longer constitutes a public health emergency.1 Yet, COVID-19 presents a greater threat of disruption to public health than other prevalent respiratory diseases such as influenza or RSV and continues to impact patients and healthcare systems worldwide:
- Peak COVID-19 hospitalisation rates during winter 2022-2023 were 1.24 times higher and 2.08 times higher than peak influenza and RSV hospitalisation rates, respectively.16–18
- COVID-19 deaths were about seven times higher in 2022 compared to the 2022-2023 influenza season.16,17
Reducing the preventable burden of disease
The World Health Organization acknowledges that while COVID-19 has become endemic to many areas, the IC continue to face an ongoing risk from the virus.19 A deeper understanding and recognition of this diverse group to help foster access to tailored, appropriate care and treatment remains an urgent unmet need. Without effective, long-term protection, the burden of COVID-19 falls on both IC patients and healthcare systems.9,20 A 2022 study suggests that more than 14,500 hospitalisations in England could have been prevented if a prophylactic intervention with 80% effectiveness had been used alongside vaccination in IC individuals.8
At AstraZeneca, we are committed to following the science to protect the most vulnerable patients, ensuring no patient is left behind. Our ambition is to develop and deliver transformative vaccines and antibodies, providing long-lasting immunity to millions of people, where the burden of disease is greatest.
