People with Down Syndrome Should Be Prioritized for COVID-19 Vaccination, Experts Say

If you have Down syndrome or are a caregiver for someone with Down syndrome, you may already be eligible to receive a COVID-19 vaccine. In some states, people with Down syndrome have been prioritized to receive vaccines due to their high risk for a severe case of COVID-19.

An international study published by The Lancet's EClinical Medicine journal found that people with Down syndrome are at an increased risk of dying from COVID-19 when compared to a general population. Health data of over 1,000 individuals with Down syndrome who had COVID-19 was collected through a survey between April and October 2020. The study found that people with Down syndrome were more likely to develop the following medical complications from COVID-19 than people without the condition:

• Viral pneumonia
• Bacterial pneumonia
• Acute respiratory distress syndrome

"Since individuals with Down Syndrome have a three-fold increased risk for mortality after infection, they definitely need to be prioritized for vaccination, especially adults above the age of 40," one of the study's authors Anke Huels, PhD, an assistant professor at Emory University in Georgia, tells Verywell.

Premature Aging Increases COVID-19 Risk

Previous research has found that individuals with Down syndrome experience premature aging and also develop conditions like Alzheimer's disease at higher rates and earlier than people who do not have the condition.

The February study found that the death rate for people with Down syndrome infected with COVID-19 increases at the age of 40. In comparison, research about COVID-19 death rates for the general population has indicated that the chance of death increases significantly around the age of 70.

"Forty is sort of the 65 for individuals with Down syndrome in terms of thinking about who should get their vaccine," Robert A. Saul, MD, professor of pediatrics at Prisma Health in South Carolina, tells Verywell. "The take-home message is that everybody with Down syndrome should get this vaccine." The exception being, according to Saul, for people under the age of 16, since more research is still needed on adolescents and children.

The Down Syndrome Medical Interest Group-USA recommends that people with Down syndrome, except for those who have severe allergies, receive vaccinations against COVID-19.

How Residential Care Affects Spread

People with intellectual and developmental disabilities may live in group residential settings. An October 2020 study published in the Disability Health Journal suggests that lack of proper safety measures against COVID-19 may be linked to an increased spread of the virus and death rate for people with intellectual and developmental disabilities who live in group homes. The study did not differentiate outcomes between people with Down syndrome and individuals with other intellectual and developmental disabilities.

Similar to older adults who live in nursing homes, people with Down syndrome who live in group homes may have a higher risk of contracting COVID-19. The study published in The Lancet did not examine whether rates of infection for people with Down syndrome varied by their living situation.

"We only included individuals who already had COVID-19, but mortality rates were similar where they lived...in group homes or care facilities or at home," Huels says.

Importance of Continuing Therapies

Children and adults with Down syndrome benefit from participating in a range of therapies. According to the Eunice Kennedy Shriver National Institute of Child Health and Human Development, these can include:

• Physical therapy
• Speech-language therapy
• Occupational therapy 
• Emotional and behavioral therapy

Huels says that one of the reasons why it is important for individuals with Down syndrome to be prioritized for the COVID-19 vaccine is so that they can return to therapies and other activities that help them manage their cognitive and physical health.

"It is really important that they are in contact with physicians, but also with just with people and have social contacts," she says. "Clinics have already observed that individuals with Down syndrome who were shielded also suffered from cognitive decline."

Prioritization for Caregivers

A few different states across the U.S., like Oregon and North Carolina, have also prioritized caregivers, paid and unpaid, for people with disabilities and older adults.

Due to the physical contact needed to support people with Down syndrome, many people with Down syndrome may not be able to isolate themselves from essential caregivers in their lives. A 2017 study published in the Portuguese journal Ciência & Saúde Coletiva found that children and adolescents with Down syndrome required significantly more help with eating, bathing, and getting dressed than people without this condition.

For states like South Carolina, Saul says that advocates worked to have caregivers be included earlier in the vaccine rollout. "We had to push hard to get the caregivers to [be allowed] to be vaccinated, because of their importance to their children with intellectual or physical disabilities," he says.

To learn more about when people with Down syndrome or their caregivers qualify for the COVID-19 vaccine in each U.S. state, you can use Johns Hopkins University's COVID-19 Vaccine Prioritization Dashboard.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.