As COVID-19 restrictions around Europe ease, the need to support the most medically vulnerable populations remains

DISCLAIMER: All opinions in this column reflect the views of the author(s), not of EURACTIV Media network.

Promoted content

Iskra Reic [AstraZeneca]

This article is part of our special report A new phase of COVID-19 fight.

Over two years after the start of the COVID-19 pandemic, countries across Europe have been lifting restrictions and societies have gradually begun returning to ‘normal’ life. With over 75% of the European population having been vaccinated with at least one dose[1], for the vast majority, catching the virus does not entail severe health consequences. Hospitalisations from COVID-19 are at some of the lowest levels since the beginning of the pandemic. However, for a small but significant part of the population, the threat of the disease is far from over.

Iskra Reic is the Executive Vice President, Vaccines & Immune Therapies Unit, AstraZeneca.

Up to 2% of the population[2], roughly nine million people in the EU, is still at increased risk of severe COVID-19, regardless of the number of vaccine doses they receive.[3],[4] They remain vulnerable due to underlying health conditions that compromise or suppress their immune system, such as cancer patients receiving chemotherapy, people who have had an organ transplant, or who are on dialysis.

These immunocompromised individuals are often unable to mount a strong enough immune response following the COVID-19 vaccine.[5] This means they are more likely to develop severe life-threatening disease and may suffer prolonged infection, which may in turn lead to new emerging variants.[6] Despite constituting a small share of the population, the immunocompromised account for more than 40% of patients hospitalised with breakthrough COVID-19 infections.3,[7]

Not only is this vulnerable population group at risk of enduring prolonged suffering, as recent studies have shown[8],[9],[10], but they have also been isolated from friends, family and society for two years and are at risk of having to continue to do so.

This isolation has included children being unable to attend school or socialize, impacting their emotional development.[11] This has resulted in a significant impact on mental wellbeing. For example, a survey of blood cancer patients found almost 90% of respondents said their mental health had been impacted by the COVID-19 pandemic.[12]

Recent studies have further shown that immunocompromised patients are anxious about the continued risk posed by possible exposure to COVID-19.8,9,10 And rightly so. The absence of words like ‘COVID’, ‘pandemic’ and ‘vaccines’ from the top news spots does not mean the virus has disappeared.

Indeed, as data from the European Centre for Disease Prevention and Control (ECDC) shows, transmission of COVID-19 infections, while decreasing, remains prevalent, and some European countries continue to report spikes in transmission in certain age groups.[13] The pandemic continues to be a threat and transmission spikes are a reminder that COVID-19 will remain a global health challenge for the foreseeable future.

So, how can we better support this at-risk population and ensure that as many people as possible can re-join society and return to their regular lives?

The first step is understanding these medically vulnerable groups and their needs, and ensuring both governments and healthcare systems have the policies and tools in place to better support them. It is imperative that the dialogue between patients, caregivers, patient advocacy groups and policymakers turns into concrete policy actions.

Supplementary measures to support immunocompromised patients must be prioritised, addressing the barriers they face and ensuring they receive the added support they need. 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 and additional therapeutic options, and providing advice and support for continued self-isolation.

Global and local patient advocacy groups have laid the groundwork for this, are raising public awareness, and have clearly outlined the needs of vulnerable groups in a joint statement. It is now for governments and health leaders to respond to their call, taking action to address the unmet needs of a population that risks being forgotten.

We must also take lessons from the COVID-19 response to ensure our healthcare systems are fit for purpose to fight future pandemics and that future responses to health challenges will be more comprehensive and attune to different populations’ needs.

The launch of a new European Parliament Special Committee on ´Lessons drawn from the COVID-19 pandemic’, agreed on 10 March this year, is a crucial step forward representing a dedicated political effort to learn from COVID-19. The Committee’s first ordinary meeting on 12th of May also showed that providing support to the medically vulnerable population is on Committee members’ minds, with Italian S&D MEP Alessandra Moretti asking what Europe can do to protect these vulnerable groups.[14]

The time to act is now to ensure that in this and future pandemics, no one is left behind.

[1] https://vaccinetracker.ecdc.europa.eu/public/extensions/covid-19/vaccine-tracker.html#uptake-tab

[2] AstraZeneca Data on File 2021. REF-129335.

[3] Brosh-Nissimov T, Orenbuch-Harroch E, Chowers M, et al. BNT162b2 vaccine breakthrough: clinical characteristics of 152 fully vaccinated hospitalized COVID-19 patients in Israel. Clin Microbiol Infect. 2021;27:1652-1657.

[4] Abbasi J. Researchers Tie Severe Immunosuppression to Chronic COVID-19 and Virus Variants. JAMA. 2021; 325:2033-2035.

[5] Belsky J, Tullius B, Lamb M, et al. COVID-19 in immunocompromised patients: A systematic review of cancer, hematopoietic cell and solid organ transplant patients. J Infect. 2021; 82(3):329-338.

[6] 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

[7] 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

[8] 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

[9] 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-%20patients-insuffisants-renaux-dialyses-et-greffes

[10] COPAC. 62% of patients with inflammatory rheumatic diseases face major problems during the pandemic. 2020. Available at: https://www.copac.ro/62-dintre-pacientii-cu-boli-reumatismale-inflamatorii-se-confrunta-cu-mari-probleme-pe-perioada-pandemiei/

[11] AstraZeneca. Press Release: Joint Statement on the Impact of COVID-19 on Immunocompromised Patients. 9 May 2022. Available at: https://www.astrazeneca.com/media-centre/statements/2022/joint-statement-on-the-impact-of-covid-19-on-immunocompromised-patients.html

[12] 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

[13] https://covid19-country-overviews.ecdc.europa.eu/index.html

[14] https://multimedia.europarl.europa.eu/en/webstreaming/covi-committee-meeting_20220512-0900-COMMITTEE-COVI  (Timestamp: 09:58:10 et seq).

Subscribe to our newsletters

Subscribe