Since March of 2020, the coronavirus has proven nonetheless that no one is and will be spared from this novel contagion. In addition to the high risk senior citizens, recent research has led to claims that people with Down Syndrome are at ten times more risk than the average young citizen.
With this new group at concern, countries such as the United Kingdom have prioritized the distribution of new vaccines to people with DS. However, many countries, including the United States, have not expressed any additional concerns or statement for people with DS. Not only have there been no alterations to the vaccine distribution algorithm, but also there has been no statement made in the list of conditions in the U.S. Centers for Disease Control and Prevention. As a result of a lack of uniformity, many people have questioned this claim.
A clinical epidemiologist at University of Oxford’s medical school and senior author, Julia Hippisley-Cox, has researched this topic thoroughly with fellow colleagues. With data collected from over 8.2 million citizens of the United Kingdom, the researchers were able to accurately eliminate other factors, such as heart disease, diabetes, and obesity, to correctly reflect the sole effect on Down Syndrome. Due to the nature of having an extra copy of chromosome 21, Down Syndrome makes patients more endangered, compromising people’s immunity with background immune abnormalities. “This is a vulnerable population that may need protective policies put in place,” says Hippisley-Cox.
Scientifically, scientists report that the extra copy of chromosome 21 results in “lax throat muscle tone”, in addition to large tonsils, large tongues, small jaws, and adenoids, which provides support for their higher infections of any respiratory condition, including COVID-19. Trisomy 21, having three copies of chromosome 21 TMPRSS2, “codes for an enzyme that the virus hijacks to help it enter human cells and cleaves the spike protein that studs the virus’ surface, launching a series of steps that allows the virus to invade the host cell.” (ScienceMag.org)
With the innate immune abnormalities, people with DS have less B cell levels and underdeveloped T cells, both of which are crucial for fighting against foreign cells in the body’s tissue.
The paper published in the Annals of Internal Medicine stated how people with DS at over 40 were at most risk. “At about the age of 40, things are getting really bad…with a mortality rate comparable with those older than 80 in the general population,” says Anke Huels, another author and a biostatistician at the Rollins School of Public Health at Emory University. Other research showed that even for patient under 40, the death rate was increased to 51% from the death rate of an average person at 7%. Despite claims that mortality was not a high concern for younger populations, this research suggests anyone with Down Syndrome is at much higher risk.
Bringing more attention globally, these researchers are not only in attempts to educate the world but also push for the vaccine distribution to prioritize people with DS before the general public. Family of Amanda Ross, a patient with DS who recently recovered from a severe case of COVID-19, has expressed that “(they) can’t begin to tell you how grateful we are to have her still” and Amanda’s case being one out of millions “is all the more reason why they need to be considered for vaccination right behind the front-line workers.”