COVID-19 isn’t discriminating by age — younger people are dying, too

Editor’s note: As what we know about COVID-19 evolves, so could the information in this story. Find our most recent COVID-19 blog posts here, and learn the latest in COVID-19 prevention at the Centers for Disease Control and Prevention.

Early in the COVID-19 pandemic, severe COVID-19 initially affected mostly older people and those with certain health conditions. Today, there are more healthy, younger people — in their 20s and early 30s — who are experiencing severe COVID-19 symptoms that send them to the hospital and/or leave them with long-term symptoms (“long COVID”). We’re also seeing more deaths in these younger adults from COVID-19.

The delta variant of the SARS-CoV-2 virus, which is responsible for nearly all COVID-19 cases in the United States now, is not only much more contagious, but it doesn’t discriminate by age as much as earlier variants did.

Certain underlying health conditions still can contribute to the severity of COVID-19 symptoms, but with the delta variant, we’re seeing patients in the hospital who are young, fit and without any underlying health conditions.

Many more of the COVID-19 deaths we’re seeing are in people in the 30- to 50-year-old age group. And at the Ohio State Wexner Medical Center, percentages of COVID-19 discharges in under-40 patients have been increasing steadily since March 2021. By September 2021, about a third of our COVID-19 patients who were hospitalized were under 40. More than 40% were under 50. These are not elderly, frail people.

What you can do

If you haven’t been vaccinated against COVID-19 and you haven’t already been infected…

• At this point, actual COVID-19 infection is much, much more likely to cause long-term damage to your body than a COVID-19 vaccine would. Beyond the expected immune response to the vaccine (injection site soreness/redness, fatigue, muscle/joint soreness, headache, fever), side effects from the COVID-19 vaccine are rare and nearly all mild.
• Getting a COVID-19 vaccine is highly recommended. It’s not too late to get vaccinated, and it’s free and relatively convenient. Visit vaccines.gov to find a vaccination site near you.
• Continue social distancing and wearing a face mask indoors and in crowded situations outside of your own household whenever possible. 

If you haven’t been vaccinated against COVID-19 and you have been infected previously… 

• If you had a mild case of COVID-19, you may have some immunity induced from prior COVID-19 infection, but we don’t have much evidence showing how protective that immunity is. We do know that people who rely on ‘natural immunity’ are more than twice as likely to become re-infected with COVID as those who have been vaccinated. We also know that a single dose of the COVID-19 vaccine at least one month after an episode of COVID-19 infection typically results in a significant boost in the levels of antibodies that protect you from COVID-19 symptoms. Consider getting one does at least one month after the infection episode has resolved, and talk to your health care provider about what they recommend. Visit vaccines.gov to find a vaccination site near you.
• If you had a moderate or severe case of COVID-19, current data tells us that you may have strong, durable-enough immunity to protect you from reinfection — potentially for at least eight months — without getting a COVID-19 vaccine.
• Continue social distancing and wearing a face mask indoors and in crowded situations outside of your own household, whenever possible.

If you have a condition that makes you concerned about getting the COVID-19 vaccine…

Unless you have hypersensitivity or a possibility of anaphylactic allergy to a component of a COVID-19 vaccine, it’s recommended that you get vaccinated against COVID-19 when possible.

Here’s why:

Based on the data we’ve now collected from millions of people who have received the COVID-19 vaccine and millions of people who have been infected with COVID-19, we can see that the risk of having long-term and/or severe symptoms from COVID-19 is much higher than the risk of having long-term and/or severe symptoms from the COVID-19 vaccine. Meanwhile, the vaccine offers much-needed protection from infection and severe symptoms.

Underlying conditions such as cancer, heart conditions, diabetes and other autoimmune diseases put people at very high risk of hospitalization and death from COVID-19 if infected. A vaccine offers protection from severe COVID-19 symptoms with a very low risk of side effects, even for people with these underlying conditions.

Some people have become worried about myocarditis or blood clots from the COVID-19 vaccine, but it’s much more likely that you would develop myocarditis or blood clots from COVID-19 infection than from the vaccine. Even for people who have blood clotting or cardiac conditions, a COVID-19 vaccine is recommended as soon as possible.

If you have been vaccinated against COVID-19…

Unless you have a condition or are undergoing treatment that leaves you immunocompromised and unable to adequately develop antibodies, you should have protection against severe symptoms of COVID-19 if you’ve been vaccinated.

Some people who are already vaccinated but are immunocompromised are now eligible for a third dose of the COVID-19 mRNA vaccines (Pfizer and Moderna).

If you were vaccinated at least six months ago but have an underlying condition, you may be eligible for a COVID-19 booster vaccine. Booster vaccines currently are available only for those who first received the Pfizer vaccine, but boosters likely will become available in the coming months for recipients of the Moderna and Johnson & Johnson vaccines. 

Data shows that the available COVID-19 vaccines are working effectively to prevent severe cases of COVID-19, hospitalization and death, but we’re seeing some waning protection (as was expected), and booster shots and third doses can help vaccinated people keep that protection longer.

The bottom line

Younger adults are not immune to severe symptoms, hospitalization and death from COVID-19, even if they have no underlying conditions. We are even seeing more severe cases and hospitalizations in children under 18.

If you’ve been putting it off, now is the time to get a COVID-19 vaccine to protect yourself, to keep hospital capacity available for more people who need it, and to help control a pandemic that is ripping through our communities.

Getting vaccinated, and social distancing and wearing a face mask when indoors and in crowded areas remain our best tools for protecting against the spread of COVID-19.

Iahn Gonsenhauser is chief quality and patient safety officer at The Ohio State University Wexner Medical Center and an assistant professor in The Ohio State University College of Medicine.