Prioritize People With Intellectual Disabilities
for COVID Treatment
— This at-risk group has not received adequate attention
by Wendy Ross, MD, and Jonathan Gleason, MD
January 10, 2022
The FDA's emergency use authorizations of monoclonal antibodies and more recently molnupiravir and nirmatrelvir/ritonavir (Paxlovid) for treating COVID-19 in people at high risk for severe disease brings great hope to the world and the global community of people impacted by intellectual disability. But access barriers pose a challenge. It is critically important that healthcare providers make these life-saving treatments available immediately to people with intellectual disabilities who test positive for COVID-19 -- and advocate for those high-risk individuals.
We struggled to get this right during the initial rollout of COVID-19 vaccines. In March 2021, our research group released a study in the New England Journal of Medicine-Catalyst where we described the devastating impact of COVID-19 on individuals with intellectual disabilities. Indeed, our analysis of 64 million medical records across the U.S. demonstrated that having an intellectual disability is the highest risk factor for getting COVID-19 and, second only to age, for dying from it. Tragically, when admitted to the hospital with COVID-19, those with an intellectual disability were 32% more likely to die as inpatients. The CDC has now recognized the robust evidence that having an intellectual disability is a significant risk factor for death from COVID-19.
Our study, and others like it, led to the expansion of vaccine prioritization to people with intellectual disabilities in more than a dozen states as well as in Japan and other countries around the world. Civil rights lawsuits against Connecticut and Maryland allege they failed to prioritize intellectually disabled persons for vaccination. Ultimately, most states and countries failed to follow the clear evidence regarding this high-risk group with their early vaccine deployments.
Wendy Ross, MD, is director of the Jefferson Center
for Neurodiversity and Autism.
Jonathan Gleason, MD, is chief clinical officer of Prisma Health.
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