COVID-19 and Down Syndrome

The COVID-19 & Down Syndrome Resource Consortium supports the CDC’s current guidance that states adults with Down syndrome age 18+ are eligible for a Pfizer COVID-19 booster shot. As adults with Down syndrome are at higher risk for severe illness associated with COVID-19, booster shots should be scheduled as soon as possible six months after their second dose of the Pfizer COVID-19 vaccine. Recent data shows they are more likely than the general population to experience a “breakthrough” COVID-19 infection and/or experience more severe outcomes during a breakthrough infection. A “breakthrough” COVID-19 infection is defined as someone who gets COVID-19 even though they are vaccinated. Please note that adults with Down syndrome who are older and overweight are at higher risk for severe outcomes. Current CDC guidance does not recommend receiving a Pfizer booster if the individual previously received the Moderna or the Johnson & Johnson vaccine. Booster shots for Moderna and Johnson & Johnson vaccine are not yet available as they are still being evaluated and we will keep you updated as we learn more from the CDC.

December 3, 2021

Analysis of various data sources collected during the COVID-19 pandemic has established that individuals with Down syndrome are at increased risk for both hospitalisation and mortality after infection with SARS-CoV-2. Adults with Down syndrome were amongst the highest risk groups for mortality. Furthermore, there have been concerns that, when admitted to hospital during peak infection periods and when demands on resources are high, people with disabilities and long-term conditions may not be prioritised for access to scarce resources such as respiratory ventilation or intensive care beds.

It has been the clinical experience of many Down syndrome clinics in different countries that COVID-19 vaccines can be safely given to children (from age 12) and adults with Down syndrome. There are also reasonable indications that full vaccination offers significant protection against the poor outcomes associated with infection in people with Down syndrome. However, based on our understanding of the immune response in Down syndrome, including reduced numbers of and differences in memory B cell responses, and previously published studies on the immunological response of those with Down syndrome to other vaccines, their antibody response to vaccination may be less robust when compared to peers without Down syndrome.

We therefore recommend that individuals with Down syndrome should be amongst those prioritised for booster vaccination for persistent production of antibodies against COVID19 antigen. There have been some indications of additional benefit by combining vaccines from different sources (e.g. Pfizer and Moderna, or Moderna and AstraZeneca) to promote better immune responses based upon studies in the general population, but any booster is preferable to none.

Susceptibility to COVID-19 in Down syndrome – https://link.springer.com/article/10.1007%2Fs12017-021-08651-5

Immune dysregulation associated with Down syndrome – https://www.frontiersin.org/articles/10.3389/fimmu.2021.621440/full

T21RS surveys of COVID-19 in Down syndrome, including side effects of vaccines – https://www.t21rs.org/results-from-covid-19-and-down-syndrome-survey/

Defective B-cell memory in patients with Down syndrome – https://www.sciencedirect.com/science/article/abs/pii/S0091674914009701

Prepared by the T21RS COVID-19 Task force

“As people with Down syndrome make plans to re-enter and re-engage in their communities, the Down Syndrome Program at Massachusetts General Hospital offers the following information and resources so caregivers can make informed decisions that are right for their families.”

May 12, 2021

Today, an important and timely COVID-19 and Down Syndrome Resource was published by a consortium of national Down syndrome organizations: the Down Syndrome Medical Interest Group-USA (DSMIG-USA), Global Down Syndrome Foundation (GLOBAL), LuMind IDSC Foundation (LuMind IDSC), National Down Syndrome Congress (NDSC), National Down Syndrome Society (NDSS), and National Task Group on Intellectual Disabilities and Dementia Practices (NTG).

The Resource builds upon the publication of the Q&A on COVID-19 & Down Syndrome and focuses on new and updated information specific to testing, vaccines, mental health, ways to stay safe, and advocacy in hospital settings and for appropriate care. It is available in both English and Spanish.

The Down Syndrome Medical Interest Group (DSMIG) has released this position statement about the COVID-19 vaccine. This statement addresses some common questions from families in the Down syndrome community in regard to considerations of who should or should not receive the COVID-19 vaccine. Click here to view the full document.

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