Information for people considered at higher risk of severe disease from COVID-19, and their whānau.
Last updated: 18 November 2022
On this page:
- People at risk of severe illness from COVID-19
- If you test positive for COVID-19
- COVID-19 preventative medicine
- What you and your whānau need to know to stay safe and healthy
- About COVID-19 medicines
- People at higher risk of severe illness from COVID-19 – Unite against COVID-19
This page lists people potentially at higher risk of severe illness from COVID-19, and provides advice for staying safe and healthy.
Not all people listed here will be eligible for free COVID-19 antiviral medicines. See Eligibility guide for COVID-19 antiviral medicines for information on medical conditions and circumstances that make you eligible for free COVID-19 antiviral medicines. Talk to your pharmacist or usual healthcare provider if you’re unsure about whether you are eligible.
Older people and people with some existing health conditions have a higher risk of more severe illness if they contract COVID-19.
Dehydration and breathing difficulties can be severe and cause a small proportion of people to need hospital level care.
- People with compromised immunity
Severe COVID-19 is more likely when people have conditions or take medicines that are associated with immunosuppression.
- Chemotherapy or radiotherapy
- Bone marrow or organ transplantation
- Some blood cancers
- Immune deficiencies including HIV infection
- Some immunity weakening medicines such as high-dose corticosteroids and disease-modifying anti-rheumatic drugs that treat inflammatory conditions such as arthritis and inflammatory bowel disease
- Long term haemodialysis or peritoneal dialysis
Eligibility criteria for COVID-19 antivirals in this category are the same as eligibility criteria for the third dose of COVID-19 vaccine.
There is information available for people with weakened immune systems:COVID-19 and people with weakened immune systems – Health Navigator Information for those living with cancer during the Omicron outbreak - Te Aho o Te Kahu (Cancer Control Agency)
- People with high risk medical conditions
COVID-19 is more likely to become severe in those with underlying medical conditions. The list below is for use with Pharmac COVID-19 therapeutics access criteria.
High risk medical conditions include:
- chronic lung or airways disease
- serious heart conditions such as congestive heart failure, coronary artery disease, rheumatic heart disease, and congenital heart disease
- chronic neurological or neuromuscular disease
- chronic kidney disease
- severe liver disease such as cirrhosis
- severe haematological disorders
- severe mental illness such as schizophrenia, major depressive disorder, bipolar or schizoaffective disorder
- active cancer
- morbid obesity (BMI greater than 35)
- sickle cell disease
- Down syndrome.
- Older people
Risk increases with age but is particularly an issue for people over the age of 70, although Māori and Pacific populations may be more likely to experience the age-related risk earlier than the age of 70.
- People in aged care facilities
Residents of aged care facilities are more at risk of severe illness from COVID-19 due to their age, frailty and underlying health conditions.
Aged care facilities have been shown to be susceptible to rapid transmission of COVID-19 with infections occurring in residents and staff.
Processes are in place to protect those living in residential care facilities, including vaccination, the use of infection prevention and control measures and rapid antigen testing of staff and visitors.
- People who are pregnant
Evidence shows that pregnant people may be at greater risk of poor outcomes if infected with COVID-19.
It is recommended that all pregnant and recently pregnant people (defined as within 6 weeks of birth) are up-to-date with their COVID-19 vaccinations. Vaccinated mothers pass immunity to their unborn children.
Talk to your midwife, GP or nurse practitioner around your risk of getting COVID-19, given your home and work environment. You may need to take extra precautions to keep yourself safe.
- Children at higher risk
Some children are at higher risk of severe disease from COVID-19.
- Infants under the age of 1 month
- Children under the age of 2 who was born premature (less than 37 weeks)
- Children with multiple chronic conditions
- People with a disability
Many people with a disability are at greater risk of contracting COVID-19 and becoming extremely unwell or suffering long-term impacts due to pre-existing medical conditions.
Disabilities can significantly affect a person’s risk in different ways including:
- underlying medical conditions
- sensory deficit, mobility issues, intellectual disability etc which may affect access to health care and access to public health information
- for those in residential care and supported care situations, the increased risk of infection due to interactions with multiple carers, and /or communal living conditions.
The Care in the Community program is committed to supporting people with disabilities and their whānau to prepare for COVID-19 and to support people who test positive and or need to isolate.
For more information:
- People living with mental health conditions and addictions
People with mental health conditions and addictions (tāngata whai ora) are more at risk of severe illness from COVID-19.
Tāngata whai ora are also more likely to have underlying medical conditions but COVID-19 risk for people with mental health conditions is independent of these conditions.
Those at particular risk include:
- people with mental health and addiction conditions in residential care settings
- people currently in contact with secondary and tertiary mental health and addiction services
- people who have a diagnosis of psychosis, bi-polar disorder, depression or substance use disorders
- people with mental health conditions and addictions who are currently homeless or without permanent housing
- Māori and Pasifika with mental health conditions or addictions
- people with mental health conditions and addictions who have not had COVID-19 vaccinations, or are not up-to-date with their COVID-19 vaccinations.
Information and tools available to support your own and others’ mental wellbeing and where to get help if you need it: COVID-19: Mental health and wellbeing resources.
- People of Māori and Pacific ethnicity
Māori, Pacific and some other ethnic groups in New Zealand are at higher risk of severe illness from COVID-19, particularly in some situations.
- People who are not up-to-date with their COVID-19 vaccinations
- People who have co-existing medical conditions
- People who whose housing is crowded
- Where there is difficulty accessing health care (eg, due to distance from care, difficulties with transport or childcare, or lack of suitable services)
- People who smoke
People with a history of smoking are more likely to have severe symptoms of COVID-19.
There are options available to help you stop smoking. You can discuss these with your GP, pharmacy or contact Quitline on 0800 778 778.
If you test positive for COVID-19 there are several ways that you can be identified as more vulnerable. You may be eligible for COVID-19 medicines that can reduce your risk of severe illness.
You may already be known to your healthcare provider as being at higher risk. Healthcare providers prioritise vulnerable people for initial assessment and follow-ups.
You may be identified as more vulnerable through filling out the self-assessment form you get when you report a positive COVID-19 test result at My Covid Record. This is why it’s important to answer the health questions on this form. If you can't use the online form or would prefer not to, call 800 555 278 for assistance to complete the form.
You may be eligible for COVID-19 medicines that can reduce your risk of severe illness.
Information and tools available for people who test positive for COVID-19:
- Eligibility guide for COVID-19 antiviral medicines
- COVID-19 Health Hub – this website has advice on what to do if you test positive for, or are exposed to, COVID-19
COVID-19 antiviral medicines
There are antiviral medicines available to treat COVID-19 and reduce the risk of severe illness and hospitalisation. They need to be taken within five days of a person first developing symptoms of COVID-19.
If you test positive for COVID-19 and have other health issues or long-term conditions, talk to your GP, community pharmacist, or health care provider as soon as possible. They will advise if COVID-19 antiviral medicines are right for you.
Evusheld is for severely immunocompromised people aged 12 and over, who don’t have COVID-19, but have medical conditions that mean vaccinations offer inadequate protection from the virus and they are at high risk of developing severe disease. This includes transplant recipients and some people having cancer treatments.
Evusheld is given by two injections before a person gets COVID-19, or at least two weeks after their recovery from COVID-19.
Evusheld is available to patients in hospital, and in some community healthcare provider facilities, including some general practices.
Talk with your general practice or other health service provider about whether your medical condition means you are more at risk of severe illness from COVID-19 and how to best manage your condition.
You should continue to access care for your medical condition. Health services such as your general practice and hospitals have measures in place to keep both you and their staff safe.
You can work with your doctor, specialist or other treating health professional if you need help understanding your level of risk and how best to stay healthy.
Get vaccinated and boosted
The best way to protect people more vulnerable to getting more seriously ill with COVID-19 is to get vaccinated and boosted.
People at high risk of severe disease or exposure to COVID-19 are particularly encouraged to get their booster dose and their second booster as soon as possible to help protect themselves, their whānau and the wider community. A second booster is recommended a minimum of 6 months after a first booster.
Read more about COVID-19 vaccines
Wear a mask
Wearing a face mask is one of the best ways to protect yourself from COVID-19 and other respiratory illnesses. Wear one whenever you leave home. If you have visitors at home, ask them to wear a face mask.
Free masks are available at some RAT collection sites for vulnerable people. Both medical masks and P2/N95 particulate respirator masks are available, with those people at highest risk of severe illness being prioritised for P2/N95 masks.
Read more about face masks
- Other ways of staying safe
- Keep a safe distance away from people you do not live with – except for your carer or support workers.
- Use good hygiene practices such as washing your hands and cleaning touched surfaces
- Stay at home if you are unwell and get tested if you have symptoms — even if they are mild.
- Try to avoid large crowds.
- If possible, arrange to meet with friends and whānau outside. If it makes you feel more comfortable, you can ask them to wear a face mask.
- If you are gathering indoors, let fresh air in to reduce the risk of catching or spreading COVID-19.
- You could ask the organisers of an event for a livestream option, if you feel more comfortable participating from home.
- Stay connected – if you are not ready to start socialising in large groups, find other ways to keep in touch with close friends and whānau.
- Keep active so you can stay healthy.
Reducing workplace risk
If you are working and are considered to be at risk of severe illness from COVID-19, talk with your employer about doing a risk assessment in your workplace to look at what the risk is for you and how it can be reduced.
If you can’t safely work at your workplace, and you aren’t able work from home, you will need to agree with your employer what your leave from work and pay arrangements will be.
Read more about ways to protecting yourself and others
- Living with or visiting someone at higher risk
You can support friends and whānau by:
- Meeting outside in the fresh air, or if meeting inside increase the air ventilation.
- Wearing a mask indoors, and also outdoors if it is difficult to keep a safe distance away.
- Isolating away from them if you test positive for COVID-19, or are a household or close contact, or are unwell.
- Not visiting them if you are unwell.
- Offering to drop off groceries or essential supplies.
- Keeping in touch with them, and checking up on their physical and mental wellbeing.
- Checking for any extra measures in place before visiting aged residential care facilities.
- Using good hygiene practices such as washing your hands and cleaning touched surfaces.
- Being kind and showing compassion for others. Giving other people space and keeping a safe distance away.
Isolating to protect those at risk
If somebody in your household or whare has COVID-19, you need to keep your distance from them to reduce your risk of getting sick.
This video shows how to isolate safely if you or those you live with someone who is vulnerable to COVID-19.
Read more on the Unite against COVID-19 website