COVID-19: Higher risk people

Information for people considered at higher risk of severe disease from COVID-19 and their whānau.

Last updated: 28 April 2022

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People at risk of severe illness from COVID-19

COVID-19 is an infection caused by a type of coronavirus that’s spread like the flu from person to person. The symptoms are typically viral with fatigue, cold and flu like symptoms including tummy bug symptoms for some people.

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. Some medicines which reduce the risk of hospitalisation are available.

People with compromised immunity

COVID-19 is more likely to become severe when people have conditions or take medicines that are associated with immunosuppression, such as:

  • 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 are the same as eligibility criteria for the third dose of COVID-19 vaccine

There is information available for people with weakened immune systems:

People with high risk medical conditions

Covid-19 is more likely to become severe in those with underlying medical conditions.

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
  • hypertension
  • chronic neurological or neuromuscular disease
  • diabetes
  • 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

Older people, in particular those who have underlying medical conditionsare more at risk of severe illness from COVID-19. 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.

More information for older people

People in aged care facilities

Residents of aged care facilities are more at risk of severe illness from COVID-19 due to their age and 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.

Information for pregnant people and those who have recently given birth

Children at higher risk

Children at higher risk of severe disease from COVID-19 include:

  • 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 healthcare 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 if:

  • people are not up-to-date with their COVID-19 vaccinations.
  • they have co-existing medical conditions
  • their housing is crowded
  • there is difficulty accessing health care (e.g. due to distance from care, difficulties with transport or childcare, or lack of suitable services).

Information for Māori and communities in New Zealand, including Pacific Peoples - Unite against COVID-19

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.

More information on how to stop smoking.


What you and your whānau need to know to stay safe and healthy

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.

Getting vaccinated

The best way to protect people more vulnerable to getting more seriously ill with COVID-19 is to get vaccinated and boosted. New Zealand has a very high rate of vaccination, especially amongst people with underlying health conditions, in aged residential care and older people.

Individuals who are severely immunocompromised, aged 12 and over, need a third primary dose of the Pfizer COVID-19 vaccine – this is different to a booster dose, they will need a booster too. This third primary dose has been offered via specialists or local healthcare providers.

People at high risk of severe disease or exposure to COVID-19 are particularly encouraged to get their booster dose as soon as possible to help protect themselves, their whānau and the wider community

Anyone aged 16 or older who has had two doses of COVID-19 vaccine can get their free booster vaccine. You can get your vaccination at walk-in sites or book a time to receive yours on the Book My Vaccine website, or by calling the COVID Vaccination Healthline on 0800 28 29 26.

Read more about COVID-19 vaccines

Supporting people at high risk

If people test positive with COVID-19 there are several ways that they can be identified as more vulnerable. They may already be well known to their healthcare provider as being at higher risk, Care community hubs and primary care prioritise vulnerable people for initial assessment and any subsequent follow-ups.

It’s important the health questions in the self-assessment form people get when they get COVID-19 are filled out. If people can't use the online form or would prefer not to, they can call 800 555 278 for assistance to complete the form.

Information and tools available for people who test positive for COVID-19:

If someone in your household tests positive to COVIID-19 this video shows how to reduce the spread of infection in your home.

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.

Staying safe

Even if you are vaccinated, you should still take precautions:

  • Keep a safe distance away from people you do not live with — except for your carer or support workers.
  • Wear a face mask whenever you leave home. If you have visitors at home, ask them to wear a face mask.
  • 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.
  • Keep active so you can stay healthy.
  • 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.

Read more about ways to protecting yourself and others.

If you live with or are visiting someone who is at higher risk, you can support friends and whanau.

  • meet outside in the fresh air, or if meeting inside increase the air ventilation.
  • wear a mask indoors, and also outdoors if it is difficult to keep a safe distance away.
  • Isolate 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
  • offer to drop off groceries or essential supplies
  • keep in touch with them, and checking up on their physical and mental wellbeing
  • some aged residential care facilities may have extra measures in place for visitors. Check before you visit.
  • use good hygiene practices such as washing your hands and cleaning touched surfaces.
  • be kind and show compassion for others. Give other people space and keep a safe distance away.
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