Table 3b. The Panel’s Framework for Assessing the Risk of Progression to Severe COVID-19 Based on Patient Conditions and COVID-19 Vaccination Status

Last Updated: August 22, 2023

Table 3b. The Panel’s Framework for Assessing the Risk of Progression to Severe COVID-19 Based on Patient Conditions and COVID-19 Vaccination Status
Conditions	Risk Level by Vaccination Status^a
Conditions	Unvaccinated	Primary Series	Up to Date
Strong or Consistent Association With Progression to Severe COVID-19
Moderately or severely immunocompromised (see Special Considerations in People Who Are Immunocompromised)	High
Obesity (BMI ≥95th percentile for age), especially severe obesity (BMI ≥120% of 95th percentile for age)^b Medical complexity with dependence on respiratory technology^c Severe neurologic, genetic, metabolic, or other disability that results in impaired airway clearance or limitations in self-care or activities of daily living Severe asthma or other severe chronic lung disease requiring ≥2 inhaled or ≥1 systemic medications daily Severe congenital or acquired cardiac disease Multiple moderate to severe chronic diseases	High	Intermediate
Moderate or Inconsistent Association With Progression to Severe COVID-19
Aged <1 year Prematurity in children aged ≤2 years Sickle cell disease Diabetes mellitus (poorly controlled) Nonsevere cardiac, neurologic, or metabolic disease^d	Intermediate
Weak or Unknown Association With Progression to Severe COVID-19
Mild asthma Overweight Diabetes mellitus (well controlled)	Low
^a Unvaccinated = individuals who are not eligible for COVID-19 vaccination or who are <2 weeks from the final dose of the primary series. Vaccinated with primary series = individuals who completed the primary series of 2 or 3 doses (the current CDC term is “fully vaccinated”) and are >2 weeks after the final dose of the primary series but have not received a booster, if they are eligible for a booster. Children aged <5 years are not currently eligible for booster doses. Vaccinated and up to date = individuals who received the recommended booster dose(s) if eligible or who have completed the primary series but are not yet eligible for a booster. See the current COVID-19 vaccination schedule from the CDC for more information. ^b The degree of risk conferred by obesity in younger children is less clear than it is in older adolescents. ^c This includes patients with a tracheostomy and those who require NIV. ^d The data for this group are particularly limited. Key: BMI = body mass index; CDC = Centers for Disease Control and Prevention; NIV = noninvasive ventilation; the Panel = the COVID-19 Treatment Guidelines Panel