Vaccine timeline changes affect CT residents with Down syndrome

Prior to the pandemic, Nick Glomb was working at the Big Y in Manchester. He was plugging away at preparations for his long-held dream of starting a hot dog business. He felt he could see members of his family who don’t live with him more often.

But like many, that reality changed when the COVID-19 pandemic hit last March. He left work, the hot dog cart is in storage and he hasn’t been able to visit much with his extended family.

Then came last week, when Gov. Ned Lamont announced a new eligibility plan for COVID vaccinations that was based on age and prioritized school and child care workers.

The plan meant the 32-yearold Glomb, who has Down syndrome, would be waiting longer than expected for a dose.

“Waiting to get COVID shots is like being in a cage,” he said.

And for those with severe underlying conditions, it’s more than waiting. According to the Centers for Disease Control and Prevention, people who have conditions such as Down syndrome, cancer, certain heart conditions and several others “are at increased risk of severe illness from the virus that causes COVID-19.”

State officials had previously planned to prioritize those with high-risk medical conditions and essential workers. Referencing a CDC list, Lamont said Feb. 16 — the week prior to his announcement of the new plan — that he thought the state would “start with that as a template” in terms of which conditions would qualify.

But the plan that came out six days later meant Glomb — and others with underlying medical conditions — would not be eligible this month unless they qualified by age or work status. In Glomb’s case, he will not be eligible until May.

“For him to step out the door or for me to have anybody here is a real risk to him,” said his mother, Laura Glomb. “It’s not like, you work in a grocery store, you’re an 18-year-old kid, you’re considered a frontline worker, they’re annoyed, they’re not getting their shots. It’s a little bit different if you have active cancer, or you have something like Down syndrome, where literally, he is at a greater risk.”

High risks

Researchers have estimated a 10 times greater “increased risk for COVID-19–related death in persons with Down syndrome,” as well as a four times greater likelihood that a person with Down syndrome would need to be hospitalized after contracting COVID-19, according to a letter published last year.

Published in the Annals of Internal Medicine in October 2020, the letter examined data from the United Kingdom of adults over 19.

Joaquín Espinosa, executive director of the Linda Crnic Institute for Down Syndrome at the University of Colorado School of Medicine, said “there are aspects of the immune system that are supercharged, hyperactive” in people who have Down syndrome.

“Specifically, the antiviral response within the immune system, what is called the interferon response, it’s the branch of the immune system that fights off viruses that is more active in individuals with Down syndrome all the time, and then when they are challenged with a virus, they super respond, they overdo it,” he said.

That response can cause problems, he said.

“The immune system can be very toxic, can be very harmful when it’s out of control,” he said, including for those who don’t have Down syndrome.

Age is also “a risk factor,” Espinosa said.

"But the impact is much accelerated much earlier in people with Down syndrome, actually by 40 years or so,” he said.

“In other words, we should treat people with Down syndrome in their 40s or so as if they were typical people in their 80s,” he said. “So if we give priority to vaccination to those that are 80 and older, well, in the case of those with Down syndrome, it should be 40 and older.”

Waiting to be eligible

Rocky Hill residents Jane and David Holschlag were disappointed when they heard about the new vaccine eligibility schedule. Their son, Matthew, has Down syndrome in addition to a variety of other conditions, including lung disease and a seizure disorder, Jane Holschlag said.

“If he caught it, the chances are he would die,” she said.

Jane Holschlag said her son has needed to go to the emergency room when he’s contracted a cold in the past because he had difficulty breathing. They’ve been nervous to have people around, or even to go buy groceries.

“It just made sense initially to focus the vaccinations first on people who would be most adversely affected by it,” David Holschlag said.

That’s what happened with older residents in the state, Jane Holschlag pointed out.

“Why are people, young, healthy people in schools and babysitters that are in their 20s and have no medical problems getting it before him?” she said. “It makes no sense at all.”

Jane Holschlag said her son returned to a day program a few months ago. She said it makes her son happy, but she’s also “frightened to death every day” that he’ll contract the coronavirus. She said he doesn’t understand the need to wear a mask or keep his hands off his face.

Since Matthew is 38, he would become eligible for the vaccine April 12. But even some of those who became eligible to register this week were not able to find an appointment until May. So Jane Holschlag knows her son could be waiting for a while.