Who is at "increased risk for severe illness" for COVID-19: The CDC guidelines

The CDC has changed the guidance on mask-wearing and social distancing for those vaccinated for COVID-19, but there's a big warning still for those at "increased risk of severe illness or death." Groups of people who have already been vaccinated for coronavirus are now considered safe to gather indoors without needing to wear a mask, but when it comes to meeting up with the unvaccinated it gets more complicated.

What is "increased risk for severe illness from COVID-19?"

As you might expect, not everyone reacts to COVID-19 in the same way. Preexisting health conditions can have a big impact on how dangerous coronavirus infection can be, not to mention age and factors like weight.

At the same time, research on COVID-19 is still underway, and the experts caution that any list of conditions that could lead to a greater chance of severe infection or even death is a work-in-progress. Nonetheless, currently the CDC says that those with the following medical conditions should be considered "at increased risk of severe illness from the virus that causes COVID-19":


Chronic kidney disease

COPD (chronic obstructive pulmonary disease)

Down Syndrome

Heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies

Immunocompromised state (weakened immune system) from solid organ transplant

Obesity (body mass index [BMI] of 30 kg/m2 or higher but < 40 kg/m2)

Severe Obesity (BMI ≥ 40 kg/m2)


Sickle cell disease


Type 2 diabetes mellitus

There's also a second list, more preliminary than the one above. That includes the CDC's current beliefs around conditions which may lead to an increased risk for severe illness from COVID-19. Although the data isn't as conclusive, those who find themselves included in the following list should still be cautious:

Asthma (moderate-to-severe)

Cerebrovascular disease (affects blood vessels and blood supply to the brain)

Cystic fibrosis

Hypertension or high blood pressure

Immunocompromised state (weakened immune system) from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines

Neurologic conditions, such as dementia

Liver disease

Overweight (BMI > 25 kg/m2, but < 30 kg/m2)

Pulmonary fibrosis (having damaged or scarred lung tissues)

Thalassemia (a type of blood disorder)

Type 1 diabetes mellitus

Are children at severe risk for COVID-19?

The impact of coronavirus on children has been a controversial and confusing subject since the early days of the pandemic. The current thinking, at the CDC anyway, is that children are less affected by COVID-19 in comparison to adults. All the same, that doesn't mean they're immune or risk-free, or that there's no knock-on risk to adults.

That's because "children can be infected with the virus that causes COVID-19 and some children develop severe illness," the CDC says. Even if they're not affected with severe symptoms, they could still pass COVID-19 onto someone else.

Children with obesity, medical complexity, severe genetic disorders, severe neurologic disorders, inherited metabolic disorders, sickle cell disease, congenital (since birth) heart disease, diabetes, chronic kidney disease, asthma and other chronic lung disease, and immunosuppression due to malignancy or immune-weakening medications could also be at increased risk, the CDC says.

What are the new CDC rules for those at "severe risk"?

If you're among the groups that the CDC cautions could be at increased risk for severe infection or even death from COVID-19, the new guidance released today around visits, social distancing, and mask requirements are different.

"You can gather indoors with unvaccinated people from one other household (for example, visiting with relatives who all live together) without masks," the CDC now says, for example, "unless any of those people or anyone they live with has an increased risk for severe illness from COVID-19."

Meanwhile, in situations where someone at increased risk of severe illness or death from COVID-19 – or someone who lives with such a person – is present, everyone should be social distancing by at least 6 feet, and still wearing masks. That's regardless of whether you're fully vaccinated or otherwise. Just because someone has been given the COVID-19 vaccine, that doesn't mean they can't also be infected by coronavirus and potentially contagious.