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Risk groups and their relatives - advice and information
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Most people who become infected with coronavirus (SARS-CoV-2) will experience mild respiratory symptoms that pass. Some groups are at particular risk of developing more severe illness (resulting in hospital admission, intensive care or even death), but even the majority of people in risk groups will experience mild symptoms.
The risk of a severe COVID-19 disease course rises with age and underlying medical conditions, with men being at greater risk than women. In rare cases, younger people without known risk factors may also experience severe illness.
Everyone should follow the general advice about good hand hygiene and cough etiquette and stay home with newly arisen symptoms of respiratory tract symptoms. This is particularly important for unvaccinated people in risk groups.
This advice applies for adults over 18 years.
Vaccination against COVID-19
Vaccination is effective in preventing infectious diseases. The purpose of vaccination against COVID-19 is to prevent disease or to make the course of the disease milder.
Per 23 september 2021, the majority of the population, including people in the risk groups had been vaccinated, see
Advice for people in the risk group who have been vaccinated or have undergone COVID-19 can be found at the bottom of this page.
Advice for people in risk groups who are not vaccinated or have had COVID-19
- Read more about After you have been vaccinated or have had COVID-19
Remember good hand hygiene and cough etiquette. Follow the general advice to the population about:
Avoid contact with people with symptoms of respiratory tract infections and stay home if you are sick.
The risk of respiratory tract symptoms can be reduced by avoiding crowds and keeping a distance to others.
Make sure you have the necessary medications available. Continue with your regular medication, and only make changes in consultation with your own doctor. Attend planned health check-ups and consultations.
Assessment of risk for people who are not vaccinated or have not had COVID-19
Risk assessment applies at a group level, not to the individual. There will be considerable individual variations within each risk group. If necessary, speak to your doctor about your risk of a severe COVID-19 disease course
Younger people are at a low risk of a severe COVID-19 disease course, but those with poorly managed diseases/conditions, or combinations of several underlying conditions, may be at greater risk.
Advice for people in the risk group who have been fully vaccinated or had COVID-19 can be found at the bottom of this page.
Groups with slightly/ moderately increased risk:
- Age 65–69 years
- Age 50–64 years with one of the following chronic diseases:
- chronic liver disease
- immunosuppressive therapy with autoimmune diseases
- chronic lung disease, including severe asthma that has required the use of high dosage inhalation steroids or steroid tablets during the last year
- obesity with body mass index (BMI) of 35 kg/m2 or higher
- cardiovascular disease (except high blood pressure)
People under 50 years of age are at lower risk of developing severe COVID-19 illness. However, some people with poorly-regulated chronic conditions or a combination of several chronic diseases might be at increased risk.
Groups with moderate/ high risk
- Residents of nursing homes
- Over 70 years of ageα
- Severe health conditions, regardless of age *:
- solid organ transplant
- hematologic cancer in the last five years
- other active cancer, ongoing or recently completed treatment for cancer (especially immunosuppressive therapy, radiotherapy targeted at the lungs or chemotherapy).
- neurological or muscular disease with impaired coughing strength or lung function (e.g. ALS and cerebral palsy)
- Down's Syndrome
- chronic kidney disease and renal failure
α There is an exponential (sliding) increase in risk from 70 years and over. Age is the most important independent risk factor.
* Other serious and/or chronic diseases that are not mentioned may also increase the risk of serious illness and death from COVID-19. This is assessed individually by a doctor.
* These diseases/conditions can result in a high risk of severe illness and even death, including amongst younger people.
Further information about risk groups
NIPH’s assessments may change as more knowledge becomes available. Here is an overview of the main risk factors. This assessment applies to people aged over 18 years.
The risk of developing severe COVID-19 illness rises significantly with age, and age appears to be the dominant risk factor regarding the development of severe illness and death. With advanced age, the incidence of chronic diseases also increases. It may be difficult to distinguish the risk caused by age from the risk caused by disease, but analyses that adjust for several risk factors show that age is an independent risk factor.
A person's risk should not be based solely on age, but also on an individual assessment of their general health.
Several studies show that people who have undergone organ transplantation have a significantly increased risk of a severe COVID-19 disease course. People on the waiting list for organ transplantation should preferably be vaccinated before transplantation. Organ transplantation shall not be postponed due to vaccination.
This includes severe congenital or acquired immune deficiency conditions that can lead to significant immune deficiency, and are more severe and rare conditions than the autoimmune diseases. People in this group may be at high risk for severe COVID-19 disease course. The conditions include severe combined immunodeficiency, immunodeficiency associated with major defects (e.g., Wiskott-Aldrich syndrome), common variable immunodeficiency, immunodeficiency with predominant antibody deficiency (e.g., hypogammaglobulinemia) and some other types of severe immunodeficiency conditions. The group also includes HIV patients with low CD4 counts who should be considered for vaccination by their doctor.
People with sickle cell anemia also have an increased risk of a severe disease course.
People with active cancer, ongoing or recently discontinued treatment for cancer (especially immunosuppressive therapy, radiation therapy for the lungs or chemotherapy) have an increased risk of a severe COVID-19 disease course. Active cancer is defined as a cancer that has not been radically treated and assumed to be cured. Recently completed cancer treatment is defined as completed within the last 6 months.
When planning the start of cancer treatment, it should be considered whether patients can be vaccinated before starting. Vaccination should not delay the start of treatment. A large study from England indicates that people with blood cancer have a particularly high risk in the first five years after the diagnosis is made.
Neurological diseases or muscle diseases that cause impaired coughing or lung function
In this group we find people with cerebral palsy (CP), mental retardation, severe muscle diseases, spina bifida, as well as diseases that affect the brain in adults and the elderly (e.g., Parkinson's and ALS). In general for these diseases, people may have physical immobility (e.g., use a wheelchair) and / or reduced lung function and coughing power, risk of food or drink entering the respiratory tract, or they have a genetic condition that increases morbidity.
The risk of a severe disease course in people with CP depends on how severe their CP is, see text above. Milder degrees of CP will not pose any risk in themselves.
Several studies show that adults with Down's syndrome have a higher risk of a severe COVID-19 disease course. The risk increases with age. Down's syndrome can lead to an increased incidence of autoimmune diseases, diabetes, low metabolism, obesity, dementia and congenital heart disease. Some of these conditions can contribute to the severe course of COVID-19.
Furthermore, people with Down's syndrome may have inappropriate immune responses in COVID-19, which further increases the risk of a severe course. All people with Down's syndrome who are 16 years and older are therefore given priority for vaccination.
Chronic kidney disease
Chronic kidney disease increases the risk of a severe COVID-19 disease course when you adjust for age and other risk factors. This is especially true for people with significantly impaired renal function. People with moderate / severe kidney failure are considered to have a significantly increased risk.
Chronic liver disease
Chronic liver disease also carries an increased risk, especially with significantly impaired liver function.
Immunosuppressive therapy in autoimmune diseases
Patients using immunosuppressive drugs may have an increased risk of severe disease course. It is probably the drugs themselves, and not the underlying disease, that increase the risk. Immunosuppressive drugs include TNF-alpha inhibitors, interleukin inhibitors, methotrexate, and more (see Felleskatalog). These drugs are used, among other things, for multiple sclerosis (MS), inflammatory joint diseases and inflammatory bowel diseases.
Diabetes has been reported as one of the most common underlying diseases in patients with a severe disease course. In studies that have been adjusted for age and other risk factors, patients with diabetes have a higher risk of severe COVID-19.
The duration of the diabetes disease and the incidence of late diabetic complications seem to increase the risk. Poor blood sugar control is a risk factor for a severe course, but diabetic patients with well-regulated blood sugar levels are also recommended to be vaccinated. All people with diabetes who are 18 years and older are therefore given priority for vaccination.
Chronic lung disease
It appears that the risk of a severe COVID-19 disease course is increased in people with chronic lung disease, including severe asthma, defined as asthma that has resulted in the use of high-dose inhaled steroids or steroid tablets during the past year.
People with obesity have an increased risk of a severe disease course, and the risk increases with increasing body mass index (BMI).
Cardiovascular diseases include a range of diseases that may increase the risk of a severe COVID-19 disease course. There is evidence to suggest that the risk increases with the severity of the underlying disease. In studies that adjust for age and other risk conditions, including other cardiovascular diseases, high blood pressure does not appear to be an independent risk factor for hospitalisation or death from COVID-19.
Other chronic diseases
A number of studies suggest that dementia and stroke are independent risk factors for a severe COVID-19 disease course
Nursing home residents
Residents of nursing homes are considered to be at greater risk of a severe COVID-19 disease course, based on a combination of advanced age, frailty, multiple chronic diseases, impaired functions and low activity level.
Children and adolescents in risk groups
Children and adolescents usually have a mild disease course, and few children become seriously ill with COVID-19, even those with chronic conditions. Vaccination will help to protect the few who may become seriously ill, in addition to helping to reduce transmission in society.
In autumn 2021, the pandemic is in a new phase where >90 % of adults have been vaccinated with one dose, and >80 % have received two vaccine doses. Vaccination of adolescents will also contribute somewhat to limiting transmission among the younger age groups, and less transmission is expected in the future.
Children continue to be infected to a lesser extent than unvaccinated adolescents and adults. However, for some children with a serious illness, based on a general recommendation on protection against transmission, there will be a need to arrange adapted teaching at home or in school / childcare centre after assessment by the responsible paediatrician / doctor in the specialist health service.
The NIPH recommends that all children aged 12-15 years can be offered one dose of coronavirus vaccine. Two doses are recommended for 12-15-year olds with underlying conditions.
For more information about these groups and about COVID-19 in children and adolescents, see:
- Norwegian Paediatric Association
- Advice and information for children and adolescents
- Vaccination of children and adolescents
Pregnant and breastfeeding women
Most pregnant women will get a mild disease course. Pregnant women with COVID-19 who develop symptoms still have a slightly higher risk of needing treatment in hospital, intensive care unit and with a respirator compared with non-pregnant women with COVID-19 of the same age.
The risk of severe COVID-19 progression increases if the pregnant woman has underlying diseases such as diabetes, cardiovascular disease and / or obesity. The risk for pregnant women increases throughout pregnancy. The NIPH therefore recommends that pregnant women should be vaccinated, read more here:
People with impaired immune systems
Patients with severely impaired immune systems should, even after vaccination with the third dose, be aware that they are assumed to have lower protection than people with normal immune function and should therefore live more sheltered when there is widespread transmission in society to avoid infection. In addition, it is important that close contacts in the same household are vaccinated.
Together with medical experts and the specialist health service, NIPH has prepared an overview of the diseases for, and medications used by, people who are recommended to take a third dose:
Employees in risk groups who are not vaccinated or have not had COVID-19
The Norwegian Directorate of Health has prepared its own recommendations for employers in the health sector.
Should people in risk groups change ongoing treatment?
No. There is no reason to advise against starting or stopping ongoing immunosuppressant treatment. If people who use immunosuppressants become ill, they should contact their doctor for advice about medication, testing and examination.
What should you do if you become ill?
Anyone with newly arisen symptoms consistent with COVID-19 should be tested. If you develop symptoms such as fever, cough, shortness of breath and reduced general condition, contact your GP or emergency out-of-hours clinic (tel. 116117) as soon as possible. If you develop severe symptoms call 113.
If you develop other acute symptoms that you would normally seek medical attention for, contact the healthcare service, regardless of whether or not you may be infected.
Advice for people in risk groups who are vaccinated or have had COVID-19
When people in risk groups have been vaccinated, they will be at lower risk of SARS-CoV-2 disease and a severe disease course and will be able to live as other people and follow the general infection control advice. The full effect of the vaccine is achieved 1 week after full vaccination. If the protection decreases over time, booster doses may be necessary. For vaccination of people with underlying conditions, see:
- Who can receive the coronavirus vaccine?
- Coronavirus vaccine– information for the general population
The Norwegian Institute of Public Health has recommended that people in risk groups should be given an influenza vaccine every year and a pneumococcal vaccine (against a bacterium which can cause pneumonia, among other things) every ten years. It is important to stress that these vaccines will not prevent infection with SARS-CoV-2.
The Norwegian Institute of Public Health receives an immense amount of enquiries about the coronavirus pandemic. Unfortunately, we do not have the capacity to reply individually to members of the public.
Our advisory service is primarily intended for Norwegian government agencies, the healthcare service and municipalities.
You will find general advice about coronavirus on this website and on helsenorge.no.
If you do not find the answer your to your question, you can ring the information helpline 815 55 015 that is open on weekdays from 08:00-15:30.
The Norwegian Directorate of Immigration has answers to many frequently asked questions about travelling to Norway, and a helpline 23351600 that is open on weekdays from 10:00-14:00.
The Ministry of Foreign Affairs also has answers to many frequently asked questions.
If you need acute medical attention, contact your doctor. If you cannot reach your doctor, contact the emergency out-of-hours clinic on 116117. If life is in danger, call 113.
For questions about the Smittestopp app, ring Helsenorge on 23 32 70 00.
For healthcare personnel
You will find information on these pages and at helsedirektoratet.no
If you are a healthcare professional who is responsible for infection control at their institution can ring Smittevernvakta.
For questions about whether or not you should attend work if you are a healthcare worker, contact the person who is responsible for infection control at your institution.
Contact your doctor or emergency out-of-hours clinic for questions about your personal health.