Evidence from the UK from the early stages of the COVID-19 pandemic showed that people with learning disabilities had higher rates of COVID-19 mortality than people without learning disabilities. However, estimates of the magnitude of risk varied widely, and only the early stages of the pandemic were analysed. Analyses of risk factors have also been limited. The Scottish Learning Disabilities Observatory carried out research that aimed to cover the whole period of the pandemic, not just the early stages, and to examine risk factors in more depth than previously investigated.

We analysed health data for the whole population of England, including who had a positive COVID-19 laboratory (PCR) test and when this took place, and who was vaccinated for COVID-19 and when they received the vaccination(s). The analysis covered the main period of the pandemic, up to the end of 2021 before the much milder Omicron variant became dominant.

We found that, for people with learning disabilities, the risk of dying from COVID-19 was over five times higher than for people without learning disabilities. (adjusting for age and sex differences). People with learning disabilities were also much more likely to be hospitalised with COVID-19.

In both populations, key drivers of COVID hospitalisation or death included age, multimorbidity and vaccination status. Therefore, the risk was substantively higher among people who were older, those who had many health conditions, and those who were not vaccinated. Additional risk factors included being a male and being from a non-White ethnic background.

The key reason why the risk was higher among people with learning disabilities was that typically people in this population have, on average, a much higher number of health conditions (multimorbidity) than people without learning disabilities.

This evidence shows that people with learning disabilities should be considered a priority group in future epidemics, particularly for interventions such as shielding and vaccinations.

The importance of taking up the invitation for COVID-19 booster vaccinations should be emphasised in communication from health authorities and organisations that support people with learning disabilities and their carers.

Additionally, the findings strongly suggest that multimorbidity among people with learning disabilities should be a priority research area in the future. It is already known that people with learning disabilities tend to develop multimorbidity earlier than other people. We need to better understand why this happens, and whether health conditions tend to emerge in a particular sequential order. Having this knowledge would allow for preventative interventions to be developed.

Project information last updated 22 November 2023.