A Review of Risk Factors for COVID-19 Disease: Opportunities for Personalized Prevention and Immunization

During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the clinical, scientific, and public health communities have had to react to new viral genetic variants. These have triggered a range of reactions from the public health community raising concerns about the effectiveness of the current vaccines and questions about the need for booster vaccinations. This is further complicated by vaccine hesitancy and the “perceived” benefit-risk of available vaccines. In the US alone there is approximately 3% of immunocompromised individuals. While the obese and elderly individuals do not fall into the classical spectrum of immunocompromised, they are at a high risk for a more severe clinical course of COVID-19. Obesity is a strong independent risk factor for hospitalization in COVID-19 patients with increased morbidity and mortality. Recently, there has been enormous progress on the understanding of vaccines benefit-risk profile. There is an opportunity for providing vaccine personalized approaches across different groups by age and by gender. This review focuses on the obese and the elderly populations but also presents opportunities for personalized interventions with different vaccines. Strategies are urgently needed to systematically address the underlying public health problems such as obesity to effectively manage this COVID-19 pandemic as well as the rapid introduction of tailored approaches for vaccination.