The people dying from COVID-19 today are overwhelmingly older adults with chronic health conditions, particularly those with weakened immune systems. While overall death counts have dropped dramatically from pandemic peaks, COVID still kills tens of thousands of Americans each year, and the burden falls on a remarkably specific slice of the population.
Immunocompromised People Bear a Disproportionate Burden
People with weakened immune systems make up roughly 4% of the general population but account for about 22% of COVID-19 deaths. Data from the INFORM observational study found that in 2023, immunocompromised individuals represented 21.9% of all COVID deaths and 21.7% of hospitalizations. That’s a fivefold overrepresentation.
This group includes people on immunosuppressive drugs for organ transplants, those receiving chemotherapy, people with blood cancers like leukemia or lymphoma, and those taking medications for autoimmune conditions like lupus or rheumatoid arthritis. Their immune systems simply can’t mount the same response to the virus, even after vaccination, which is why they remain so vulnerable while the risk for the broader population has fallen.
The Conditions That Raise the Risk Most
Beyond immune suppression, the CDC identifies obesity, diabetes with complications, and anxiety and fear-related disorders as having the strongest associations with COVID-19 death. That last one surprises many people: the link likely reflects the broader health burden and reduced healthcare engagement that often accompanies chronic mental health conditions, not the anxiety itself.
In practice, the typical person dying from COVID today has multiple overlapping conditions. They’re usually over 65, often over 75, and living with some combination of heart disease, diabetes, kidney disease, or lung disease. A 40-year-old with no chronic conditions faces a vanishingly small risk of death from current variants. An 80-year-old with diabetes and heart failure faces a risk that, while lower than in 2020, is still meaningful.
Current Variants Are Less Lethal but Still Dangerous for Some
Every variant circulating today descends from Omicron, and the case fatality rate dropped roughly 70% when Omicron replaced Delta in late 2021. Since then, the various Omicron subvariants have shown no statistically significant differences in lethality compared to each other. The virus hasn’t become meaningfully more or less deadly in the past three years of Omicron-lineage dominance.
What has changed is population immunity. Nearly everyone now has some combination of vaccination and prior infection, which dramatically lowers the chance of severe illness on an individual level. The people who remain most vulnerable are those whose immune systems can’t fully benefit from that accumulated protection.
Vaccination Still Cuts Death Risk Significantly
The updated 2024-2025 COVID vaccines reduced the risk of death by about 66% compared to being unvaccinated, according to effectiveness data published in Nature. In concrete terms, the death rate was 0.11 per 1,000 vaccinated people versus 0.31 per 1,000 unvaccinated people. Those are small numbers on both sides, but for someone who is 75 with multiple health problems, that threefold difference matters.
Uptake of the updated vaccines has been low across all age groups, which means many of the people dying are those who either skipped vaccination entirely or received their last dose years ago, when the vaccines were designed against earlier variants. For high-risk individuals, an outdated immune response provides less protection than a recently updated one.
Antivirals Help but Aren’t Reaching Everyone
Oral antiviral treatment, when started within the first five days of symptoms, reduced 28-day mortality from 32% to 19% in patients with severe COVID. That’s a substantial benefit for the sickest patients, but it requires getting tested early and receiving a prescription quickly. Many older adults, particularly those in rural areas or without regular primary care, don’t access treatment in time. Others don’t test at all because they assume their symptoms are a cold.
Racial Disparities Have Narrowed but Not Disappeared
Early in the pandemic, Black, Hispanic, and American Indian or Alaska Native communities experienced dramatically higher COVID death rates than white Americans. By 2021, those gaps had narrowed by 34% to 40% for most groups, driven by increased vaccine access and better treatment availability. White Americans, meanwhile, saw their death rates rise by 35% from 2020 to 2021 as the virus spread into rural communities with lower vaccination rates.
The pattern today is less about race per se and more about the factors that cluster with it: access to healthcare, rates of chronic disease, housing density, and whether someone has a regular doctor who can prescribe antivirals quickly. Communities with fewer healthcare resources continue to see higher death rates regardless of racial composition.
The Profile of a Typical COVID Death in 2025
If you could draw a composite portrait of who is dying from COVID right now, it would look something like this: a person over 65, often over 75, with at least two chronic health conditions, who either wasn’t vaccinated recently or whose immune system couldn’t respond fully to vaccination. They may not have received antiviral treatment, either because they weren’t tested or because treatment started too late. They’re more likely to be in a long-term care facility than living independently.
Young, healthy people dying from COVID has become genuinely rare. It still happens on occasion, but it’s no longer a defining feature of the pandemic. The virus has settled into a pattern seen with other respiratory infections like influenza: it takes its heaviest toll on the oldest and most medically fragile members of the population, and it does so year-round rather than only in winter months.