Eve Smyth, aged 64 years at the time of writing, is blind and was diagnosed with asthma as an adult, and has experienced a steady worsening of her symptoms across the years. Though it has made her life more difficult, especially during the period of the COVID-19 pandemic, it has left her determined to do what she can to help others with asthma and other respiratory diseases. Although she has lived in the UK (near Glasgow) for more than four decades, she is American by birth and grew up in southern California, an hour's drive from Los Angeles. “I can still remember how smoggy it was around LA then”, Eve tells The Lancet Respiratory Medicine. She would be bused to and from the school she attended for blind children, often coming home with a tight chest and unable to explain the sensation to her parents. “That was probably the start of the asthma”, she recalls. She has also always suffered bad hay fever symptoms and had an allergy to cigarette smoke, but it wasn't until she was expecting her first child at age 25 years that she suffered her first asthma attack. “I remember feeling panic and having to get outside to the fresh air”, she recalls. However, it would be another 8 years until Eve was formally diagnosed with asthma. Like many others with the condition, there can be multiple triggers. Cigarette smoke, paint fumes, smog, animals—a range of things typically associated with allergies. “I always check if someone has animals before I visit them”, she says. “And people have been very understanding and tolerant on the whole over the years, although of course there have been a few incidents!” Several people have been key in helping Eve manage her situation. First, her husband of 41 years Adrian, who has been her rock in more ways than one, helping her navigate safely away from anything that might trigger an attack. Second, the asthma nurse at her general practice, who has been working with her for more than 30 years. “Because I'm blind, obviously I can't use a written plan, so my nurse Sandra talks me through anything I need to know; for example, when changing medications, and helped me distinguish an asthma flare-up from a chest infection. Really I've been so fortunate to have care like this with the same person over such a long time.” Her nurse also provided a tactile strip for the peak flow meter Eve uses to measure her lung function, so she can interpret the results despite being blind. Eve always knows that when a cold comes, a flare-up is going to follow. She is currently managing her asthma with Trelegy Ellipta (a combination treatment containing flucitasone furoate, umeclidinium bromide, and vilanterol trifenatate, more commonly used in treatment of chronic obstructive pulmonary disease). This drug was recommended to her by her hospital asthma consultant. She also uses montekulast maintenance therapy and an inhaler called Bricanyl (containing terbutaline sulphate) to relieve flare-ups. “I cannot use Ventolin inhalers like most people with asthma, because I have found they can trigger migraines”, she explains. Although the activities of daily life present challenges—for example, she does most of her supermarket shopping online rather than face the difficulties of going in person—she tries to live as normal a life as possible. “We do like to go to restaurants, I just have to be kind of prepared for anything that might trigger my symptoms”, Eve explains. She and her husband are not going on holiday as much as they used to, especially during these COVID times. For exercise, Eve still loves to dance. “With dancing, I can do it in a controlled indoor space in my home, without worrying about anything triggering an attack”, she explains. Far from being a passive observer as the COVID pandemic took hold in Scotland and beyond, Eve wanted to make a contribution to research making a difference. As such, she is part of the EAVE II research collaboration based in the Usher Institute at the University of Edinburgh, UK, which is using patient data to track the COVID-19 pandemic and vaccine effectiveness across Scotland. She is part of the Public Advisory Group that advises the researchers, giving them essentially that—the perspective of the public on the research. In November, 2021, the EAVE II Collaboration, whose authors include Prof Aziz Sheikh and Sir Lewis Duthie Ritchie, published an important paper (see panel). “We wanted to give population-wide evidence to the UK's Joint Committee on Vaccination and Immunisation (JCVI) on the risk of serious COVID-19 outcomes for children with asthma in Scotland”, explains Eve. “This was the first national-scale study to look at this question. Because asthma is so common, we wanted to understand whether certain children with asthma were at higher risk than others of becoming seriously ill with COVID-19. This should help to inform which children with asthma might be prioritised or encouraged to have one or more doses of a COVID-19 vaccine in the future.”PanelKey findings of the study•Children with a previous history of hospital admission for asthma were over 6-times more likely to be admitted than children without asthma. They were also over 4-times more likely to be admitted than children with better controlled asthma.•Children having two or more courses of prescribed oral steroids in the previous 2 years were 3-times more likely to be hospitalised than children not on oral steroids for the same period.•Children with poorly controlled asthma were more likely to be tested for, and admitted to hospital with, COVID-19. This is compared to both children without asthma and those with better controlled asthma. •Children with a previous history of hospital admission for asthma were over 6-times more likely to be admitted than children without asthma. They were also over 4-times more likely to be admitted than children with better controlled asthma.•Children having two or more courses of prescribed oral steroids in the previous 2 years were 3-times more likely to be hospitalised than children not on oral steroids for the same period.•Children with poorly controlled asthma were more likely to be tested for, and admitted to hospital with, COVID-19. This is compared to both children without asthma and those with better controlled asthma. This research—coming at an absolutely vital time as the UK and other European countries decide on the relative risks and benefits of vaccinating children against COVID-19—shows that children aged 5–17 years are at 3–6-times higher risk of being admitted to hospital with COVID-19 if their asthma is not controlled, compared with those with no asthma. This is equivalent to 9124 children in Scotland, including 1962 adolescents aged 12–15 year. When scaled up across the rest of the UK, there are over just under 110 000 children with uncontrolled asthma who should be considered a priority for COVID-19 vaccination. This includes 23 544 children aged 12–15 years. As this interview was going to press, the JCVI announced that clinically vulnerable children aged 5–11 years would now be eligible for vaccination with the Pfizer-BioNtech vaccine, although the JCVI had not specifically stated which children would be included as clinically vulnerable other that those who are immunosuppressed or who live with an older child or adult who is. Asthma has not been specifically mentioned as a condition that would make a child clinically vulnerable. “The results from our study are as clear as day”, says Eve. “Children with asthma should be prioritised for vaccination. And now the younger children are eligible, those younger children with clinical vulnerabilities such as asthma should also be prioritised”, says Eve. She hopes the Scottish Government, which has devolved responsibility for health matters from the UK Government, will also take these results into consideration in its upcoming Respiratory Care Action Plan. Eve's interest in this particular research project stemmed from the fact that it was a live, ongoing pandemic and as such new, quality research is required to learn more, and fast. However, she has been a research application reviewer for Asthma UK for more than a decade, again giving the patient perspective on issues as straightforward as “will this research be of use to patients with this condition?”, and providing context on that for researchers. “I have also reviewed PhD applications, grant applications, projects at scientific meetings…all kinds of things”, she explains. “It's so important to advocate for respiratory diseases, because even today, in the 2020s, lung disease is not taken seriously. Many people just assume anyone with a breathing problem is a smoker, there is stigma attached to respiratory conditions”, she says. “Society has to take all respiratory illness more seriously. And learn the lesson that I have learned over my whole life—don't take your breathing for granted.”