The COVID-19 and Immunocompromised Connection

Immunocompromised People Are At Higher-Risk for Severe COVID-19

Moderately and severely immunocompromised people are more likely to become severely ill with COVID-19. They may not be protected even if they are up to date on their COVID-19 vaccines and may need to take additional precautions to stay safe.

What does it mean to be immunocompromised? The immune system defenses are lowered and may not be able to fight off infections and diseases. This can be due to a medical condition or treatment for a medical condition.

Immunocompromising health conditions:

  • Autoimmune diseases include lupus, type 1 diabetes, multiple sclerosis, rheumatoid arthritis, inflammatory bowel disease
  • Certain cancers, especially cancers of the blood
  • HIV infection
  • Primary Immunodeficiency including DiGeorge syndrome, Wiskott-Aldrich syndrome, Bruton’s agammaglobulinemia
  • Certain developmental disabilities can put you at increased risk of developing immunocompromising conditions.

Immunosuppressants are medications that serve a variety of roles involving the immune system and may reduce or suppress your immune system response. They differ depending on what they are being prescribed for.

Different categories of immunosuppressants include:

  • Biologics such as certain treatments for eosinophilic asthma.
  • Calcineurin inhibitors used to manage autoimmune conditions including interstitial lung disease (ILD).
  • Corticosteroids such as prednisone, used in some anti-inflammatory medications. 
  • Monoclonal antibodies used as part of cancer treatment.
  • Inosine monophosphate dehydrogenase (IMDH) inhibitors and rapamycin inhibitors are used to help prevent organ transplant rejection.
  • Janus kinase (JAK) inhibitors are used as treatments for certain autoimmune diseases.

Health conditions that may be treated with immunosuppressants include:

  • Some people with asthma, COPD, sarcoidosis or pulmonary fibrosis.
  • People going through cancer treatment.
  • People who get organ transplants to help prevent organ rejection.
  • People with autoimmune diseases such as lupus, rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease.
  • People who get stem cell transplants, this can include people who have blood cancers, blood disorders and bone marrow disorders.

Precautions immunocompromised people can take to help protect themselves from COVID-19

1. Receive all COVID-19 vaccination doses available. The immune response from vaccination in moderately to severely immunocompromised people may be lower than people who are not immunocompromised. There are additional vaccinations recommended for this group.


Pfizer-BioNTech
Moderna
Novavax
Age
6 months +6 months +18+
Number of doses to complete primary series332
BoosterAge 5+, at least 3 months after the 3rd doseAge 5+,  at least 3 months after 3rd doseNo
Second BoosterAge 12+, at least 4 months after 1st boosterIndividuals 18+, at least 4 months after 1st boosterNo

You can read more about the dosing schedule for people who are moderately to severely immunocompromised on the CDC website.

2. Consider wearing a well-fitting mask.

Mask Types

Cloth

  • Multiple layers of breathable fabric
  • Wash daily
  • Some protection

Surgical

  • Multiple layers of non-woven fabric
  • One-time use
  • More protection

KN95

  • Filtration is different depending on standards
  • Limited reuse
  • More protection

N95

  • NIOSH approved
  • Limited reuse
  • Highest protection

3. Check the COVID-19 community levels to help determine individual preventive strategies.

4. Open windows and increase ventilation throughout indoor spaces. Improving ventilation can help reduce virus particles in the home. CDC has an interactive ventilation tool to learn how you can decrease COVID-19 virus particles during and after guest visits.

5. Clean high-touch surfaces such as doorknobs and light switches frequently to remove virus particles that may be on surfaces.

6. Have a plan for rapid COVID-19 testing. This can include having rapid tests available at home or visiting testing sites nearby.

7. Talk to your healthcare provider about whether you are a candidate for PrEP, a medication for individuals 12+ who do not currently have COVID-19 and have not been exposed to an individual with COVID-19 to help prevent COVID-19 illness.

8. Visit COVID.gov for information about COVID-19 community levels, masks, ordering COVID-19 rapid tests, and Test to Treat locations throughout the United States.

What is Test to Treat?

Test to treat is a program where people can go to a testing location and if they are positive for COVID-19 can receive treatments that are available and appropriate for them.

Visit our preventing COVID-19 page for more tips.

Learn More

Steps friends, family and community members can take to help protect immunocompromised people from COVID-19:

  1. Stay up to date on recommended COVID-19 vaccines.
  2. Get tested if you have symptoms or before contact when community levels are medium or high.
  3. Consider wearing a mask when indoors.
  4. Check the COVID-19 community levels to determine additional preventive strategies.

Page last updated: July 29, 2022

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