Understand what it means to be immunocompromised, know the current recommendations, and take concrete actions to support them.
TL; DR: Being immunocompromised means the body can’t fight infection well. This can be caused by something or the person could have been born with this condition. If you are supporting someone who is immunocompromised, it is important to know the current guidelines, support extra precautions they may need to take, and share their stories (with permission and with personal information protected) so that others take their experience into consideration.
What does being immunocompromised mean?
It means that the immune system does not work like that of a non-immunocompromised person. 🚦 It can’t tell when a cell is harmful or not so the body does not mount an immune response 📉 (i.e. it can’t fight an infection as well).
So to be immunocompromised, someone’s immune system: 1) Doesn’t detect cells/viruses/bacteria from outside the body OR 2) Can’t create a defense or immune response to the cells/viruses/bacteria OR 3) Can’t do either.
🦠 🧫 💊 People are immunocompromised for many reasons. Some reasons are: being on medication after a transplant, having cancer, or taking medication that changes the immune system because of an autoimmune or autoinflammatory disease. People can be born immunocompromised, have a disease that causes them to be immunocompromised, or have to take medications that suppress their immune system and cause them to be immunocompromised. It is important to remember that we cannot tell someone is immunocompromised by looking at them. They can “look” like a healthy person and be able to do most things that we all do, but be struggling with a difficult condition. Many people with chronic illnesses find ways to live around their illness so that they can still take part in life, but it can require great effort to do this. We don’t see what goes on behind the scenes.
🔬 People who are immunocompromised do not have as big of an immune response to the COVID-19 vaccine after two doses, based on the data from many studies as well as early clinical trials. All adults who are immunocompromised should get a third dose of the mRNA vaccine series (Pfizer or Moderna) to complete their primary series (the initial number of doses someone needs to complete their first part of a vaccine series). They should also get a booster dose of the most recent booster available (the bivalent booster right now). Children who are immunocompromised should also receive the primary series plus the most recent booster available, however the number of doses needed for a primary series can differ by the child’s age.
😕 If you or a loved one are immunocompromised, it can be hard to know what guidance to follow, so it is important to talk to your treating clinician. Guidance is not always as clear depending on what condition someone has. For example, transplant recipients are generally considered moderately to severely immunocompromised, but others (even some cancer patients) may not be.
🙋 So what can I do?
For anyone who wants to support people who are immunocompromised during this season of flu, RSV, and COVID, it is important to:
1. Recognize that people who are immunocompromised will need to take extra precautions to prevent infection (mask, space, ventilation cleaning, limiting group of people who they see, and applying #SMARTS).
➡️ Mask up around them and encourage them to mask indoors and when around large groups of people.
2. Know and support people to follow the guidance for COVID vaccination (Primary series + most recent booster) and to stay up to date on routine care and other vaccines. People who are moderately to severely immunocompromised are still eligible to receive Evusheld, however it does not seem to protect against new variants (See our previous post on this here.).
➡️ Remind people that it is still important to get vaccinated.
3. Advocate for your friends, colleagues, and families who are immunocompromised so that others understand they are not being over cautious. When we share their experiences, it also helps improve data and guidance (See the link below from Johns Hopkins for thoughts on this). Please note that it is important that your friend or loved one gives permission to share their story and that you take care to not share any personal information unless it is mutually and previously agreed upon for a specific reason.
➡️ Acknowledge that for most people who are moderately to severely immunocompromised, their daily living can be challenging. It is hurtful when we do not discuss how public policies aimed at protecting most people can negatively influence their daily lives.
🫂 There are 5-7 million immunocompromised people in just the United States. We acknowledge that these are still difficult times for you and your loved ones. We see you, hear you, and will continue to try to share your perspectives and experiences.
Stay safe. Stay well.
Those Nerdy Girls
Additional links:
CDC Recommendations on COVID19 vaccine for moderately or severely immunocompromised people
Johns Hopkins School of Public Health Podcast on Immunocompromise
NYtimes perspectives on living as an immunocompromised person
Study in BMJ that looked at multiple studies about immunocompromise and the COVID-19 vaccine
