Can Immunocompromised People Get the Vaccine?

Yes, but vaccination isn’t as straightforward for people with immune issues

Credit: David Ryder / Stringer / Getty Images

The most recent U.S. federal guidance opened up vaccination to anyone age 65 and older and any adults who are considered high risk for Covid-19. It didn’t, however, include details on the eligibility of immunocompromised people of any age. The decision to make immunocompromised people eligible for the vaccine is being made by state governments, though this has been inconsistent across the country.

Understandably, you may be wondering whether immunocompromised people can get vaccinated if it’s available in their state.

An immunocompromised person is someone who has a weakened immune system, which makes them more vulnerable to illness and infection. An immune system can be weakened for a number of reasons: autoimmune diseases like lupus, rheumatoid arthritis, or type 1 diabetes; viruses that attack the immune cells, like HIV; cancer treatments, including chemotherapy; and having had a recent bone marrow transplant.

In 2016, researchers reported in the journal JAMA that more than 4% of Americans had been told by a doctor that they were immunocompromised. And according to the Centers for Disease Control and Prevention, people who are immunocompromised may be at higher risk for severe Covid-19.

So, can these people get the vaccine? The short answer is yes (if they are considered eligible in their state), but they must take into account serious medical considerations with the help of a health care professional.

The important thing to know is that there isn’t any data on vaccine safety and efficacy in immunocompromised people. As science journalist Tara Haelle wrote in Elemental’s thorough FAQ on vaccines, all of the vaccine trials save one (from Janssen, whose vaccine isn’t available yet) excluded people on immunosuppressing or immune-modifying drugs.

The interim CDC guidance says that immunocompromised people can get vaccinated, but only if they have no contraindications to vaccination — conditions that increase their risk of a bad reaction to the vaccine — and they must be counseled about the unknowns about the safety and effectiveness in this group. In addition, they must be informed that they might have a diminished immune response to the vaccine (that is, it might not produce as many antibodies as expected) and told to continue to take all precautions to protect themselves from infection.

The decision for an immunocompromised person to get vaccinated should be made together with a health care professional, who can take all of these and other considerations — like a person’s medical history and medications — into account.

People have criticized the fact that immunocompromised people were not included in the vaccine trials in the first place, especially considering that this group was identified as at-risk for severe Covid-19. And, since the overarching guidance on vaccination from the CDC is to do so in a way that reduces death and serious disease as much as possible, states that have not made immunocompromised people eligible for vaccination have been criticized for picking and choosing who is most deserving of a vaccine.

New York is one example of a state that has not opened up eligibility to immunocompromised people; state governor Andrew Cuomo has hesitated to do so, citing a limited number of vaccine doses and a lack of clarity about the definition of immunocompromised. Guidance from Texas, in contrast, says immunocompromised people are recommended for early vaccination. This resource from the Washington Post, which tracks vaccination policy in each state, is very useful for finding out the eligibility of immunocompromised people in a specific area.

“It is so wrong that immunocompromised people and those with health risks who need urgent medical care have been left behind in the vaccine rollout,” tweeted Lucky Tran, PhD, a scientist and public health communicator, on Tuesday. “If we care about saving lives, this group should have always been prioritized.”

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A blog from Medium for Covid-19 news, advice, and commentary.

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Yasmin Tayag

Yasmin Tayag

Editor, Medium Coronavirus Blog. Senior editor at Future Human by OneZero. Previously: science at Inverse, genetics at NYU.

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