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Saturday, December 10, 2022

What does it mean to be immunocompromised?

️ Put simply, if you are immunocompromised it means that your immune system does not work like the system of a non-immunocompromised person.

It can’t tell when a cell is harmful or not so it does not mount an immune response (ie it can’t fight an infection as well). So to be immunocompromised, someone’s immune system either 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, for example because they are on medications after having an organ transplant or because they have cancer or because they have an autoimmune disease and they have to take medications that change their immune system. Broadly speaking, people can be born with an immune condition, 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.

Early clinical trials showed that people who were identified as immunocompromised did not have as big of a response to getting a second dose of the COVID-19 mRNA vaccine series (Pfizer or Moderna). For this reason, all people who are immunocompromised should get an additional mRNA dose to complete the full series of vaccination (28 days after the second mRNA dose or 2 months after Johnson and Johnson). Note that children can only receive Pfizer for their third dose and are not eligible for booster doses. People 12 and older who are immunocompromised should also get a fourth mRNA dose (Pfizer only for 12+, Moderna or Pfizer for 18+) three months after completing the primary vaccine series.

For people who are immunocompromised, it may be difficult to understand guidance during the COVID-19 pandemic and it is recommended to speak to your treating clinician. It is generally understood that transplant recipients are considered moderately to severely immunocompromised whereas for others (even cancer patients as it depends on type of cancer and treatment), it is not as clear.

For anyone who wants to support people who are immunocompromised, it is important to:

1. Recognize that people who are immunocompromised will need to take extra precautions to prevent infection (mask, space, cleaning, limiting group of people who you interact with, and continue to apply those #SMARTS).

2. Know and support people to follow the guidance for vaccination (3 doses + booster mRNA OR 1 doseJ+J + mRNA dose within a month + mRNA booster two months later for anyone with moderate to severe immunocompromised conditions).

3. Advocate for your friends, colleagues, and families who are immunocompromised so that we have more data and information on how to provide guidance. By highlighting the stories of immunocompromised people, we can share their experience and what information we need to improve guidance. (See the link below from Johns Hopkins for thoughts on this).

There are 5-7 million immunocompromised people in the United States alone. We know these are not easy times. We see you and hear you and will continue to try to educate others on your experience.

Stay safe. Stay well.

Those Nerdy Girls

Additional Links:

John’s Hopkins University Public Health on Call Podcast on COVID-19 and Immunocompromised Patients

Thoughtful piece on Living as an Immunocompromised Person in the Atlantic by Ed Yong

Yale Medicine FAQ

CDC Guidance

Link to Original FB Post

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