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Immunocompromised And Concerned About The Vaccine? Here's What You Need To Know


Millions of Americans with weakened immune systems, like a lot of people, have questions about getting vaccinated against COVID-19. Experts say vaccinating immunocompromised patients is especially important, but it also raises special considerations. NPR's Maria Godoy reports.

MARIA GODOY, BYLINE: Dr. Sharon Dowell is a rheumatologist at Howard University Hospital in Washington, D.C. Her patients have conditions like lupus and rheumatoid arthritis, in which the immune system mistakenly attacks their own bodies. These days, she says, patients are coming in with a barrage of questions about the COVID vaccines.

SHARON DOWELL: Patients want to know whether it's safe to get it. And if they do get it, which one should they get? And, of course, they also have concerns about how it can affect their own condition, as well.

GODOY: Roughly 10 million adults in the U.S. are estimated to have compromised immune systems for a wide range of reasons. Some have conditions like Crohn's disease or psoriasis. Others are organ transplant or cancer patients. Dowell says she spends a lot of time each visit encouraging her patients to get the vaccine.

DOWELL: So in terms of patients who are immunocompromised, they are the ones that we are actually striving to get vaccinated.

GODOY: That's because research shows that people with vulnerable immune systems are at higher risk of bad outcomes if they do get COVID. Doctors say all three COVID vaccines currently authorized for emergency use in the U.S. are safe for immunocompromised patients, but they don't yet know if people on immunosuppressive treatments will have a weaker immune response to the vaccines.

KATHLEEN MULLANE: If they're highly immunosuppressed, they may not make very many antibodies.

GODOY: That's Kathleen Mullane, an infectious disease doctor at the University of Chicago School of Medicine who works with severely immunocompromised patients like transplant recipients. She says with other vaccines like the flu, when a shot doesn't elicit much of an immune response in immunocompromised patients, doctors can just give them a second shot. But with COVID vaccine still in short supply, that's not an option.

MULLANE: It's a huge issue.

GODOY: She says that's why it's critical that immunocompromised patients work with their doctors to figure out when to get their COVID vaccine so it has the best chance of triggering a stronger immune response.

MULLANE: We sit down each and every patient and look to say, when is going to be the best time that we can give them their vaccine to give them the best response and to make sure that we're taking care of their underlying disorder?

GODOY: So the question of when to get the vaccine can be answered very differently from one patient to the next. Dr. Gregory Poland is head of the Vaccine Research Group at the Mayo Clinic.

GREGORY POLAND: There are considerations like what drugs you're taking, how often you're taking them, anticipated changes, whether they could be - that regimen could be altered.

GODOY: For example, he says many patients who take a daily immunosuppressant drug should probably go ahead and get the vaccine - after consulting with their doctors, of course. In other cases, doctors may decide to pause or delay a patient's treatment to give the vaccine a chance to work better.

POLAND: These are reasons to work with your health care provider in order to determine, what is the best course for me?

GODOY: Many patients with autoimmune disorders worry that getting vaccinated may make their conditions flare up. The doctors NPR spoke with say it's theoretically possible, but tens of millions of doses into America's vaccine rollout, there's no evidence that's the case. Dr. Sharon Dowell says the bottom line for immunocompromised patients is the same as for everyone else.

DOWELL: Really, truly, everyone should get vaccinated.

GODOY: Maria Godoy, NPR News.

(SOUNDBITE OF GUILTY GHOSTS' "INDIGO OF THE KINGS") Transcript provided by NPR, Copyright NPR.