Can Immunocompromised People Safely Receive the COVID-19 Vaccine?

Key TakeawaysHealthcare providers recommend immunocompromised people receive the COVID-19 vaccine.The Pfizer and Moderna COVID-19 vaccines do not contain live traces of COVID-19.People who are immunocompromised may not receive as much protection from the vaccine as those who are not.

Key Takeaways

Healthcare providers recommend immunocompromised people receive the COVID-19 vaccine.The Pfizer and Moderna COVID-19 vaccines do not contain live traces of COVID-19.People who are immunocompromised may not receive as much protection from the vaccine as those who are not.

Immunocompromisedpeople are at higher risk of severe COVID-19, including hospitalization and death.

There has been significant research into the effectiveness of COVID-19 vaccines in immunocompromised people. Although the immune response in an immunocompromised patient may not be as robust as in someone who is not immunocompromised, the available vaccines still offer protection.

This article looks at the effectiveness of COVID-19 vaccines for immunocompromised people, and the CDC’s current recommendations for this group.

Are You Immunocompromised?

People who are immunocompromised have weakened immune systems. According to the Centers for Disease Control and Prevention (CDC), this includes:

People who have weakened immune systems may not respond as well to the COVID-19 vaccine.

What This Means For YouTalk to your healthcare provider about your immunocompromised status and how the vaccine may impact you.

What This Means For You

Talk to your healthcare provider about your immunocompromised status and how the vaccine may impact you.

Vaccine Type Matters

There are different types of vaccine available for different diseases. Immunocompromised people generally need to be careful about which type they receive.

Peter Gulick, MDis an associate professor of medicine at Michigan State University. He tells Verywell that most vaccines are either inactivated or attenuated.

Attenuated vaccines are vaccines that use a live but weakened version of the germ. This helps create a stronger, long-lasting immune response. These vaccines includemeasles, mumps, rubella (MMR),smallpox,chickenpox, and yellow fever.Attenuated vaccines can be dangerous for immunocompromised people. This is because the live virus may cause illness.

Attenuated vaccines are vaccines that use a live but weakened version of the germ. This helps create a stronger, long-lasting immune response. These vaccines includemeasles, mumps, rubella (MMR),smallpox,chickenpox, and yellow fever.

Attenuated vaccines can be dangerous for immunocompromised people. This is because the live virus may cause illness.

The COVID-19 Pfizer and Moderna vaccines are neither attenuated or inactivated. They are mRNA vaccines. These vaccines teach your cells to make a protein or piece of a protein that triggers an immune response and results in the production of antibodies.The antibodies help protect you from COVID-19.

5 Experts Explain mRNA Vaccines for Non-Science People

“A vaccine that’s not live is usually a component that triggers your body to create a memory for that specific virus and then create antibodies, versus a live vaccine which has a low concentration of the actual virus itself” Navya Mysore, MDCM, CCFP tells Verywell. Mysore is a New York-based family physician and medical director for the Tribeca office of One Medical.

“These COVID vaccines are not live vaccines," Gulik says. “And so, a patient that is immunocompromised—no matter what degree of compromise—could take the vaccine.”

The Johnson & Johnson COVID-19 vaccine is a viral vector vaccine. It uses an inactivated common cold virus called anadenovirusas a vector or delivery method. The Johnson & Johnson vaccine is also a recombinant vaccine. This means it uses a small piece of the virus’s genetic material to trigger an immune response. These vaccines are usually safe for immunocompromised people.

COVID-19 Vaccine Recommendations For the Immunocompromised

Adults aged 18 and up can get either the Pfizer vaccine or the Moderna vaccine. The Pfizer vaccine is the only one currently approved for use in children.

Can Babies and Toddlers Get a COVID-19 Vaccine?

At this time, the CDC doesn’t recommend the Johnson & Johnson vaccine except in certain circumstances. This is because there is a higher risk of adverse reactions with this vaccine. The Johnson & Johnson vaccine may be a better choice if:

If you received the Johnson & Johnson vaccine as your primary COVID-19 vaccine, you can choose to get an mRNA vaccine as a booster.

Weaker Immune Response

Studies have shown that COVID-19 vaccine effectiveness tends to be lower in immunocompromised people than it is in the general population. However, vaccination does still provide good protection. A 2022 review found that vaccines in immunocompromised people were still 63% to 100% effective at preventing hospitalization, compared to 81% to 92% in the general population.

It is important to note, though, that vaccine effectiveness may vary depending on how immunosuppressed the recipient is.

Research shows that people with HIV who have lower T-cell counts don’t respond as well to the vaccine as people with higher T-cell counts.For these patients, the timing of the vaccine can optimize its efficacy.

“I want to not delay it, but try to optimize their immune systems so they can get a good response,” Gulick says. Gulick waits for his patients who are HIV positive to have a T-cell count above 200 before recommending they get the vaccine. “With my HIV patients, I try to get their T-cells up to at least above 200 and as high as I can before I give them any vaccines,” Gulick says. “If their T-cells are low, they may not get the response I want them to get.”

This is one of the reasonssocial distancingand mask-wearing are still important, especially in areas that have medium to high levels of COVID-19. These “community levels” are based on variables like hospital admissions and the number of new cases in the area.

If you are immunocompromised and your community level is medium, talk to your healthcare provider about masking and social distancing. In areas where the community level is high, extra precautions are warranted for immunocompromised people regardless of vaccination status.

“Because such patients have the potential for reduced immune responses, they must continue to follow all current guidance to protect themselves against COVID-19, even after vaccination,” Sri Banerjee, MD, PhD, MPH, tells Verywell. Banerjee is an epidemiologist and core faculty in Walden University’s School of Health Sciences.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit ourcoronavirus news page.

9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Jakharia N, Subramanian A, Shapiro AE.COVID-19 in the immunocompromised host, including people with HIV.Infect Dis Clin North Am. 2022. doi:10.1016/j.idc.2022.01.006Center for Disease Control and Prevention.General information for immunocompromised persons.U.S. Department of Health & Human Services.Vaccine types.Center for Disease Control and Prevention.Understanding mRNA COVID-19 vaccines.Centers for Disease Control and Prevention.COVID-19 vaccines for moderately or severely immunocompromised people.Centers for Disease Control and Prevention.Johnson & Johnson’s Janssen COVID-19 vaccine overview and safety.Di Fusco M, Lin J, Vaghela S, et al.COVID-19 vaccine effectiveness among immunocompromised populations: a targeted literature review of real-world studies.Expert Rev Vaccines. 2022:1-7. doi:10.1080/14760584.2022.2035222Tamuzi JJ, Muyaya LM, Mitra A, Nyasulu P.Systematic review and meta-analysis of COVID-19 vaccines safety, tolerability, and efficacy among HIV-infected patients.medRxiv. 2022. doi:10.1101/2022.01.11.22269049Centers for Disease Control and Prevention.What prevention steps should you take based on your COVID-19 community level?

9 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Jakharia N, Subramanian A, Shapiro AE.COVID-19 in the immunocompromised host, including people with HIV.Infect Dis Clin North Am. 2022. doi:10.1016/j.idc.2022.01.006Center for Disease Control and Prevention.General information for immunocompromised persons.U.S. Department of Health & Human Services.Vaccine types.Center for Disease Control and Prevention.Understanding mRNA COVID-19 vaccines.Centers for Disease Control and Prevention.COVID-19 vaccines for moderately or severely immunocompromised people.Centers for Disease Control and Prevention.Johnson & Johnson’s Janssen COVID-19 vaccine overview and safety.Di Fusco M, Lin J, Vaghela S, et al.COVID-19 vaccine effectiveness among immunocompromised populations: a targeted literature review of real-world studies.Expert Rev Vaccines. 2022:1-7. doi:10.1080/14760584.2022.2035222Tamuzi JJ, Muyaya LM, Mitra A, Nyasulu P.Systematic review and meta-analysis of COVID-19 vaccines safety, tolerability, and efficacy among HIV-infected patients.medRxiv. 2022. doi:10.1101/2022.01.11.22269049Centers for Disease Control and Prevention.What prevention steps should you take based on your COVID-19 community level?

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Jakharia N, Subramanian A, Shapiro AE.COVID-19 in the immunocompromised host, including people with HIV.Infect Dis Clin North Am. 2022. doi:10.1016/j.idc.2022.01.006Center for Disease Control and Prevention.General information for immunocompromised persons.U.S. Department of Health & Human Services.Vaccine types.Center for Disease Control and Prevention.Understanding mRNA COVID-19 vaccines.Centers for Disease Control and Prevention.COVID-19 vaccines for moderately or severely immunocompromised people.Centers for Disease Control and Prevention.Johnson & Johnson’s Janssen COVID-19 vaccine overview and safety.Di Fusco M, Lin J, Vaghela S, et al.COVID-19 vaccine effectiveness among immunocompromised populations: a targeted literature review of real-world studies.Expert Rev Vaccines. 2022:1-7. doi:10.1080/14760584.2022.2035222Tamuzi JJ, Muyaya LM, Mitra A, Nyasulu P.Systematic review and meta-analysis of COVID-19 vaccines safety, tolerability, and efficacy among HIV-infected patients.medRxiv. 2022. doi:10.1101/2022.01.11.22269049Centers for Disease Control and Prevention.What prevention steps should you take based on your COVID-19 community level?

Jakharia N, Subramanian A, Shapiro AE.COVID-19 in the immunocompromised host, including people with HIV.Infect Dis Clin North Am. 2022. doi:10.1016/j.idc.2022.01.006

Center for Disease Control and Prevention.General information for immunocompromised persons.

U.S. Department of Health & Human Services.Vaccine types.

Center for Disease Control and Prevention.Understanding mRNA COVID-19 vaccines.

Centers for Disease Control and Prevention.COVID-19 vaccines for moderately or severely immunocompromised people.

Centers for Disease Control and Prevention.Johnson & Johnson’s Janssen COVID-19 vaccine overview and safety.

Di Fusco M, Lin J, Vaghela S, et al.COVID-19 vaccine effectiveness among immunocompromised populations: a targeted literature review of real-world studies.Expert Rev Vaccines. 2022:1-7. doi:10.1080/14760584.2022.2035222

Tamuzi JJ, Muyaya LM, Mitra A, Nyasulu P.Systematic review and meta-analysis of COVID-19 vaccines safety, tolerability, and efficacy among HIV-infected patients.medRxiv. 2022. doi:10.1101/2022.01.11.22269049

Centers for Disease Control and Prevention.What prevention steps should you take based on your COVID-19 community level?

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