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COVID-19 Vaccines for the Immunocompromised

Can you safely get a COVID-19 vaccine if you are immunocompromised?

“People with HIV infection or other immunocompromising conditions or people who take immunosuppressive medications or therapies might be at increased risk for severe COVID-19. No data are available to establish COVID-19 vaccine safety and efficacy in these groups. However, the currently authorized COVID-19 vaccines are not live vaccines and therefore can be safely administered to immunocompromised people.”

Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States

Although you should certainly talk to your health care provider, in general, the answer seems to be yes.

COVID-19 Vaccines for the Immunocompromised

However, just because COVID-19 vaccines are likely safe for folks who are immunocompromised, that doesn’t necessarily mean that they are going to work well.

“People should be counseled about the unknown vaccine safety profile and effectiveness in immunocompromised populations, the potential for reduced immune responses, and the need to continue to follow current guidance to protect themselves against COVID-19..”

Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States

After all, if you are immunocompromised, then you might not be able to mount an antibody response to your COVID-19 vaccine.

Anthony Fauci said that “It is clear that if you are on immunosuppressant agents, history tells us that you are not going to have as robust a response as if you had an intact immune system that was not being compromised. But some degree of immunity is better than no degree of immunity. So, for me, it would be recommended that these people do get vaccinated.”

Still, since they are likely safe, then even with the potential for a “reduced immune response,” then it likely makes sense to get vaccinated and protected, as you might be at increased risk for severe COVID-19.

“The safety of mRNA vaccines is still under investigation in solid organ transplant recipients. There were no transplant recipients in the phase 3 trials for Moderna or Pfizer, however, some transplanted individuals have already received vaccination as part of the EUA. Based on their mechanism of action, expert opinion is that these vaccines are unlikely to trigger rejection episodes or have novel or more severe side effects in transplant recipients,but more data will be needed in.

Preliminary data of 187 SOT recipients who received their first SARS-CoV-2 vaccine doses has recently provided early insight into safety and efficacy of the mRNA vaccine in this population. Equal numbers of recipients received the Pfizer and Moderna vaccines and had low rates of local (61% pain, 7% redness, 16% swelling at injection site) and systemic (4% fever, 9% chills, fatigue 38%, headache 32% and myalgias 15%) reactions. No episodes of graft rejection were reported in these patients.7

The safety of Adenovirus-vector vaccines is still under investigation in solid organ transplant recipients as transplant recipients were not included in the phase 3 trials of the Janssen/Johnson & Johnson vaccine. Unlike live virus vaccines, Adenovirus-vector vaccines have been genetically engineered to not replicate, and therefore cannot cause Adenovirus infection in the recipient. Based on the mechanism of action, expert opinion is that this vaccine is unlikely to trigger rejection episodes or have novel or more severe side effects in transplant recipients,but more data are needed.

American Society of Transplantation COVID-19 Vaccine FAQ Sheet

And know that many specialty associations have weighed in to help you make this decision…

“There is no reason to believe COVID vaccines will be any less safe in patients with blood cancer. However, COVID-19 vaccine clinical trials have not included many cancer patients. Cancer treatment can affect how well a patient’s immune system responds to vaccines. While some immunocompromised patients may experience decreased immune response to the vaccine, it may still confer some benefit and is important for reducing the risk or severity of COVID-19 to cancer patients. LLS encourages blood cancer patients to discuss COVID-19 vaccines with your oncologist and healthcare team.”

Leukemia and Lymphoma Society COVID-19 Vaccines FAQ for Patients and Caregivers

But again, talk to your health care provider and decide what is best for you.

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