Can Immunocompromised People Safely Receive the COVID-19 Vaccine?

Woman receiving a vaccine while wearing a face mask.

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Key Takeaways

  • Doctors recommend immunocompromised people receive the COVID-19 vaccine. 
  • The Pfizer and Moderna COVID-19 vaccines are inactivated vaccines—meaning they do not contain live traces of COVID-19. 
  • Depending on the person's immunocompromised level, some may receive lower levels of immunity from the vaccine.

The highly anticipated COVID-19 vaccine rollout is here with Pfizer-BioNTech and Moderna leading the charge. It was made clear by the government that healthcare workers and adults over 75 years of age would be the first in line to receive the vaccines, and so far, 5.48 million doses have been given in the United States.

But as more people get vaccinated, what will getting vaccinated mean for immunocompromised people, and how does immunocompromised status potentially impact COVID-19 vaccine immunity?

People who are immunocompromised have weakened immune systems. According to the Centers for Disease Control and Prevention (CDC), people with weakened immune systems include people living with HIV/AIDs, have undergone radiation or transplants, are older adults, or have diseases that affect their immune system.

What This Means For You

Once your turn to receive the vaccine arrives, consult with your healthcare provider about your immunocompromised status and how the vaccine may impact you. Ask them what kind of vaccine you'd be receiving and what their recommendations are.

The Type of Vaccine You Get Matters

For immunocompromised people, the type of vaccine they receive matters. “There are different types of vaccines," Peter Gulick, MD, associate professor of medicine at Michigan State University, tells Verywell. "There’s a live vaccine and attenuated where it doesn’t have any kind of live virus."

What Gulick is referring to are inactivated vaccines, a type of vaccine that uses the killed version of the germ that causes a disease. Examples of inactivated vaccines include Hepatitis A, Flu, Polio, and Rabies. Because inactivated vaccines do not provide as much strength as live vaccines, they are usually administered in doses. The COVID-19 Pfizer and Moderna vaccines are both inactivated vaccines.

On the other hand, activated vaccines are vaccines that use a weakened version of the germ to build a strong and lasting immune system. These vaccines include measles, mumps, rubella (MMR), smallpox, chickenpox, and yellow fever. Activated vaccines can be dangerous for immunocompromised people because the active virus present in the vaccine runs the risk of causing illness.

The Pfizer and Moderna vaccines work by teaching our cells to make a protein that triggers our body's immune response, leading to the production of antibodies. These antibodies then work to keep us healthy and protect us from getting COVID-19. “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, a New York-based family physician and medical director for the Tribeca office of One Medical, tells Verywell. 

“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."

In some cases, one dose of a live-attenuated vaccine can give a lifetime of protection. Because the Pfizer and Moderna COVID-19 vaccines are inactivated vaccines, they will require multiple doses.

Weaker Immune Response

Although the COVID-19 vaccines have a roughly 94% to 95% efficacy rate, immunocompromised people might be less likely to respond to the vaccine. “They [immunocompromised people] may only get a 20% or 30% response depending on how immunosuppressed they are,” Gulick explains.

Timing of the vaccine matters in order to 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 above 200 T cells 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 reasons social distancing and mask-wearing should be standard procedure even after vaccination. “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, epidemiologist and core faculty in Walden University’s School of Health Sciences, tells Verywell. 

Next Steps 

If you are immunocompromised, Mysore recommends speaking with your provider about your immunocompromised status and the COVID-19 vaccine. “What I’ve been telling my patients is when the time comes for them to be vaccinated, to individually touch base with your primary care doctor to figure out what those considerations are and whether or not you should be or should not be getting vaccinated,” Mysore says. 

Some questions you may consider asking your healthcare provider include:

  • What kind of vaccine am I getting? 
  • Should I get the vaccine? 
  • If the answer is no, why am I not recommended to get the vaccine? 
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Article Sources
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  1. Bloomberg. More Than 15 Million Shots Given: COVID-19 Vaccine Tracker. Updated January 6, 2021.

  2. Center for Disease Control and Prevention. General Information for Immunocompromised Persons. Updated August 14, 2017. 

  3. U.S. Department of Health & Human Services. Vaccine Types. Updated March 2020.

  4. Center for Disease Control and Prevention. A Closer Look at How COVID-19 mRNA Vaccines Work. Updated December 18, 2020.