The COVID-19 pandemic has been frightening enough for individuals who do not have underlying healthcare conditions. For those who are immunocompromised, that fear was heightened by the reality that contracting COVID-19 might mean an immediate trip to the hospital or ICU. Vaccines changed that for millions of immunocompromised people, and yet the myth that those individuals are unable to get vaccinated persists.
What does it mean to be immunocompromised? According to Yale Medicine, “It’s when your immune system isn’t working as well as it should to protect you from infection—or that your immune system can’t distinguish between normal and foreign cells.” Why is this important with respect to the COVID-19 pandemic? This can lead to an inability to mount an effective response to the COVID-19 vaccine, an inability to effectively defend against the COVID-19 virus, or a response to the virus that leads to a long-lasting, lengthy infection.
It is this last point that has some researchers particularly concerned as it relates to variants. According to research published in Nature Medicine and in Genetic Engineering and Biotechnology News, “New research reveals that the many SARS-CoV-2 variants are likely formed in chronic COVID-19 patients who suffer from immunosuppression. The research suggests that a weakened antibody response, particularly in the lower airways of these chronic patients, may prevent full recovery from the virus and drive the virus to mutate many times during a lengthy infection. The virus’s ability to survive and reproduce in the immunosuppressed patient’s body—without restriction—leads to the evolution of many variants.”
This is supported by the authors of the New England Journal of Medicine article “SARS-CoV-2 Variants in Patients with Immunosuppression.” According to the authors, patients that are immunocompromised have a greater possibility of persistent SARS-CoV-2 infection, leading to the possibility of a multitude of variants. “Such patients should be prioritized for anti-COVID-19 immunization not only to protect them from SARS-CoV-2 but also to mitigate persistent SARS-CoV-2 infections.”
What can people who are immunocompromised do to protect themselves and guard against pervasive COVID-19 infections? Several things. First, as stated above, they should get vaccinated and get boosters if safe and medically indicated for them to do so. According to Dr. Torian Easterling, the first deputy commissioner and chief equity officer for the New York City Department of Health and Mental Hygiene, in an interview with the AmNews, “We know that the guidance has been updated” and people who are immunocompromised are now encouraged to get more than one booster shot. According to Easterling, that is “step one.” Easterling’s comments are supported by other experts regarding the ability for people who are immunocompromised to get more than one booster shot.
Second, according to Easterling, “There are treatments available…there are monoclonal antibodies that health systems do have available that can really support an individual who is immunocompromised and is affected with COVID.”
Third, if someone who is immunocompromised does test positive for COVID-19, they should talk with their healthcare provider about options and treatments. According to Easterling, “[It’s important that] individuals know where they can get tested and [check] in with their provider that in the event that they do become positive with COVID-19 that they speak with their provider about what’s the right treatment for them.”
Other safeguards include: ensuring that people around the person that is immunocompromised have been recently tested for COVID-19, continuing to wear masks that are well-fitting, hand-washing, and avoiding large indoor crowds.
Updates on COVID-19 prevention and treatment for individuals who are immunocompromised can be found on the NYC DOH page COVID-19: Prevention and Groups at Higher Risk: https://www1.nyc.gov/site/doh/covid/covid-19-prevention-and-care.page.
For more information regarding vaccines and boosters in New York City, please go to www1.nyc.gov/site/doh/covid/covid-19-vaccines.page. These and other resources can also be accessed on the AmNews COVID-19 page: https://amsterdamnews.com/covid/