Will the COVID-19 vaccines be safe for immunocompromised patients?

Key Resources for Patients with Altered Immunocompetence

  1. The care team managing your immunodeficiency.
  2. Immune Deficiency Foundation, and especially their handbook.
  3. Advisory Committee on Immunization Practice Guidelines
  4. Infectious Disease Society of America Guidelines for Vaccination of the Immunocompromised Host 2013

COVID-19 Vaccines

The COVID-19 vaccines farthest advanced in the clinical trials process are mRNA vaccines, which are inviable- though they encode a fragment of a viral protein, they do not encode a functional virus. As a result, they likely can generally be given safely to patients with altered immunocompetence (but their efficacy is entirely unknown in this patient cohort). Replication-deficient adenovirus vectors are also considered inviable, and thus should be generally safe to give to patients with altered immunocompetence (ChAdOx vaccine from Oxford and Astra-Zeneca). This of course presupposes regulatory approval of these vaccine candidates, which is not yet guaranteed.

Patients are, however, unique and not every disease or treatment has the same presentation so be sure to consult your treating physician before making changes to any aspect of your lifestyle, including vaccination.

References (these are copied from the more detailed post on altered immunocompetence that I took down)

  1. Ajitkumar A, Yarrarapu SNS, Ramphul K. 2020. Chediak Higashi Syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing.
  2. Almarza Novoa E, Kasbekar S, Thrasher AJ, Kohn DB, Sevilla J, Nguyen T, Schwartz JD, Bueren JA. 2018. Leukocyte adhesion deficiency-I: A comprehensive review of all published cases. J Allergy Clin Immunol Pract. 6(4):1418–1420.e10.
  3. Altered Immunocompetence. 2020 Nov 18. Cdc.gov. https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/immunocompetence.html.
  4. Bousfiha A, Jeddane L, Picard C, Ailal F, Bobby Gaspar H, Al-Herz W, Chatila T, Crow YJ, Cunningham-Rundles C, Etzioni A, et al. 2018. The 2017 IUIS phenotypic classification for primary immunodeficiencies. J Clin Immunol. 38(1):129–143.
  5. Kathleen E. Sullivan ERS. 2020. Stiehm’s Immune Deficiencies. London, England: Elsevier.
  6. Medical Advisory Committee of the Immune Deficiency Foundation, Shearer WT, Fleisher TA, Buckley RH, Ballas Z, Ballow M, Blaese RM, Bonilla FA, Conley ME, Cunningham-Rundles C, et al. 2014. Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts. J Allergy Clin Immunol. 133(4):961–966.
  7. Panday A, Sahoo MK, Osorio D, Batra S. 2015. NADPH oxidases: an overview from structure to innate immunity-associated pathologies. Cell Mol Immunol. 12(1):5–23.
  8. Skokowa J, Dale DC, Touw IP, Zeidler C, Welte K. 2017. Severe congenital neutropenias. Nat Rev Dis Primers. 3:17032.
  9. Sobh A, Bonilla FA. 2016. Vaccination in primary immunodeficiency disorders. J Allergy Clin Immunol Pract. 4(6):1066–1075.
  10. Sullivan KE. 2019. Neutropenia as a sign of immunodeficiency. J Allergy Clin Immunol. 143(1):96–100.
  11. Wen L, Atkinson JP, Giclas PC. 2004. Clinical and laboratory evaluation of complement deficiency. J Allergy Clin Immunol. 113(4):585–93; quiz 594.
  12. Yu H-H, Yang Y-H, Chiang B-L. 2020. Chronic granulomatous disease: A comprehensive review. Clin Rev Allergy Immunol. doi:10.1007/s12016–020–08800-x. http://dx.doi.org/10.1007/s12016-020-08800-x.

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Edward Nirenberg

Edward Nirenberg

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I write about vaccines here. You can find me on Twitter @enirenberg and at deplatformdisease.com (where I publish the same content without a paywall)