Points of View: COVID Vaccines in the Immunocompromised

Niraj Patel (Allergist): The COVID vaccine and boosters for patients are important. I stress the importance of staying well, particularly in immunocompromised patients, and that the COVID infections are still around so it’s important to get vaccinated, because vaccines are the number one way to prevent severe hospitalization and death.

For boosters, that booster immunity will improve your odds chances of staying well, but also by augmenting the immunity to potential variants in the future that may provide a cross reaction.

It’s so important that people get vaccinated. There are still a large percentage of Americans who are not vaccinated. At least one in six Americans are not vaccinated, and so we still, despite being 2 years into the pandemic, have a lot of work to do.

Soiffer (Hematologist/Oncologist): We recommend that all patients with malignancy, in particular, in my field of blood cancers, be vaccinated against COVID-19. We recommend that they be vaccinated with the three-vaccine series and have a booster shot. In those who’ve had that booster shot, we do recommend that they get the bivalent omicron booster, and we recommend that that occur 2 to 3 months after their last booster, or after actual infection.

For patients who have had a hematopoietic stem cell transplant or a bone marrow transplant, we actually re-vaccinate. Even if they’ve had a whole vaccine series, the assumption is their immunity is wiped out by the transplant process and we have to begin again. It’s our policy to begin the vaccination series again for patients starting about 100 days after their transplant. And then they go through the process as before.

Cassandra Calabrese, DO (Rheumatologist): Vaccines remain a really important tool in preventing COVID in healthy people, and more importantly, in immunocompromised people. And I think the most challenging thing for providers who take care of immunocompromised persons is that immunocompromised is very heterogeneous and kind of understanding who's at risk and who's at higher risk is really complex and poorly appreciated. And vaccines are important. They're important for everyone. You know, even if you're healthy, initial series and appropriate booster, we recommend that to all of our patients.