Points of View: COVID Vaccines in the Immunocompromised

Soiffer, Hematology/Oncology: Like the general public, both physicians and patients are bombarded by lots of information coming at us. Initially, it seemed like at a daily or weekly level, but as things have settled out, we have a pretty good idea, at this point, of how things are playing out.

We do recognize as physicians that, from the data that's out there, vaccination, while important and critical to prevent infection, does not last forever. A single vaccination or a single vaccination series is not permanent, and that protection wanes with time and it’s important for us to consider booster vaccines in all individuals so that they’re able to maintain their protection.

In addition, we’ve certainly learned that the COVID virus is pretty clever at mutating, like many viruses and many infectious agents. Their goal is to escape the medications that we use or escape the vaccinations. So new variants emerge and it’s been pretty remarkable that we, as community, have been able to come up with vaccines that address those new variants. I suspect that will continue over the coming months to years, and we’ll see other variants and we'll have to perhaps get a new series of vaccines.

Patel, Allergy: The vaccine attitudes in the beginning of the pandemic were very positive. For the most part, when vaccines were initially rolled out there was a lot of interest. There was a lot of acceptance, and there was a lot of eagerness to get vaccinated. There was information for physicians to provide to patients about ways to get vaccinated, side effects, etc.

Now that we have been into the COVID pandemic for a while, now that we're starting to see multiple vaccines and manufacturers with multiple boosters, it’s not surprising that some Americans are feeling vaccine fatigue.

There are just so many rules, so many regulations. In fact, in October 2022, 4% of all individuals in the US had actually gotten their booster vaccine. That goes along with this fatigue that is being experienced both by physicians and by patients. Now is not the time to be very lackadaisical about getting vaccinated. COVID infections are still prevalent. They still can cause severe disease and a death and hospitalization in immune compromised patients. So we as health care providers need to be very vigilant, and need to be very proactive in getting patients, particularly those at risk, vaccinated and protected.

Calabrese, Rheumatology: Over time with more real-world data and experience and seeing research and numbers on how effective vaccines are in preventing hospitalization and death across the board, and as things continue to improve, seeing numbers that people in the hospital and on ventilators with COVID are people who are not vaccinated for the most part and that these are really working, and knowing people who've been in the ICU with COVID or died with COVID, I think this has changed patients' stances on getting vaccines, at least those that were hesitant.

Also, another huge source of fear, the newness, the not FDA approved has been lifted. Now they are FDA approved, there is another level of comfort. From a provider standpoint, seeing our patients who are vaccinated, most of them, depending on what medicine they’re on, do relatively well in most cases with aggressive outpatient management with things like antivirals, we’ve seen how important it is to be vaccinated.