March 11, 2022

Despite low case numbers, COVID-19 still dangerous for millions of immunocompromised patients nationwide

A person putting on a KN95 mask

Doctors urge public to be mindful of the more vulnerable among us

Madison, Wis. — While many Americans are celebrating the loosening of COVID-19 restrictions, there are millions of Americans with compromised immune systems for whom the pandemic is far from over.

“There’s no question we are all experiencing pandemic fatigue, but we cannot forget about some of the most vulnerable people among us,” said Dr. Jeannina Smith, medical director, transplant infectious disease program at UW Health. “Despite all medical advances, people with compromised immune systems are continuing to die, and we can all help keep them safe.”

While many people are happy with the recent shift in the CDC’s guidelines, Smith worries they’ve been widely interpreted to mean that COVID-19 is no longer a threat, yet millions of individuals are still at risk of serious illness and death.

“Even if most vaccinated people will not get seriously ill if they become infected, many of my patients with weakened immune systems are still rightly very worried about getting sick,” she said.

Data shows that vaccinated organ transplant patients, for example, have over 80 times the risk of getting COVID, and once infected their rate of serious illness is 485 times higher than other vaccinated individuals. Of those infected, 50 percent are hospitalized and one out of every 10 will die. Complications from a COVID infection was one of the leading causes of death among transplant recipients since the pandemic started.

According to the American Medical Association, immunocompromised people account for at least 2.7 percent of U.S. adults — about 7 million people. This includes people who’ve had organ transplants, stem cell transplants, HIV/AIDS and cancer, as well as those with autoimmune diseases such as rheumatoid arthritis, type 1 diabetes, multiple sclerosis and inflammatory bowel disease.

“There are so many people in our own communities – many of whom you’d never know have weakened immune systems – who do not have the luxury of simply removing their masks and putting COVID-19 behind them,” said Smith. “Let’s not lose sight of those individuals and families for whom no variant is an easy one. We need to continue to look out for each other.”

Smith offers the following guidance:

For the immunocompromised

  • Most immune compromised patients should have four doses of vaccine (three if the first dose was from Johnson & Johnson). Get the fourth dose three months after your last dose

  • Take the preventative treatment Evusheld if you can

  • Ask friends and family to get vaccinated and boosted

  • Tell friends and family to stay away if they are ill, even if their symptoms seem mild

  • Continue to wear a high-quality mask while in groups indoors

  • Continue to avoid indoor spaces where you remove your mask, like restaurants, for now

  • Opt for outdoor activities when possible

  • Have rapid antigen tests (available at pharmacies and online) on hand to test at the first sign of symptoms

  • If you test positive, take immediate action to get early treatment

For people with healthy immune systems

  • Get vaccinated and boosted

  • Masking might no longer be required, but it is still encouraged in many circumstances: because you or your loved ones are at higher risk, to better protect the vulnerable, or to prevent other illnesses

  • Wear a mask in “essential spaces” like the grocery store, pharmacy or clinic

  • Stay home if you have symptoms

  • If you are planning to meet with someone who may be at higher risk, plan to have your gathering outside or do an antigen test beforehand and stay home if positive.