5 Things to Know About COVID-19 Vaccines for People who are Immunocompromised

1. Encourage your immunocompromised patients to get their updated COVID-19 vaccine.

Everyone aged 6 months or older who is moderately or severely immunocompromised needs at least one age-appropriate dose of the updated 2023-2024 COVID-19 vaccine formula (ie, Moderna, Novavax, Pfizer-BioNTech). People who are aged 65 years or older should receive a 2023-2024 formula COVID-19 vaccine and a second dose at least 2 months after the first dose. People who are up-to-date on vaccination have lower risk for severe illness, hospitalization, and death from COVID-19 than do people who are unvaccinated or who have not completed the doses recommended by the Centers for Disease Control and Prevention (CDC).

2. People with moderately or severely immunocompromising conditions are at increased risk for severe illness due to COVID-19 and are eligible for additional doses of COVID-19 vaccine.

• People aged 6 months to 64 years may receive one additional dose of an updated 2023-2024 COVID-19 vaccine at least 2 months after their previous updated dose.
• People aged 65 years or older should receive one additional dose of an updated COVID-19 vaccine at least 2 months after their previous updated dose.
• Further additional updated doses for everyone aged 6 months or older and moderately or severely immunocompromised may be administered as informed by the clinical judgement of a healthcare provider and personal preference and circumstances. Any further additional doses should be administered at least 2 months after the last updated dose.

3. Updated 2023-2024 COVID-19 vaccines provide protection against JN.1 and other circulating variants.

A new study published in Morbidity and Mortality Weekly Report (MMWR) showed that updated 2023-24 COVID-19 vaccines reduce risk for hospitalization by about one third among vaccinated adults with weakened immune systems. Between September 2023 and February 2024, adults with weakened immune systems who had received an updated 2023-2024 COVID-19 vaccine were about one third less likely to be hospitalized with COVID-19 compared with those who had not received an updated COVID-19 vaccine. JN.1, a variant with mutations potentially associated with decreased immune response to vaccination, was detected in the United States and became predominant by January 2024. Another MMWR study showed that the updated COVID-19 vaccines provide protection against infections caused by diverse co-circulating variants including XBB lineage and JN.1 co-circulating variants.

4. Preexposure prophylaxis with a monoclonal antibody pemivibart (Pemgarda), is available for prevention of COVID-19 for people who are moderately or severely immunocompromised and are unlikely to mount an adequate immune response to COVID-19 vaccination and who meet the US Food and Drug Administration–authorized conditions for use. For persons who do get infected, early testing and treatment is important to prevent severe disease.

Preexposure prophylaxis helps prevent COVID-19 but does not take the place of vaccination in people who are eligible to receive an updated COVID-19 vaccine. Pemivibart is still being studied, and there is limited information about the safety and effectiveness of pemivibart in preventing COVID-19. For more information, please see the new guidance on COVID-19 vaccination and pemivibart.

Clinicians should consider COVID-19 treatment in patients with mild to moderate COVID-19 who have one or more risk factors for severe COVID-19. Persons with immunocompromising conditions are at risk for severe disease. Treatment must be started as soon as possible and within 5-7 days of symptom onset.

5. CDC's Bridge Access Program provides free COVID-19 vaccines to adults without health insurance and adults whose insurance does not cover all COVID-19 vaccine costs.

CDC programs such as Vaccines for Children and Partnering for Vaccine Equity are also helping people get vaccinated to protect themselves. People can get help finding and receiving their COVID-19 vaccines by visiting vaccines.gov.