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COVID-19 vaccine recommendations and treatments include guidelines for people who are moderate to severely immunocompromised. Talk with your doctor if you are unsure, but this list may help to guide you.

You may be considered immunocompromised if you:

Had a transplant

• A solid organ transplant such as heart, lung, liver, or kidney transplant and taking drugs to prevent rejection.
• A bone marrow transplant, also called a stem cell or Hematopoietic cell transplant, within the last 2 years, or longer than 2 years if you are taking medicines to suppress the immune system.
• You have chronic graft-versus-host disease (GVHD) and are taking medicines to suppress your immune system.

Have decreased immunity from:

• A primary immunodeficiency. Examples: Wiskott-Aldrich syndrome, DiGeorge syndrome, Severe combined immunodeficiency disease (SCID), or Chronic granulomatous disease.
• An autoimmune or chronic inflammatory disease AND you are taking medicine to decrease the body’s immune response. Examples: Rheumatoid arthritis, Lupus, Inflammatory bowel disease (IBD).
• “Car-T” therapy in the past 2 years.
• Neutropenia, which is having too few immune cells called neutrophils in your blood.
• A medical condition that requires you to receive immunoglobulin replacement therapy.
• Receiving a medicine that lowers the function of your B or T cells.

Have cancer

• A solid tumor and are currently receiving chemotherapy.
• Blood-related cancers such as leukemia, lymphoma, and multiple myeloma.
• Myelodysplastic Syndrome – you have low numbers of blood cells.

Have a chronic illness

• You do not have a spleen
• Sickle Cell Anemia
• Thalassemia
• Aplastic Anemia
• Chronic kidney disease, stage 4 or 5
• Receiving dialysis, whether through the blood(Hemodialysis) or through your abdomen (Peritonealdialysis)
• Untreated or advanced HIV infection (CD4 count of200 or less)

If you:

• Are age ≥ 65 AND:

• You do not have enough antibodies as measured in your blood.

OR

• You are unable to perform 2 or more normal daily activities without help, such as bathing, dressing, going to the toilet, and walking.

• Do not have antibodies against COVID-19 after 3 vaccines, as measured in your blood.

Medicines that Affect the Immune System May Include:

• Daily prednisone (a dose of 20mg per day or more)
• Methotrexate
• Leflunomide (Arava®)
• Mycophenolate mofetil (CellCept®) or mycophenolate sodium (Myfortic®)
• Azathioprine (Imuran®)
• Abatacept (Orencia®)
• Tocilizumab (Actemra®)
• Cyclophosphamide
• Cyclosporine, tacrolimus
• Infliximab, etanercept, adalimumab, golimumab, certozilumab or biosimilars
• Rituximab, ocrelizumab, ofatumumab (please call your provider for the timing of the 3rd shot)
• Belimumab (Benlysta®)
• Secukinumab, guselkumab, ustekinumab, ixekizumab
• Tofacitinib, baricitinib
• Anifrolumab (Saphnelo®)
• Natalizumab

This is not a full list of all medicines. Please talk with your doctor if you think you may be immunocompromised.

Learn more about COVID-19 vaccination guidelines for immunocompromised patients.