Immunocompromised: What Does it Mean?

Immunocompromised individuals are potentially at a higher risk for severe illness from the coronavirus, or COVID-19, according to the Centers for Disease Control and Prevention (CDC). We’re here to help — here is some general information about what it means to be immunocompromised, and how you can protect yourself.

This information is specific to people who are currently or have previously received cancer treatment. If you have additional questions regarding either your current or past treatments, contact your oncologist for more information.

What does it mean to be immunocompromised?

Being immunocompromised means having a weakened immune system, which reduces the body’s ability to fight infections and other diseases. Cancer patients can become immunocompromised (at least for a period of time) due to the disease, as a result of treatment they are undergoing, or a combination of both reasons.   

How do I know if I am immunocompromised?

As a general guideline, if you have either undergone a stem cell transplant in the last two years (it typically takes 3-12 months, if not longer, for your immune system to recover from your transplant), have chronic graph-versus-host disease (GVHD), or are currently on ongoing, intensive chemotherapy (or a similar potent drug), you are likely immunocompromised.

People who are immunocompromised would have been told this by their oncologist prior to starting treatment, and should be practicing COVID-19 type precautions, according to Joseph H. Antin, MD, chief emeritus of Adult Stem Cell Transplantation at Dana-Farber/Brigham and Women’s Cancer Center.

If I am immunocompromised, am I at higher risk for developing COVID-19? How can I protect myself?

Based on current information available, those at high-risk for severe illness from COVID-19 include people who are immunocompromised, including from cancer treatment.

Antin encourages all cancer patients, whether they are in active treatment or not, to adopt more aggressive precautions. It is still unclear as to what extent (if any) a previous cancer diagnosis increases your chance of developing severe illness from COVID-19, even if you are no longer immunocompromised.

Patients who have been told that they are currently immunocompromised should avoid leaving their homes unless it is absolutely essential and limit their contact with others. In instances where you must leave your homes (such as for a doctor’s appointment), you will likely be given masks and gloves to wear while you’re out. Be sure to change your gloves if you touch a “high traffic” item (such as an elevator button or handrail) and wash your hands once you have returned from your destination.

All patients should be in contact with their care teams to determine if their current care schedule is still appropriate, or if it can be temporarily adjusted.

How can I protect myself otherwise?

There are many things you can do to help protect yourself, and those around you, from contracting COVID-19. The best way to prevent illness is to avoid being exposed to the virus. It is recommend that you:

• Wash your hands properly and often (if soap and water is not available use a hand sanitizer that contains at least 60% alcohol)
• Shower daily
• Stay inside and practice social distancing
• Avoid touching your eyes, nose, and mouth
• Stay home if you are sick and immediately wash your hands if you cough or sneeze
• Regularly clean and disinfect commonly touched surfaces
• Stay away from anyone who is currently or recently was sick
• Keep your home clean, especially your bathroom

What caregivers and visitors should keep in mind

If you are caring for or even visiting someone who is immunocompromised, it is important to also follow these heightened precautions. Remember: Anything you carry can be transferred to the patient. This is why anyone who will come in contact with an immunocompromised person needs to follow the same guidelines as someone who is immunocompromised.

Today, it is important to self-quarantine and practice social distancing as much as possible. Consider exchanging physical interactions with virtual ones; Facebook Messenger, FaceTime, or even video conferencing applications (such as Zoom) can serve as temporary alternatives.  

COVID-19 vaccine(s) information

While more information is still needed as to how a COVID-19 vaccine will affect individuals diagnosed with cancer, it is believed both cancer survivors, and those who have not received immunosuppressive therapy for more than several months, will be able to mount a successful immune response to the COVID-19 vaccine. It is still unknown if cancer patients undergoing active treatment would benefit from a COVID-19 vaccine, but there is ongoing research to determine its safety and efficacy in this patient population. Learn more here.

Self-care for patients and caregivers

Both patients and their caregivers need to practice self-care for emotional and physical well-being in this challenging time. Read helpful information on coping day-to-day with COVID-19 uncertainty.

About the Medical Reviewer

Dr. Antin received his MD from Cornell University in 1978, and postgraduate training in hematology and medical oncology at DFCI and Brigham and Women's Hospital. He subsequently served as director of the Bone Marrow Transplantation Service at BWH from 1987 to 1997. He now heads the Stem Cell Transplant Program of the Department of Medical Oncology at DFCI and BWH. He is a founding member and past president of the American Society of Blood and Marrow Transplantation and a past Chairman of the Steering Committee of the BMT Clinical Trial Network.