Physician viewpoint: Protecting immunocompromised from COVID-19 is everyone's responsibility

Society as whole has a hand in protecting immunocompromised people from COVID-19, according to two physician scientists who treat transplant recipients at Baltimore-based Johns Hopkins University School of Medicine. 

In a guest essay published in The New York Times Jan. 13, Dorry Segev, MD, PhD, associate vice chair of surgery at JHU School of Medicine; and William Werbel, MD, transplant and oncology infectious disease physician at the medical school, wrote that while the omicron variant has been linked to less disease severity compared to earlier strains, society should take that with a grain of salt when it comes to the millions of Americans with weakened immune systems and remain conscious of this population's increased risk of both infection and severe illness. 

"High-risk people should not be made to feel that they are on their own to protect themselves," Drs. Segev and Werbel wrote. "As a society, we can help substantially by getting vaccinated and boosted as recommended, which can help control the pandemic. People who are going to interact with immunocompromised individuals should take additional precautions, like using masks and getting tested beforehand to avoid infecting them."

Immunocompromised people shouldn't be expected "to hide in the basement until the omicron variant disappears," the physicians wrote. "They have jobs, families and lives to live." 

The physicians pointed out that many immunocompromised people do not mount an immune response after vaccination, citing research that showed transplant patients who received two doses of Moderna or Pfizer's mRNA vaccines still had an 82-fold higher risk of infection and 485-fold higher risk of hospitalization or death compared the vaccinated general population overall. 

They called on the CDC and FDA to provide more information on and access to resources such as antibody testing, additional vaccine doses and timing of boosters for high-risk individuals. 

The CDC's current guidance for moderate to severely immunocompromised people is to receive an additional primary dose of an mRNA COVID-19 vaccine at least 28 days after completing their initial two-dose series. Five months after that, the agency recommends they receive a fourth shot or booster dose. 


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