Moderate to severe immunocompromising conditions that may result in suboptimal COVID-19 vaccine response^[1]

Active treatment for solid tumor and hematologic malignancies

Hematologic malignancies associated with poor responses to COVID-19 vaccines regardless of current treatment status (eg, chronic lymphocytic leukemia, non-Hodgkin lymphoma, multiple myeloma, acute leukemia)

Receipt of solid-organ transplant or an islet transplant and taking immunosuppressive therapy

Receipt of chimeric antigen receptor (CAR)-T cell therapy or hematopoietic cell transplant (HCT) (within 2 years of transplantation or taking immunosuppressive therapy)*

Moderate or severe primary immunodeficiency (eg, common variable immunodeficiency disease, severe combined immunodeficiency, DiGeorge syndrome, Wiskott-Aldrich syndrome)

Advanced HIV infection (HIV and CD4 cell counts less than 200/microL, history of an AIDS-defining illness without immune reconstitution, or clinical manifestations of symptomatic HIV) or untreated HIV infection

Active treatment with:

High-dose corticosteroids (ie, ≥20 mg prednisone or equivalent per day for ≥2 weeks)
Alkylating agents
Antimetabolites
Transplant-related immunosuppressive drugs
Cancer chemotherapeutic agents classified as severely immunosuppressive
TNF blockers
Other biologic agents that are immunosuppressive or immunomodulatory (eg, B cell-depleting agents)

In the United States, the Centers for Disease Control and Prevention lists the above conditions as examples of immunocompromising conditions that warrant additional COVID-19 vaccine doses. This list is not exhaustive; other immunocompromising conditions, such as impaired splenic function, may also warrant the same vaccine adjustments. Refer to other UpToDate content for specifics of vaccine doses and intervals.

CAR: chimeric antigen receptor; TNF: tumor necrosis factor; ACIP: Advisory Committee on Immunization Practices.

* For those who received COVID-19 vaccination prior to hematopoietic stem cell transplant or CAR-T cell therapy, repeat vaccination is recommended at least 3 months after the transplant or therapy.

Reference:

Centers for Disease Control and Prevention. Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States. Available at: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html (Accessed on April 24, 2023).

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خرید پکیج

Moderate to severe immunocompromising conditions that may result in suboptimal COVID-19 vaccine response[1]

Moderate to severe immunocompromising conditions that may result in suboptimal COVID-19 vaccine response^[1]