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CDC Updated Recommendations for Moderately or Severely Immunocompromised Individuals

On October 19, the U.S. Centers for Disease Control and Prevention (CDC) updated its recommendations for precautions for those who are immunocompromised or who have weakened immune systems. Immunocompromised individuals are more likely to get sick with COVID-19 and may be sick for a longer period of time.

According to the CDC:

Some people who are immunocompromised (have a weakened immune system) are more likely to get sick with COVID-19 or be sick for a longer period. People can be immunocompromised either due to a medical condition or from receipt of immunosuppressive medications or treatments.

Examples of medical conditions or treatments that may result in moderate to severe immunocompromise include but are not limited to:

  • Active treatment for solid tumor and hematologic malignancies
  • Hematologic malignancies associated with poor responses to COVID-19 vaccines regardless of current treatment status (e.g., 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 stem cell transplant (within 2 years of transplantation or taking immunosuppressive therapy)
  • Moderate or severe primary immunodeficiency (e.g., common variable immunodeficiency disease, severe combined immunodeficiency, DiGeorge syndrome, Wiskott-Aldrich syndrome)
  • Advanced or untreated HIV infection (people with HIV and CD4 cell counts less than 200/mm3, history of an AIDS-defining illness without immune reconstitution, or clinical manifestations of symptomatic HIV)
  • Active treatment with high-dose corticosteroids (i.e., 20 or more mg of prednisone or equivalent per day when administered for 2 or more weeks), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor necrosis factor (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory

Talk to your healthcare provider if you have another medical condition or are on medication that may not be reflected above.

If you or someone you live or spend time with is immunocompromised, it is important to have a COVID-19 plan to protect yourself from infection and prepare for what to do if you get sick. Information on this page can help you build a COVID-19 plan for preventing, diagnosing, and treating COVID, so you know what to do and can act quickly if you’re exposed, develop symptoms, or test positive and when COVID-19 levels are increasing in your community.
 

How to Protect Yourself

Stay up to date on COVID-19 vaccinations

COVID-19 vaccines are effective at protecting people—especially those who are up to date— from getting seriously ill, being hospitalized, and even dying. As with vaccines for other diseases, you are protected best when you stay up to date with your COVID-19 vaccines. The people you live or spend time with can help protect you and themselves by staying up to date on their COVID-19 vaccines too.

You are up to date with your COVID-19 vaccines when you have received all doses in the primary series and all boosters recommended for you, when eligible. Since your immune response to COVID-19 vaccination may not be as strong as in people who are not immunocompromised, you have different recommendations for COVID-19 vaccines, including boosters. Learn more about COVID-19 vaccine recommendations for people who are moderately or severely immunocompromised.

To find COVID-19 vaccine locations near you: Search vaccines.gov, text your ZIP code to 438829, or call 1-800-232-0233.

COVID-19 pre-exposure prophylaxis

Evusheld is authorized by the U.S. Food and Drug Administration (FDA) as pre-exposure prophylaxis to prevent COVID-19. It is a medicine containing antibodies and is given before you are exposed to or test positive for COVID-19.

Evusheld continues to be authorized for people who are moderately to severely immunocompromised and may not be able to mount an adequate response to the COVID-19 vaccine, and for people who could have a history of severe adverse reaction to the COVID-19 vaccine or its components. If you’re eligible for a vaccine, we encourage you to talk with your healthcare provider.

Evusheld still protects people from getting COVID-19, but it may offer less protection against three strains (BA.4.6, BF.7, and BA.2.75.2) of the Omicron variant. Even if you receive Evusheld, you should continue to take the necessary steps to protect yourself and others, including undergoing testing and seeking medical attention if you develop symptoms of COVID-19, as well as starting treatment for COVID-19 as appropriate.
Your healthcare provider will determine if you are eligible for Evusheld. Talk to your healthcare provider about whether Evusheld is the best option for you.
 
Download: Evusheld EUA Fact Sheet for Patients, Parents and Caregivers

Take extra precautions

Even if you stay up to date on COVID-19 vaccines and receive Evusheld, taking multiple prevention steps can provide additional layers of protection from COVID-19.

  • Wear a well-fitting, high quality mask or respirator. Properly fitting respirators provide the highest level of protection.
  • Avoid poorly ventilated or crowded indoor settings.
  • When indoors with others, try to improve ventilation as much as possible.
  • Wash your hands often with soap and water or use a hand sanitizer that contains at least 60% alcohol.

Know What to Do If You Get Sick

It’s important to be prepared and know what to do if you get sick with COVID-19. Don’t delay seeking medical care. Be prepared by understanding the following steps:

What you can do now

  • Know the symptoms of COVID-19.
  • Learn how to check your COVID-19 Community Level. Knowing your community levels will help you decide when to add layers of protection, like wearing a mask.
  • Know how to get tested as soon as possible if you develop symptoms.
  • Order free at-home tests to have when you need them. If you need more tests, check with your health insurance, Medicaid, or Medicare plan to learn what tests are available.
  • Know where free or low-cost testing locations are near you so you know where to go.
  • Know how to reach a healthcare provider right away, including after hours or weekends. Ask them about telehealth appointment options.
  • Have an updated list of all your current medications in case you need to see a different provider.


What to do if you were exposed to COVID-19

  • Determine if you should stay home.
  • Monitor your health for COVID-19 symptoms and get tested at least 5 days after you had close contact with someone with COVID-19, even if you don’t develop symptoms.
  • Wear a high quality mask for 10 full days any time you are around others inside your home or in public. Do not go to places where you are unable to wear a mask.

What to do if you have COVID-19 symptoms

  • Stay home.
  • Get tested right away. Use a self-test at home or find a testing location near you.

What to do if you test positive for COVID-19

Effective treatments are now widely available and free, and you may be eligible.

  • Contact your healthcare provider, health department, or Community Health Center to learn about treatment options. Don’t delay! Treatment must be started soon after you first develop symptoms to be effective.
  • If you don’t have timely access to a healthcare provider, check if a Test to Treat location is in your community. You can get tested, receive a prescription from a healthcare provider (either onsite or by telehealth), and have it filled all at one location.
  • Isolate until it’s safe to be around others. CDC recommends that you isolate for at least 10 and up to 20 days. Check with your healthcare provider to learn when you can be around others.
  • Monitor your symptoms. Call your healthcare provider if you develop symptoms that are severe or concerning to you. If you notice emergency warning signs, call 911 or call ahead to your local emergency facility.

Learn How to Get Treatment Quickly

If you test positive for COVID-19, oral antiviral and monoclonal antibody treatments are available for people who are more likely to get very sick. Learn more about COVID-19 treatment.

Don’t delay: Treatment must be started right away to be effective. Talk to your healthcare provider about what treatment options are best for you.

Antiviral treatments

Antiviral treatments may help your body fight COVID-19 by stopping the SARS-CoV-2 virus (the virus that causes COVID-19) from multiplying in your body or by lowering the amount of the virus within your body. You can get a prescription from your healthcare provider or a Test to Treat location. Oral antivirals can be taken at home and must be given within 5 days after the first symptoms of COVID-19 appear.

Monoclonal antibodies

Monoclonal antibodies can block the virus that causes COVID-19 from entering cells in your body, which can limit the amount of the virus within your body. These must be prescribed and administered by a healthcare provider within 7 days after first symptoms of COVID-19 appear.

Build Your Personal COVID-19 Plan

Make a COVID-19 plan now so you’re prepared. Consider the ways you will protect yourself and how to be prepared if you get sick with COVID-19. Include how you will adjust your plan if the COVID-19 situation changes in your community.

Your plan should include:

  1. What you’re doing to protect yourself and prepare (in case you get COVID)
  2. What you’ll do if you’re exposed or develop symptoms
  3. What you’ll do if you test positive

Talk with your family, friends, and healthcare provider about your plan

Share your COVID-19 plan with your family, friends, and healthcare providers so they can support your prevention and preparation steps. Consider how others may help you if you get sick and identify the supplies you may need. Be sure to stick to your treatment plans, your routine healthcare appointments, and have all your prescriptions filled. Plan for options for work, childcare, and other responsibilities that may cause stress if you were to become sick.

COVID-19 remains a major health concern and this can be stressful to manage. Understanding what you can do to protect yourself and what to do if you get sick can help minimize that stress. Take as many steps as you can to prevent COVID-19 and get treated quickly if you test positive for COVID-19.

 

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