Carolyn,* Age 65

Living with Non‑Hodgkin Lymphoma *Actor Portrayals

For Your Immunocompromised Patients Expand Their COVID‑19 Prevention Options

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A COVID‑19 protection gap may exist for immunocompromised people, compared with that of immunocompetent people1-3

Immunocompromised people may be at increased risk for severe COVID-19-related outcomes, including intensive care unit admission and death, regardless of vaccination status4

In a study, nearly 20% of solid organ transplant recipients and patients with rare autoimmune diseases or hematologic malignancies did not demonstrate detectable antibodies against COVID-19, despite vaccination2

Immunocompromised people may be at increased risk for prolonged, symptomatic COVID-19 (“long COVID”)5,6

Immunocompromised patients can be vulnerable to severe COVID-19 outcomes, as they may demonstrate reduced response to vaccines1,2,6

Immunocompromised Patients

Between 8 and 18 million people in the United States are considered immunocompromised and at risk for developing severe COVID-197-9

As defined by the CDC, moderately to severely immunocompromised conditions include6:

  • Solid organ, stem cell, and islet transplant recipients
  • Chimeric antigen receptor (CAR) T-cell therapy recipients
  • Active treatment for solid tumor or hematologic malignancies
  • Moderate or severe primary immunodeficiency
  • Advanced or untreated HIV infection
  • Active immunosuppressive treatment, such as high-dose corticosteroids, transplant-related immunosuppressives, immunomodulating biologic agents, TNF blockers
Carolyn

Carolyn,*
age 65

Patient With Non-Hodgkin Lymphoma10

Married, and grandmother to 3 preschool-age children. Frequently visits friends…

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Luke

Luke,*
age 17

Patient With Heart Transplant11

Current high school student and varsity tennis player. Also enjoys playing the guitar…

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Maria

Maria,*
age 50

Patient With Allogeneic Hematopoientic Stem Cell Transplant12

Widow with 4 children, currently working…

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*Not actual patients

Expand Their COVID‑19 Prevention Options

Prevention Strategies3,6

Encourage exercising extra precautions (using high-quality masks and practicing good hand hygiene)

Stay up to date with COVID-19 vaccination

Learn about multilayered prevention options

Exploring a Multilayered Approach to COVID‑19 Prevention in Immunocompromised People

Vaccine14

Exposes the body to weakened or inactive components of an antigen to trigger an immune response

Primes the body to recognize and fight infections

Requires time to build long-term immunity

A multilayered COVID-19 prevention approach for immunocompromised people is suggested given their increased odds for severe outcomes from infection4

Monoclonal
Antibody13,15

Molecule designed to mimic or augment the natural immune response

Targets specific viral proteins, neutralizing or tagging them for removal

May offer immediate protection, yet the duration of potential effectiveness may vary

What confers protective immunity against COVID-19?

Immunity to COVID-19 may be achieved through the presence of disease-specific antibodies. There are 2 types of immunity – active and passive.16

Types of Active Immunity

Natural
Infection

Antibodies made by host after exposure to an infection

Artificial
Vaccination

Antibodies made by host after getting a vaccination

Types of Passive Immunity

Natural
Maternal

Antibodies transmitted from mother to baby

Artificial
Antibody Therapies

Antibodies acquired from a medicine

Resources

COVID-19 Resources

Links provided lead to external websites and are provided as a courtesy for informational purposes only.

ACIP, Advisory Committee on Immunization Practices; CDC, Centers for Disease Control and Prevention; COVID-19, coronavirus disease 2019; TNF, tumor necrosis factor

References:

  1. Patel P, Twentyman E, Koumans E, et al. Information for persons who are immunocompromised regarding prevention and treatment of SARS-CoV-2 infection in the context of currently circulating omicron sublineages — United States, January 2023. MMWR Morb Mortal Wkly Rep. 2023;72:128-131.
  2. Pearce FA, Lim SH, Bythell M, et al. Antibody prevalence after three or more COVID-19 vaccine doses in individuals who are immunosuppressed in the UK: a cross-sectional study from MELODY. Lancet Rheumatol. 2023;5:e461-e473.
  3. US Centers for Medicare & Medicaid Services. COVID-19 monoclonal antibodies. Accessed November 30, 2023. https://www.cms.gov/monoclonal
  4. Singson JRC, Kirley PD, Pham H, et al. Factors associated with severe outcomes among immunocompromised adults hospitalized for COVID-19 — COVID-NET, 10 states, March 2020–February 2022. MMWR Morb Mortal Wkly Rep. 2022;71(27):878-884.
  5. National Institutes of Health. Special considerations in people who are immunocompromised. Accessed November 30, 2023. https://www.covid19treatmentguidelines.nih.gov/special-populations/immunocompromised/
  6. Centers for Disease Control and Prevention. People who are immunocompromised. Accessed November 30, 2023. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-who-are-immunocompromised.html
  7. Patel M, Chen J, Kim S, et al. Analysis of MarketScan data for immunosuppressive conditions and hospitalizations for acute respiratory illness, United States. Emerg Infect Dis. 2020;26(8):1720-1730.
  8. Harpaz R, Dahl RM, Dooling KL. Prevalence of immunosuppression among US adults, 2013. JAMA. 2016;316(23):2547-2548. 
  9. United States Census Bureau. Quick Facts United States. Accessed January 31, 2024. https://www.census.gov/quickfacts/fact/table/US/AGE295222
  10. National Comprehensive Cancer Network Guidelines. B-Cell Lymphomas. Accessed February 14, 2024. https://www.nccn.org/professionals/physician_gls/pdf/b-cell.pdf  
  11. Nelson J, Alvey N, Bowman L, et al. Consensus recommendations for use of maintenance immunosuppression in solid organ transplantation: Endorsed by the American College of Clinical Pharmacy, American Society of Transplantation, and the International Society for Heart and Lung Transplantation. Pharmacotherapy. 2022;42(8):599-633.
  12. National Comprehensive Cancer Network Guidelines. Acute Myeloid Leukemia. Accessed February 14, 2024. https://www.nccn.org/professionals/physician_gls/pdf/aml.pdf
  13. Chary M, Barbuto AF, Izadmehr S, Tarsillo M, Fleischer E, Burns MM. COVID-19 Therapeutics: use, mechanism of action, and toxicity (vaccines, monoclonal antibodies, and immunotherapeutics). J Med Toxicol. 2023;19(2):205-218.
  14. Centers for Disease Control and Prevention. Understanding how vaccines work. Accessed March 8, 2024. https://www.cdc.gov/vaccines/hcp/conversations/understanding-vacc-work.html
  15. Lloyd EC, Gandhi TN, Petty LA. Monoclonal antibodies for COVID-19. JAMA. 2021;325(10):1015.
  16. Centers for Disease Control and Prevention. immunity types. Accessed March 8, 2024. https://www.cdc.gov/vaccines/vac-gen/immunity-types.htm

Carolyn,* age 65

Patient With Non-Hodgkin Lymphoma10

  • Married, and grandmother to three pre-school-aged children. Frequently visits friends and is an active member of a book club
  • Diagnosed with stage II diffuse large B-cell lymphoma (a type of Non-Hodgkin Lymphoma) approximately 3 months ago
  • Recently completed 2 of 3 cycles of R-CHOP treatment regimen; restaging of DLBCL to be completed after cycle 310

R-CHOP, rituximab-cyclophosphamide-doxorubicin-vincristine- prednisone; DLBCL, diffuse large B cell lymphoma

*Not an actual patient

Luke,* age 17

Patient With Heart Transplant11

  • Current high school student and varsity tennis player. Also enjoys playing the guitar and going to concerts
  • Diagnosed with hypoplastic left heart syndrome and underwent Fontan procedure at age 2 years. Underwent orthotopic heart transplant approximately 1 year ago due to Fontan failure
  • Currently on a steady tacrolimus and mycophenolate dosage, and fully tapered off prednisone11

*Not an actual patient

Maria,* age 50

Patient With Allogeneic Hematopoientic Stem Cell Transplant12

  • Widow with four children, currently working as a Human Resources Specialist. Enjoys playing pickleball with friends and spending time with family
  • Diagnosed with acute myeloid leukemia (AML) approximately 4 months ago
  • Achieved complete remission after induction therapy with 7+3 (cytarabine and daunorubicin) regimen; consolidation treatment ongoing with 2 of 4 HiDAC cycles completed as bridge to allogeneic hematopoietic stem cell transplantation12

HiDAC, high-dose cytarabine

*Not an actual patient