Fully vaccinated but immunocompromised: What’s safe for you to do?

The Centers for Disease Control and Prevention’s (CDC) recent announcement that those who’ve been fully vaccinated against COVID-19 no longer need wear a mask in most situations was welcome news to many people. Finally, they could start doing more of the things they used to, stop dealing with “maskne” and get one step closer to pre-pandemic life.

But if you’re still in active treatment for cancer, or you’re immunocompromised due to a previous cancer diagnosis or treatment, you might be confused. Do the CDC’s updated guidelines apply to you? If so, which activities can you safely resume? And are there any that you shouldn’t engage in yet?

We asked Chief Infection Control Officer Roy Chemaly, M.D., for clarification.

If I’m immunocompromised, but fully vaccinated, am I protected against COVID-19?

Not necessarily. What we know so far is that the COVID-19 vaccines work very nicely in regular patient populations. But immunocompromised patients don’t respond nearly as well. And highly compromised individuals may not mount any immune response.

So, if you fall into either of those last two categories, you could still get COVID-19 – and possibly even a severe case of it. In fact, we’re seeing cancer patients being admitted to the hospital right now with active COVID-19 infections – and some after having been fully vaccinated.

So, do the new guidelines change anything at all for immunocompromised individuals?

Right now, I’d say not much. Any time you have a high transmission rate of any contagious disease in the community, you need to take the same precautions immunocompromised patients have always taken – even before the pandemic. That includes washing your hands frequently, wearing a mask in public, avoiding large crowds or anyone who is sick, and social distancing.

The one exception might be gatherings of any size, if you can be sure that everyone present is fully vaccinated. Even fully vaccinated people can still contract the coronavirus and transmit it, so there are no guarantees that you won’t get COVID-19. But the risk is still greatly reduced among fully vaccinated people with healthy immune systems, so your risk would be much lower, under those circumstances.

If you can’t be sure of a group’s vaccination status, it’s safest to assume no one around you is vaccinated, and act accordingly. Wear a mask, keep your distance, and wash your hands.

When do you think things might change for the immunocompromised?

Roughly half the adult population in Texas and 60% of all Americans have now been at least partially vaccinated against COVID-19, so based on the CDC’s predictions, there may be minimal transmission by the end of this summer.

If that’s the case, then things could well be less restrictive in the future. And immunocompromised people could go back to wearing masks mainly during the winter season, when colds, the flu, and other viruses are more common, or whenever they’re directed to do so by their care teams.

What if I’ve been vaccinated but I have an immunocompromised loved one living with me? What COVID-19 precautions do I need to take?

You’ll still need to be cautious in public, because not everyone in the community is vaccinated yet. But if you don’t bring unvaccinated people into your home and you don’t take your immunocompromised loved ones out in public without wearing a mask, then the risk to both you and to them is fairly low.

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