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Researchers say COVID-19 vaccines are safe for immunocompromised people. Ariel Skelley/Getty Images
  • Researchers say the Pfizer and Moderna COVID-19 vaccines are safe for people with compromised immune systems.
  • They say the two mRNA-based vaccines produced relatively few side effects in people who are immunocompromised.
  • Experts encourage people with compromised immune systems to get their full allotment of COVID-19 vaccines.
  • They add that family and friends of those who are at high risk should also be fully vaccinated.

Pfizer and Moderna COVID-19 vaccines are well tolerated by people with impaired immunity.

A new study concludes that the two mRNA-based vaccines produced relatively few side effects in people who are immunocompromised due to cancers, rheumatological, or neurological conditions.

“Strikingly, we found that the occurrence of adverse events in these high-risk patients is comparable to that reported in vaccine trials conducted in the general population,” said Nicola Silvestris, PhD, a senior author of the study and a researcher at the University of Bari Aldo Moro, Italy, in a press release.

“Our patients did not show a higher incidence of severe adverse events and we did not see an increased risk of discontinuation of treatment programs due to vaccination,” Silvestris added. “Therefore, vaccination for COVID-19 is confirmed as safe, even in this group of high-risk patients.”

Dr. Dean Blumberg, the chief of pediatric infectious diseases at the University of California Davis, says while the results aren’t surprising, the research still provides positive news.

“It’s an expected result, but it’s always reassuring to have the data because we’ve been surprised so many times during this pandemic when things didn’t turn out as expected,” Blumberg told Healthline.

“With most vaccines, people who are immunocompromised have similar reactions, compared to those who are immune-competent for vaccines which are non-live,” he said. “And, of course, the mRNA vaccines are not live vaccines… so they would be expected to have a similar side effects profile in immune-compromised compared to immune-competent populations.”

People who are immunocompromised are at higher risk of complications due to COVID-19, but those in this category may also be concerned about vaccine side effects.

Dr. William Schaffner, an infectious disease expert at Vanderbilt University in Tennessee, says it’s been understandable that some people who are immunocompromised may feel hesitant about getting the COVID-19 vaccine.

“It is quite an appropriate concern,” Schaffner told Healthline. “For example, there are organ transplant recipients who receive immune suppressive medications, and they are concerned that a substantial immunological stimulus, such as a vaccine, might… initiate a reaction that would reject the graft, the transplant.”

“No evidence for that exists,” he said. “It was a concern among the professionals as well as patients who received it. But all the data indicate, very fortunately, that that’s not the case.”

The efficacy of the COVID-19 vaccine varies considerably among people who are immunocompromised, and Blumberg says this is made all the more complicated by variants and sub-variants.

“We already know that… the vaccines don’t protect as well against Omicron compared to Delta,” he said. “This would be exaggerated in an immune-compromised population.”

“Then when we get the sub-variants of Omicron, the BA.2 sub-variant, this appears to be even more infectious,” Blumberg added. “This provides an additional risk for those who are immune-compromised and really emphasizes the need for an adequate immune response.”

The Centers for Disease Control and Prevention advise that anyone 12 years or older who’s moderately or severely immunocompromised should receive four doses of the COVID-19 vaccination.

Three of these doses are given as primary doses, and the fourth is given as a booster at least 3 months after the third shot.

Children ages 5 to 11 who are immunocompromised should receive three primary doses of the Pfizer vaccine. The second dose should take place 21 days after the first dose, and the third dose should be given 28 days after the second dose.

Schaffner says these additional doses are important in keeping immunocompromised people safe, but those around immunocompromised people also have an important role to play.

“Immunocompromised people clearly are at increased risk of more severe disease,” he said. “Therefore, this attention we devote to them is completely justified. The recommendation continues to be that not only should the immunocompromised person be vaccinated, but everyone around them should be vaccinated to create what has been called a cocoon of protection around that person.”

“In other words, it just makes it harder for the COVID virus to get through all those people well protected… to actually get through and infect the person at greatest risk,” he added.