Tips for immunocompromised people: Healthy habits, vaccines and more

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Your immune system is in charge of protecting you against harmful bacteria, viruses, toxins and other substances. However, not everyone has an immune system that is at full strength. If you are someone with a compromised immune system, your body has a harder time fighting illness. You might get infections more frequently than others. And, once you have an infection, you will likely have a harder time returning to health than people with typical immune systems.

How do you become immunocompromised?

There are many different ways people can become immunocompromised, including:

Congenital immune disorders (primary immunodeficiencies). Congenital immune disorders happen when people are born with a weak immune system. Their bodies may be missing some of the body’s immune defenses, or their immune system might not be working properly. Experts have identified more than 300 forms of primary immunodeficiency disorders. These are often hereditary.

Acquired immune deficiencies. When a diseaseyou encounter after birthweakens your immune system, you may develop an acquired immune deficiency. For example, a human immunodeficiency virus (HIV) infection can lead to acquired immune deficiency syndrome. Malnutrition, lymphoma and leukemia also can result in acquired immunodeficiencies.

Medications and treatments. Some medications and treatments weaken your immune system on purpose. For example, medical professionals use immunocompromising chemotherapy to treat cancer, immune modulating drugs to control autoimmune diseases and immunosuppressing drugs to prevent organ rejection in people following organ transplant.

Autoimmune diseases. When your body’s immune system attacks your own tissues and organs, you have an autoimmune disease. Examples of autoimmune diseases include rheumatoid arthritis, lupus, type 1 diabetes and inflammatory bowel disease.

According to Robert M. Jacobson, M.D., a pediatrician at Mayo Clinic, “Genetics appear to play a role in nearly every known autoimmune disease. In most diseases, more than one gene is involved.”

He adds, “It is clear that other factors affect whether a person will get an autoimmune disease. These include environmental factors. Triggers include infectious diseases. Autoimmune diseases themselves are not necessarily immunocompromising but their treatments often are.”

Bolster your compromised immune system with healthy habits

Most people who are immunocompromised have full, active lives. But, when you’re immunocompromised, it’s wise to take extra care to prevent infections from bacteria, toxins and viruses.

Experts suggest that you:

Stay away from people with colds or other infections.
Practice good hygiene — wash your hands with soap and water after being with others, before eating and after using the toilet.
Do not touch your eyes, mouth or nose without washing your hands first with soap and water.
Brush your teeth at least twice daily and floss daily.
Eat a healthy, balanced diet.
Stay hydrated.
Exercise and be physically active.
Get good sleep, have a regular sleep schedule and get the same number of hours of sleep every night.
Avoid crowds when possible.
Use a well-fitted mask over your mouth and nose when you are with others.

Get vaccinated (especially for flu, COVID-19, RSV and pneumococcal disease)

Vaccines are a critical tool for fighting viruses and infections. However, if you have a compromised immune system, it’s important to talk to your doctor about what vaccines are appropriate for your situation.

Inactivated vaccines vs. live vaccines

There are two main types of vaccines: inactivated and live vaccines.

Live vaccines. Using a weakened form of the germ that causes a disease, scientists produce fragments similar to the germ in order to produce “specific immunity” — when your immune system learns to recognize and fight off specific viruses or bacteria. This kind of vaccine prompts an immune response without causing disease. Live vaccines often need one or two doses to make long-lasting immunity without boosting. Live vaccines are used to protect against measles, mumps, rubella, rotavirus and chickenpox.

Inactivated vaccines. There are two types of inactivated vaccines to help the body prepare to fight viruses or infections. The first type uses isolated, purified and treated fragments of germs from each virus or infection. The other type of vaccine uses mRNA designed to get your body to make the proteins you need to generate immunity.

“With mRNA vaccines, the vaccine uses the body’s cellular machinery to make protein fragments temporarily,” says Dr. Jacobson. “The fragments trigger the immune response but cannot cause an infection.

Often inactivated vaccines need more than one dose to create immunity and sometimes requires regular boosting.”

Inactivated vaccines are used to prevent RSV, shingles, hepatitis B, polio, diphtheria, tetanus, pertussis, COVID, HPV, Hib, meningococcal infections, hepatitis A, pneumococcal infections and rabies.

Yearly respiratory virus vaccines

The CDC recommends that people who are immunocompromised get an annual:

Updated COVID-19 vaccine for everyone ages 6 months and older.
Flu vaccine for everyone 6 months of age and older.

Immunocompromised people will need more than one dose of the COVID vaccine as well as frequent boosters. Some individuals immunocompromised as a result of a solid organ transplant should receive a flu vaccine made for adults 65 years and older, even when they are as young as 19 years of age. Immunocompromised individuals should avoid the live attenuated influenza vaccine given by nasal spray.

Pneumococcal vaccinations

According to the CDC, pneumococcal infections that cause pneumonia, bloodstream infections (sepsis) and meningitis kill tens of thousands of people in the United States every year. Vaccines help prevent pneumococcal disease.

There are several kinds ofpneumococcal vaccine. The vaccine that’s best for your circumstances depends on your age and risk factors and past pneumococcal vaccines received.

People who are advised to get pneumococcal vaccines include:

All children younger than 5 years old.
Children 5 through 18 years old with certain risk conditions.
All adults 50 years or older.
Adults 19 through 49 years old with certain risk conditions.

Learn more about why you should get pneumococcal vaccinations.

Additional vaccines suggested for immunocompromised people

Additional vaccines you may need include:

Shingles vaccine. Shingles vaccination protects you against shingles and related complications. The vaccine is given as a two-dose series to all people 50 and older. People who are 19 and older who are immunocompromised are recommended to get the vaccine as soon as possible.
Hib vaccine. This vaccine is designed to help people avoid severe, lifethreatening infections caused by the Hib bacteria. It’s recommended for adults with certain immunocompromising conditions who have not previously completed the Hib series as a child. Conditions include functional or anatomic asplenia, anticipation of a splenectomy, human immunodeficiency virus (HIV) infection, immunoglobulin deficiency (including immunoglobulin G2 subclass deficiency), early component complement deficiency, recipients of a hematopoietic stem cell transplant, and those receiving chemotherapy or radiation therapy for cancer.
Meningococcal ACWY vaccine. This vaccine is for immunocompromised individuals at increased risk of a meningococcal disease. This includes people with medical conditions such as anatomic or functional asplenia, certain complement component deficiencies, HIV infection, or people taking acomplement inhibitor such as eculizumab (Soliris) or ravulizumab (Ultomiris).
Meningococcal B vaccine. This vaccine is for individuals at increased risk for anatomic or functional asplenia, complement component deficiencies, or complement inhibitor use.

Make mental health a priority

When you’re immunocompromised, you need to focus on your mental and physical health. It’s normal for people with chronic diseases to have feelings like anger, fear, sadness and stress.

After all, it’s no fun when you have to deal with:

Health flare-ups.
Missing events you want to attend.
Explaining your disease to others.
Dealing with medical routines and appointments.

You don’t have to do this alone. Consider:

Finding a support group.
Doing yoga or meditation.
Making time for your friends and hobbies.
Volunteering in your community.
Keeping a journal.

Other behaviors practiced every day also can improve your mood and reduce your anxiety. Make these important habits stick:

Get 8 to 9 hours of sleep every night.
Keep a regular bedtime and awakening time.
Get dressed for the day.
Get regular daily doses of sunshine.
Get regular aerobic exercise.
Stay hydrated throughout the day, drinking and eating enough that you are urinating every two hours during the waking day.
Eat three regular meals at the usual times every day.

If you feel depressed or have significant anxiety, seek the help of a mental health professional.