6.2. Risks in Immunocompromised Vaccinated PeopleĀ
The vaccines that are currently available have either not been tested in
immunocompromised individuals during phase 3 trials, or there is very
limited information about such cases. As per CDC (Centres for Disease
Control and Prevention) guidelines, immunocompromised patients involve
patients with solid tumor and hematologic malignancies, solid organ
transplant, hematopoietic stem cell transplant, moderate or primary
immunodeficiency, and patients receiving high dose corticosteroids,
chemotherapy, and immunosuppressants. Immunocompromised people are at a
higher risk of experiencing severe COVID-19 symptoms and even after
receiving a vaccination, they might not achieve the same level of
protection from the infection as immunocompetent people. There are
increasing concerns that in patients who have received an organ
transplant and are thus immunocompromised due to the immunosuppressants
administered to them, allograft rejection could occur following the
administration of COVID-19 vaccination due to the sudden increase in the
immune response that can act against the allograft. For patients who are
administered immune checkpoint inhibitors, there is a risk of
immune-related adverse effects due to unintentional activation of the
immune system following the vaccination .In addition, patients who have
undergone hematopoietic stem cell transplants represent a tricky group
of people because administering the vaccine to them essentially requires
the health care provider to balance the risk of a severe COVID-19
infection due to an immunocompromised state against the chances of a
poor vaccine response. Inactivated vaccines are recommended and live
vaccines are generally not advised and the consequences depend on the
type of vaccine, age of the patient, and the time of the infection.
Therefore, it is important to plan the vaccination of immunosuppressed
patients to avoid drastic consequences and to maximize seroprotection.