Immunocompromised patients remain frightened and frustrated that vaccines aren’t offering enough protection as everyone else moves on. Scientists are racing to figure out what will work
Janet Handal was feeling optimistic when she booked her flight to Texas in early 2021. The 71-year-old New York City resident had just scheduled her first COVID-19 vaccine appointment amid news that the mRNA vaccines available in the U.S. were highly effective. She carefully counted the days until she would be safe to travel, eager to see family for the first time in over 18 months.
Handal is among the estimated 10 million people in the U.S. with a compromised immune system. Unlike everyone else, they mount a much weaker immune response to several vaccines. But when pharmaceutical companies first began testing COVID-19 vaccines in 2020 and 2021, the clinical trials excluded immunocompromised individuals and issued the same vaccination recommendations for them without conducting separate trials.
Even now it remains unclear whether more vaccine doses will help protect the severely immunocompromised. The U.S. Food and Drug Administrationfor certain immunocompromised people. Some transplant recipients have since been vaccinated with a fourth shot and a smaller subset have secured a fifth dose. But Kumar says more may not always be better, and additional studies are needed to prove that further doses are effective.
Without robust protection from two shots, Handal knew her weak immune system meant greater chances of severe disease or death from exposure to the SARS-CoV-2 virus. So she and some others like her got a third COVID-19 shot—well before the FDA authorized its use. But not all immunocompromised people did, making things tricky in May 2021 as the Centers for Disease Control and Prevention was saying “no masks for the fully vaccinated.
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