Can Fully Vaccinated People With Weakened Immune Systems Stop Wearing Masks?

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The COVID-19 vaccines have been shown to be very effective at preventing infection and serious illness from COVID-19. Because of this, the Centers for Disease Control and Prevention (CDC) recently said that those who are fully vaccinated against COVID-19 no longer have to physically distance and wear a mask (except where required by laws, rules and regulations, such as in workplaces, in a healthcare setting, and while taking public transportation).

But what about people who are fully vaccinated against COVID-19 but have a weakened immune system due to cancer treatment, an autoimmune disease or an organ transplant? Can they, too, adhere to these rolled-back restrictions?

“Because immunocompromised patients have weakened immune systems, they mount a lower immune response to a vaccine as compared to healthy people,” says Mayur Ramesh, M.D., an infectious disease specialist who works with cancer and transplant patients. “We don’t know exactly how effective the COVID-19 vaccines are in immunocompromised people, which means they should adhere to strict precautions even if they’re fully vaccinated.”

How Immunocompromised Patients Can Stay Safe

Whether or not there’s a pandemic, immunocompromised patients are advised to wear masks, social distance and practice frequent hand hygiene. They are at a higher risk level of a severe outcome, should they contract any illness.

And with COVID-19, specifically, until the majority of the population is vaccinated, they should follow protocols such as:

  • Wearing a mask in public and around anyone who is not fully vaccinated.
  • Maintaining at least six feet of distance while in public or when around those who are not fully vaccinated.
  • Practicing frequent hand hygiene.
  • Ensuring that their household members and caregivers get vaccinated as soon as possible to help keep them safe. 
  • Getting themselves vaccinated as soon as possible.

While some wonder whether having their antibody levels checked after vaccination could measure their level of protection against COVID-19, Dr. Ramesh cautions that this isn’t necessarily an effective tool. “Even in people who aren’t immunocompromised, antibody levels wane with time, but they’re still protected,” he says.

And just because immunocompromised patients might mount a lower immune response, it doesn’t mean that the COVID-19 vaccines won’t be effective. “No matter the effectiveness, vaccination will make symptoms less severe, should they catch COVID-19,” says Dr. Ramesh.

Booster doses and combined vaccines are currently being studied by researchers around the country to see whether they can boost someone’s immune response and protect against COVID-19 variants.

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Mayur Ramesh, M.D., is a physician specializing in infectious diseases in transplant and cancer patients. He sees patients at Henry Ford Hospital in Detroit.

Categories: FeelWell