COVID Vaccine Uptake Among Immunocompromised Individuals Is Low

A cohort study published in JAMA Network Open determined that COVID vaccine uptake among immunocompromised individuals was low, implying that many people did not adhere to the CDC guidelines. According to the study, only 41% of immunocompromised individuals had received four COVID vaccine doses — three doses in the primary series and a booster — as of August 2022. Additionally, less than 1% of immunocompromised people had gotten five doses by that time.

The publication explained that, in December 2020, the CDC began recommending a third dose of the mRNA vaccine for immunocompromised individuals, an extension of the typical two-dose primary series. Additional guidelines advocated for a monovalent mRNA booster in September 2021, stipulating that the booster should be six months after the primary series. Eventually, the CDC shortened the time between the primary series and the booster dose. Finally, in March 2022, the CDC recommended a second booster for immunocompromised individuals who had gotten their first booster at least four months prior.

To analyze how well this patient population adhered to these guidelines, the researchers used data from patients over 18 at Kaiser Permanente Southern California (KPSC) from December 14, 2020, to August 6, 2022. The study looked at over 40,000 patients of varying ages and genders.

The researchers determined that only 78% of patients in the study had received three doses of the mRNA COVID vaccine — three doses of the primary series. Additionally, only 41% of individuals had gotten the primary series and a booster. Finally, only 0.9% of people had received all the doses recommended by the CDC.

The clinicians also analyzed trends among different groups of immunocompromised patients.  they found that patients over 65 were nearly four times more likely to have gotten four or more of the recommended vaccine doses compared to other age groups. Additionally, Hispanic and Black adults were 23% and 18% less likely to have received the recommended doses of the vaccine, respectively, compared to White individuals.

The researchers concluded that “adherence to CDC mRNA monovalent COVID-19 booster dose recommendations among immunocompromised individuals was low. Given the increased risk for severe COVID-19 in this vulnerable population and the well-established additional protection afforded by booster doses, targeted and tailored efforts to ensure that immunocompromised individuals remain up to date with COVID-19 booster dose recommendations are warranted.”