As most of us “go back to normal” regarding the pandemic, millions of people feel left behind. This group consists of people with immunocompromising conditions, which leaves them unsure whether their COVID-19 vaccinations will protect them from severe disease.

Unfortunately, many of these people are unaware there’s now a treatment, Evusheld, that can protect and allow them to lead more normal lives.

Many conditions weaken the immune response leaving people immunocompromised. They include genetic defects in the immune system, cancers treated with chemotherapy or radiation, advanced HIV or AIDS and autoimmune disorders — those where the body attacks itself— such as psoriasis or inflammatory bowel disease when treated with medications that dampen inflammation.

Also, people who’ve had an organ transplant usually require medications that suppress the immune system to prevent rejection.

Immunocompromised people are at high risk for severe COVID-19 illness because their immune system has difficulty fighting the virus. At the same time, the alterations in their immune system may reduce their response to vaccination, increasing their vulnerability.

In contrast, individuals with high-risk conditions for serious COVID-19 such as obesity, diabetes and high blood pressure but with normal immune systems are well protected from severe disease by vaccination.

Evusheld consists of two monoclonal antibodies against COVID-19. It’s given by injection in the office setting every six months. It’s considered a “passive immunization” in that the protection doesn’t depend on the immune system responding to a vaccine. Not surprisingly, protection begins right after injection because it doesn’t depend on the immune system to ramp up.

While most immunizations we receive are “active,” passive immunization has been used for decades to protect high-risk individuals from diseases like hepatitis A, measles and chickenpox. A clinical trial found that Evusheld reduced the risk of symptomatic COVID-19 by 80 percent and was 100 percent effective in preventing death.

There are no Food and Drug Administration licensed tests to see whether a person is protected from COVID-19 following infection or vaccination. Antibody levels aren’t foolproof in predicting the level of protection. Because of this, Evusheld should be given to all moderately and severely immunocompromised individuals ages 12 years and older, who weigh more than 88 pounds.

It can also be used with individuals with a contraindication to vaccination. For the most part, the only contraindication to COVID-19 vaccination is a severe allergic reaction to a previous dose. Importantly, Evusheld isn’t a treatment for this infection and isn’t licensed for use following recent exposure to COVID-19.

Immunocompromised individuals receiving Evusheld should still be current with their COVID-19 vaccinations, including boosters. It’s likely that vaccination still has a positive effect even in immunocompromised individuals as it likely activates some additional protective factors.

Many health care professionals are still unfamiliar with Evusheld and its indications. Readers who feel they may benefit from Evusheld should seek the advice of a health care professional who works within a facility that administers this lifesaving medication.

Vaccine Smarts is written by Sealy Institute for Vaccine Sciences faculty members Drs. Megan Berman, an associate professor of internal medicine, and Richard Rupp, a professor of pediatrics at the University of Texas Medical Branch. For questions about vaccines, email


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