Underlying Medical Conditions

People with underlying health conditions who are at risk for severe outcomes from COVID-19 include:

  • Solid organ transplant recipients,
  • individuals with specific cancers
    • who are undergoing active chemotherapy
    • people with lung cancer who are undergoing radical radiotherapy
    • people with cancers of the blood or bone marrow such as leukemia, lymphoma or myeloma who are at any stage of treatment
    • people having immunotherapy or other continuing antibody treatments for cancer
    • people having other targeted cancer treatments that can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
    • people who have had bone marrow or stem cell transplants in the last six months or who are still taking immunosuppression drugs,
  • people with severe respiratory conditions, including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD)
  • people with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell disease)
  • people on immunosuppression therapies sufficient to significantly increase risk of infection (biologic modifiers, high dose steroids, AZT, cyclophosphamide)
  • people who had their spleen removed
  • adults with very significant developmental disabilities (such as Down’s Syndrome) that increase risk
  • adults on dialysis or with chronic kidney disease (stage 5)
  • women who are pregnant with significant heart disease, congenital or acquired,
  • significant neuromuscular conditions requiring respiratory support

Who is considered immune compromised?

Examples of immunocompromised or immunosuppressed individuals include

  • receipt of treatment for solid tumors and hematologic malignancies (including individuals with lymphoid malignancies who are being monitored without active treatment),
  • receipt of solid-organ transplant and taking immunosuppressive therapy,
  • receipt of chimeric antigen receptor (CAR)-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy),
  • moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome, common variable immunodeficiency, Good’s syndrome, hyper IgE syndrome),
  • advanced or untreated HIV infection, and/or
  • active treatment with high-dose corticosteroids (i.e., ≥20 mg prednisone or equivalent per day when administered for ≥2 weeks), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis factor (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory.
Published date: 
June 28, 2023