I am immunocompromised, and the vaccine may not keep me safe. As the country reopens and mask mandates lift, millions of people like me feel scared and abandoned.

·6 min read
A crowd of people wearing masks are in various lines at a bus station.
Commuters line up at a transport hub wearing masks. In the US, mask mandates are lifting as more people get vaccinated, leaving those with weakened immune systems behind. Gustavo Minas/Getty Images
  • Research indicates the COVID-19 vaccines do not work well for many immunocompromised people.

  • As mask mandates lift, people who are immunocompromised are feeling scared and left behind.

  • There are steps that businesses, health officials, and the CDC need to take to keep us safe.

  • Kathryn Mayer is a Denver-based writer and editor.

  • This is an opinion column. The thoughts expressed are those of the author.

  • See more stories on Insider's business page.

The vaccines are here, businesses are reopening, and now the Centers for Disease Control and Prevention (CDC) says vaccinated people don't have to wear masks in public places. All of this messaging shouts: The pandemic is over! It's safe for vaccinated people! Let's move on with our lives without precaution!

But all this premature optimism and jubilation is leaving out one important group: immunocompromised individuals who suffer weakened immune systems and are among the most vulnerable to serious illness and death from COVID-19.

Worse yet, emerging research indicates that COVID-19 vaccines may not be as effective for immunosuppressed patients - for many people in this group, the vaccines do not produce much, if any, immune response against the virus - leaving many of them just as vulnerable as if they hadn't been vaccinated.

This is an important finding in part because the group is not insignificant in numbers: About 10 million people in the US are immunocompromised, typically because of organ transplants or illnesses like cancer and autoimmune diseases, as well as the immune-suppressing medications many use to help treat these conditions.

I'm one of them - I have two autoimmune diseases in which my body attacks healthy tissue and cartilage, and more broadly wreaks havoc on my system. To help treat these illnesses, I take immune-suppressing drugs that in turn make me even more vulnerable and prone to long-lasting viruses, infections, and other illnesses.

Like many others in my shoes, I've already felt left behind in many respects over the past year. Since last March, I've done my due diligence and followed all the recommendations, rules, and guidelines, including forgoing travel, visiting restaurants, and visits from family and friends - even as those around me gave up one precaution after another, lured by vacations, indoor holiday gatherings, and crowded bars and restaurants.

But the latest guidance from the CDC allowing vaccinated people to shed their masks in indoor, public places - and worse yet, essentially allowing unvaccinated people to remove masks in public as well since businesses typically do not require proof of inoculation - has made individuals like me feel even more left behind, anxious, and forgotten. I'm vaccinated, but it's not clear what kind of protection that provides for me. (Immunocompromised individuals were excluded from the vaccine trials, but a new study is now underway from the National Institutes of Health).

The things I've been looking forward to doing once I was vaccinated now seem far out of reach, knowing the extra precaution of masks is no longer required. Yes, I can and will wear one, but being around scores of maskless people is a risk too many immunocompromised people can't take. After a year of "we're all in this together" and "let's keep each other safe," people are now rushing to take off their masks without thinking of those who still need to be protected. It's not as simple as vaccinated or unvaccinated - there's a murky middle camp of chronically ill patients who are inoculated, but who simply don't have the normal defenses that allow the vaccines to work.

President Biden said recently that the new mask guidance means the unvaccinated "will end up paying the price," but he's wrong - he's leaving out the vulnerable immunocompromised community. It's a real punch in the gut for these people after an especially challenging and frightening year.

How to keep immunocompromised people safe

Despite these failings, there are steps that health officials, government, and businesses can take to make me and the 10 million others like me feel more safe and seen in this phase of the pandemic.

First of all, both public health officials and businesses should not rush to take away every precaution. Although this seems simple enough, it's worth saying. Don't take away every precaution and health and safety protocol that makes us feel ever-so-slightly more safe. If people can go maskless, don't take away precautions like capacity limits and alternate options like virtual events and curbside pickup until vaccination rates are significantly higher and research has been conducted on vaccine efficacy for immunocompromised individuals.

For companies that want to return workers to the office - and plan to forgo mask mandates - allow your immunocompromised workers to continue to work from home.

Another suggestion is for the government to consider a widespread vaccination passport policy. I know, I know: No one can agree on this. But relying on the honor system to keep public spaces safe is not going to cut it. Chronically ill people, who for years have gotten extremely ill from being around sick people, no longer trust others to keep us healthy - especially during a pandemic.

Remember at the beginning of the pandemic when there were special hours at stores for elderly and immunocompromised people (because at one point, we mattered)? I'd love to see this return for grocery stores and other businesses. For places that are following the updated CDC guidance and allowing people to go maskless, offering a mask-mandated hour for chronically ill and immunocompromised individuals - or just anyone who feels safer wearing a mask - will help keep us safe.

Certain types of businesses that make appointments in advance - hair salons or financial institutions, for instance - should make it a policy to ask customers their mask preference during the booking process.

The CDC should update health guidance to inform the public about immunocompromised risks and how people can help. When the CDC released its new mask guidance, it included a line addressed to immunocompromised people, telling them they are still vulnerable and to "be aware of the potential for reduced immune responses to the vaccine, as well as the need to continue following current guidance to protect themselves against COVID-19" - um, thanks?. But besides the "you're on your own!" message, it did not inform the public about what risks they pose to this vulnerable group of people or what they can do to help. This needs to be rectified.

Most importantly, I urge the CDC and health officials to share information about the continued risks for vaccinated immunocompromised people to the general public, so people are aware of this underreported issue and understand that they can help keep this group safe by continuing to wear masks (even though they are not required to). I would also urge the CDC to update their mask guidance to tell the public that those who continue to wear masks, especially in public places or in circumstances where they might be in contact with an immunocompromised person, will help protect this vulnerable population.

It may be too late to reverse the mask guidance, but it's not too late to do the right thing to help keep millions of people like me safe. Our lives might actually depend on it.

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