Being Immunocompromised: What Does it Mean?
Published: 23 March 2023
Published: 23 March 2023
People who are immunocompromised are affected more frequently and severely by infections.
The term immunocompromised (or immunosuppressed) refers to people who have an ‘immunodeficiency’ or weakened immune system, meaning their ability to fight infections and diseases is reduced (NCI 2018).
There are two types of immunodeficiency:
(Mayo Clinic 2022; British Society for Immunology 2017)
Primary immunodeficiencies comprise over 400 disorders that are caused by defects in the immune system. They cause the immune system to function less efficiently than normal, potentially causing complications. These disorders are often inherited (ASCIA 2021).
Primary immunodeficiencies may be mild and evade detection for years, or they may be severe enough to be noticed right at birth (Mayo Clinic 2022).
They fall broadly into one of the following six categories:
(ASCIA 2021; Fernandez 2023a; ASCIA Immunodeficiency Strategy 2021)
Secondary immunodeficiencies are more common than primary immunodeficiencies. They are acquired after the immune system is weakened by an external factor (Primary Immunodeficiency UK 2017). These causes may include:
(British Society for Immunology 2017; Fernandez 2023b)
Secondary immunodeficiencies may also affect critically ill, older or hospitalised people (Fernandez 2023).
Currently, the only known risk factor for primary immunodeficiency is having a family history of a primary immunodeficiency disorder (Mayo Clinic 2022).
(Mayo Clinic 2022)
Symptoms and effects may vary depending on the type of immunodeficiency. They can include:
(Mayo Clinic 2022; HIVinfo 2021; ASCIA 2021)
Additionally, those who are immunocompromised are more at risk of illness and death from some vaccine-preventable illnesses (AIH 2023).
(Mayo Clinic 2022; Canadian Paediatric Society 2019)
Vaccination for people who are immunocompromised is challenging (AIH 2023).
Immunocompromised people are at increased risk of serious illness or death from certain vaccine-preventable illnesses. There are certain vaccines that are routinely recommened for immunocompromised people, and in some cases, they may require additional vaccine doses (AIH 2023).
However, live vaccines are often contraindicated in immunocompromised people due to the risk of adverse effects (AIH 2023).
The decision on whether to administer vaccines to an immunocompromised person should be made based on a thorough, individualised risk assessment and recommendations from the Australian Immunisation Handbook (2023).
Please note that immunodeficiency treatment will differ depending on many factors, including the type of immunodeficiency, the individual and the treatment options available.
Primary immunodeficiency disorders can be treated in several ways:
(Mayo Clinic 2022)
Secondary immunodeficiencies can potentially be resolved if the underlying condition is treated (Primary Immunodeficiency UK 2017).
Question 1 of 3
True or false: Secondary immunodeficiencies are acquired from environmental factors.