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Table. Examples of severely immunocompromising conditions (Ref 10-26) for which additional doses of COVID-19 vaccine are recommended or can be considered

The example conditions and therapies listed are not exhaustive, and providers may include conditions or therapies similar to those below based on clinical judgement.

Condition Example conditions or treatments
Haematological malignancies (untreated, during or < 6months after therapy completion) leukaemia, lymphoma, other lymphoproliferative disorder, plasma cell dyscrasia
Malignancy, solid organ transplantation, autoimmune, and inflammatory conditions currently treated with:
  • haematopoietic stem cell transplant or CAR-T therapy within the last 24 months
  • solid organ transplant within the last 12 months
  • conventional chemotherapy
  • conventional immunosuppressive agent at significant doses, e.g.: 
    • prednisone ≥20mg/day (≥2mg/kg/day for children) for ≥14 days in a month
    • methotrexate >25 mg/week
    • azathioprine >3 mg/kg/day 
    • 6-mercaptopurine >1.5mg/kg/day
    • mycophenolate
    • tacrolimus and other systemic calcineurin inhibitors
    • sirolimus and other mTOR inhibitors
    • cyclophosphamide
  • rituximab or other B-cell, and T-cell, targeted monoclonal antibody
  • monotherapy with infliximab or other anti-TNF alpha monoclonal antibody or anakinra, tocilizumab or other anti-interleukin monoclonal antibody are not considered severely immunocompromising for the purposes of COVID-19 vaccine recommendations
HIV infection

Infants (<12 months): CD4+ <750 cells/μL

Children (1–5 years): CD4+ <500 cells/μL

Adults and children >5 years: CD4+ <200 cells/μL 
Inborn errors of immunity (primary immunodeficiency) Severe antibody (B-cell) deficiencies, severe combined immunodeficiency (SCID/complete DiGeorge)
Chronic kidney disease on dialysis  
Related diseases
COVID-19

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