People With Asthma, COPD May Not Get Full Protection From COVID Vaccines

People living with asthma, chronic obstructive pulmonary disease (COPD), and interstitial lung disease (ILD) may have a weaker response to the COVID-19 vaccine than people with healthy lungs, making them more susceptible to COVID-19 than their vaccinated counterparts without lung disease, according to a new study.

According to lead author R. Lee Reinhardt, PhD, an associate professor in the Department of Immunology and Genomic Medicine at National Jewish Health, there are a few reasons why.

“Chronic lung illness causes lung inflammation that may prevent the immune system from fully responding to the COVID vaccine,” Reinhardt told Verywell.

Treatment for chronic lung diseases can also muddy vaccine response. Many patients take medications that suppress inflammation in the lungs, such as steroids and biologics.

“These medications can dampen the immune system’s reaction to vaccines, leaving the individual less fully protected than a healthy person,” Reinhardt said.

If you’re living with a lung disease like asthma or COPD, here’s what experts want you to know about getting a COVID vaccine and the best way to deal with illness this winter.

You Should Definitely Still Get Vaccinated

For the study, the researchers looked at blood samples taken from 32 patients with either asthma, COPD, or ILD who had gotten a COVID vaccine. They checked the patients’ COVID antibody levels and compared them to the levels of 31 vaccinated people who did not have lung disease.

Three to four months after getting a COVID vaccine, about half of the participants with lung disease had lower COVID antibody levels than the people with healthy lungs. The researchers concluded that lower antibody levels meant that the patients with lung disease had a weaker response to the vaccine and may not have had as much protection as vaccinated people with healthy lungs.

Reinhardt emphasized that the study findings do not mean that people with chronic lung disease should avoid getting a COVID vaccine—having slightly less protection is still better than having none.

“The [COVID] vaccine is highly effective at controlling COVID-19 and preventing severe disease.” Reinhardt said, adding that both the immune (T) cell and antibody responses “are sufficient to protect the public.”

An Extra Dose May Be Necessary

Since they may not mount as strong an immune response, patients with chronic lung conditions may need an additional dose of a COVID vaccine as their immunity starts to wear off to ensure they stay protected.

“Patients with underlying lung disease may have the same level of immunity at three months as healthy people have at six to eight months, so they may need two doses a year instead of one seasonal dose,” Reinhart said.

There are no official guidelines on vaccinating people with chronic lung disease against COVID, so people with asthma, COPD, and ILD should talk to their healthcare providers to figure out the best plan.

What About Other Vaccines?

Reinhardt’s team wants to find out if their study’s findings on COVID vaccines might apply to other vaccine-preventable respiratory illnesses, like the flu, pneumonia, and respiratory syncytial virus (RSV).

Having more data to help providers make decisions about vaccinating at-risk patients is important, as previous studies looking at immune responses to flu vaccines among people with chronic lung disease have been mixed.

For example, a 2021 study found that asthma patients who controlled their condition with treatments like immunotherapy and steroids had similar immune responses to flu vaccines as those who didn’t have asthma. However, older studies have suggested that people with asthma may mount a weaker response to flu vaccines.

A 2022 study found that the response to flu shots was similar between people with COPD and people who didn’t have COPD. But the researchers added that personalizing flu shots based on immune responses would make them even more effective for high-risk people. And like with the asthma studies, other studies on COPD have suggested that people with the condition may not mount a strong response to flu shots.

Even though people with lung disease are at high risk for respiratory illnesses, there’s still a lot that providers don’t know when it comes to the best way to protect them. More studies are needed to understand how people with chronic lung disease’s immune responses to vaccines stack up against those of people with healthy lungs, as well as establish guidelines to make sure they get the most protection from vaccines.

How to Protect Yourself This Winter

“Anyone who is immunocompromised or concerned about reducing their risk of contracting respiratory illness during periods of community surges is encouraged to wear a mask when out in public,” Tammy Lundstrom, MD, JD, Senior Vice President and Chief Medical Officer at Trinity Health in Livonia, Michigan, told Verywell.

If prolonged mask-wearing is difficult, a person “should avoid crowded indoor spaces when RSV, influenza, or COVID are surging in their locale,” said Lundstrom.

High-risk groups, including older adults, immunocompromised people, and people with chronic lung conditions, should see their provider right away if they do get sick. Antiviral medications like Paxlovid can reduce the risk of COVID complications for high-risk people. Lagevrio may be a good alternative if you’re taking a medication that interacts with Paxlovid.

“Anyone who qualifies for the use of COVID outpatient treatments should seek care as soon as possible after diagnosis to maximize effect since the medications need to be given within five days of the onset of symptoms,” Lundstrom said.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.