Chronic Conditions and COVID Vaccines: The Rules Are Different

Medically Reviewed by Melinda Ratini, MS, DO on October 27, 2022

Anyone can catch COVID-19. But it doesn’t affect everyone the same way. Serious complications are more likely if you also have other health conditions. And some medical treatments can impact your ability to fight off the virus.

Even so, vaccines are still the best way to protect yourself from serious illness or death from COVID-19. But you might need to follow different recommendations than someone who doesn’t have a chronic condition. Here’s what you need to know.

Which Conditions Put You at Risk?

The CDC keeps track of medical conditions that raise the odds you’ll get very sick from COVID-19. You can visit their website to see all of them, but some chronic conditions on that list include: 

  • Cancer
  • Diabetes
  • Heart, lung, liver, and kidney diseases
  • Use of immunosuppressive drugs
  • Obesity

Other conditions include:

  • Some disabilities
  • Mood disorders, such as depression
  • Schizophrenia

Can You Follow General Vaccine Rules?

Certain chronic conditions fall under regular vaccine guidelines. What’s right for you depends on how your health problems or medications affect your immune system. Work with your doctor to find the best way to stay up to date with your vaccines.

You are considered up to date with your COVID-19 vaccines if you have completed a COVID-19 vaccine primary series and received the most recent booster dose recommended for you by CDC. They recommend that people ages 5 years and older receive one updated (bivalent) booster if it has been at least 2 months since your last COVID-19 vaccine dose, whether that was:

  • your final primary series dose, or 
  • an original (monovalent) booster.

Even if you've gotten more than one original (monovalent) booster they recommend that you get an updated (bivalent) booster.

When possible, the CDC recommends mRNA vaccines made by Pfizer and Moderna over Johnson and Johnson’s vaccine. Talk to your doctor about the pros and cons of all your choices.

General guidelines for each vaccine include:

  • Pfizer (6 months and older). Primary series consists of 3 doses for those 6 months to 4 years. For those 5 years old and up, the primary series is two doses followed by an updated (bivalent) booster at least 2 months after their 2nd dose. (Children 6 months to 4 years are not recommended for a booster.)
  • Moderna (6 months and older). Like Pfizer, the primary series is two doses. For those 5 years and up, this is followed by an updated (bivalent) booster at least 2 months after their 2nd dose. (Children 6 months to 4 years are not recommended for a booster.)
  • Johnson & Johnson. Your doctor might suggest this shot if you have an allergy to mRNA vaccines or one isn’t available. You’ll get one shot as a primary series followed by an updated (bivalent) booster at least 2 months after the dose.
  • Novavax (12 and older). This vaccine is authorized as a 2-dose primary series a booster dose can be given to those 18 or older after 6 months.

Who Needs an Additional Dose?

You might not respond strongly to the first round of vaccines if you have a weakened immune system. An extra dose of the same vaccine might help you build more protection against COVID-19. That’s called an additional dose. It’s another shot in your primary series, not a booster.

The CDC strongly encourages additional doses for people ages 5 and older who are moderately to severely immunocompromised. 

Certain medical conditions and treatments can weaken your immune system, including:

  • Treatment for solid tumors or blood cancer
  • Stem cell treatment within the past 2 years
  • Advanced or untreated HIV
  • Certain immune system disorders
  • Medications to suppress your immune system

Talk to your doctor if you take medication but you’re not sure if it weakens your immune system. Some of those drugs might include:

  • Biologics
  • Immunosuppressive drugs for organ transplant
  • Corticosteroids
  • Cancer drugs

Your health care team will let you know if you might benefit from an additional dose. They’ll consider your other health conditions, how COVID-19 is spreading in your community, and any current or future therapies that might affect how your body responds to the vaccine.

Your doctor might delay your vaccine in some situations. That includes during medical treatment or surgeries that weaken your immune system for a certain period of time. They’ll let you know when it’s best to schedule your shots.  

What Is Revaccination?

This is repeat doses of vaccine. It’s something your doctor might suggest if you were vaccinated for COVID-19 before or during certain kinds of medical therapies. Work with your health care team to decide if revaccination is right for you.

Protect Your Health

It’s important to stay up to date with all your COVID-19 vaccines, including any future boosters or additional doses. But there are other steps you can take to stay healthy, including:

Follow your regular treatment plan. Take your medication exactly how your doctor tells you to. Bring up any health concerns that stem from your drug therapies. Your doctor will let you know if it’s safe to make any changes to your care plan.

Take preventive steps. If COVID-19 is high in your area, you can also:

  • Wear a mask that fits well.
  • Avoid crowds.
  • Wash your hands often.
  • Keep track of your symptoms.
  • Call your doctor if you feel sick.

Get medical care when you need to. Schedule routine visits and keep up with your preventive care. Check in with your doctor whenever you have any health issues. A telehealth visit may be an option. But hospitals and clinics also have plans in place to protect you from COVID-19.

Show Sources

Photo Credit: Alden Chadwick / Getty Images


CDC: “COVID-19 – Medical Conditions,” “COVID-19 – Stay Up to Date with Your Vaccines,” “Vaccines & Immunizations — Interim Clinical Considerations,” “COVID-19 – COVID-19 Vaccines for Moderately to Severely Immunocompromised People,” “Vaccines & Immunizations – Talking with Patients who are Immunocompromised,” “COVID-19 – Underlying Medical Conditions.”

Yale University – Yale Health: “Information for Special Populations and the COVID-19 vaccine.”

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