Information for immunocompromised individuals regarding the prevention and treatment of SARS-CoV-2 infection in the context of currently circulating Omicron sublines – United States, January 2023

Take your place in the textBOX. SARS-CoV-2 prevention measures for immunocompromised individuals, their household members, and close contacts in the context of currently circulating Omicron sublines — United States, January 2023

Because Evusheld is not currently cleared for pre-exposure prophylaxis against SARS-CoV-2 infection in the United States, it is important that moderately to severely immunocompromised individuals,* those who may have an immune response inadequate to COVID-19 vaccination, and those with contraindications to receiving COVID-19 vaccines, exercise caution and recognize the need for additional preventive measures to protect against SARS-CoV infection -2. Immunocompromised individuals, members of their household, and close contacts can use the following steps and precautions to help prevent SARS-CoV-2 infection and mitigate COVID-19 disease if infected.

COVID-19 vaccines, booster doses and update*
  • COVID-19 vaccines remain the best way to protect against severe COVID-19. COVID-19 vaccines help the body develop protection against SARS-CoV-2 infection. Although vaccinated people are sometimes infected with SARS-CoV-2, staying up to date with COVID-19 vaccines significantly reduces the risk of serious illness, hospitalization or death from COVID-19.
  • The CDC recommends that all eligible individuals, especially those who are immunocompromised or have weakened immune systems, get an updated (bivalent) booster dose and stay up to date with their COVID-19 vaccines.
Personal COVID-19 Action Plan§
  • People need to think about how to protect themselves and others if they get sick with COVID-19 or if the level of COVID-19 transmission in the community changes. The plan should include:
    • ways to protect yourself and others, including considerations when sick, such as finding a room to isolate yourself in
    • what to do if you are exposed or have symptoms
    • what to do if you receive a positive SARS-CoV-2 test result
  • People should share their COVID-19 plan with family, friends and healthcare providers so they can support the prevention and preparedness steps. The CDC suggests people think about how others can help them if they get sick. It’s important to stick to treatment plans, keep routine medical appointments, and make sure prescriptions are filled. People should make alternate plans for work, childcare, and other responsibilities that could cause stress if they get sick.
Masks or respirators
  • Masks are designed to contain droplets and particles that people breathe in, cough or sneeze. A variety of masks are available. Some masks offer a higher level of protection than others. Wearing a mask with the best fit and comfort provides the best protection.**
  • Respirators (for example, NIOSH-approved N95 and KN95) provide better protection than masks.†† Respirators are designed to protect people by fitting tightly over their face to filter out particles, including SARS-CoV-2. They can also block droplets and particles that a person breathes in, coughs or sneezes to limit transmission to others. NIOSH approves many types of filtering facepiece respirators. The most widely available are N95 respirators, but other types (N99, N100, P95, P99, P100, R95, R99, and R100) provide the same or better protection than an N95 respirator.
Physical distancing
  • The small particles that people exhale may contain virus particles. The closer a person is to other people, the higher the risk of exposure to SARS-CoV-2. People can minimize the risk of exposure by avoiding crowded indoor areas or maintaining a distance ≥6 feet (1.8 m) from others. Such actions must be weighed against the risks of avoiding such activities.
  • Opening windows and doors to bring as much fresh air into the house as possible (weather permitting) can improve ventilation.
  • Portable high-efficiency particulate air purifiers are useful if a home does not have an HVAC system.
  • Exhaust fans and other fans can improve airflow.
  • In homes where HVAC fan operation can be controlled by a thermostat, the fan should be set to the «on» position instead of «auto» when other people are visiting. This allows the fan to run continuously, even if the heater or air conditioner is not turned on, to ensure the HVAC system provides continuous airflow and filtration.
weather outside
  • Spending time outdoors, when possible, rather than indoors, can also help reduce transmission. Virus particles spread more easily between people indoors than outdoors.
Hand washing
  • Frequent hand washing preferably with soap and water or using hand sanitizer containing ≥ 60% alcohol can reduce the risk of many diseases, including COVID-19.
Screening for SARS-CoV-2¶¶
  • People should get tested if they have symptoms of COVID-19. Viral tests are used for the detection of SARS-CoV-2. There are two types of viral tests: rapid tests and laboratory tests. These tests may use nose, throat, or saliva samples. People can take steps to reduce transmission if they are aware of their SARS-CoV-2 infection.
  • Free at-home testing*** is available. People should check with their health insurance, Medicaid or Medicare to find out what tests are available.††† People with disabilities can get help from the Disability Access and Information Line§§§ to access a test or identify an accessible test location.
  • Individuals should be aware of free or low-cost testing locations¶¶¶ who are close to home.
Treatment of covid19****
  • Individuals should contact their healthcare provider, health department or community health center†††† for treatment options. To be effective, treatment should be started within 5 to 7 days of the onset of symptoms.
  • Test to Treat Community Sites§§§§ can be consulted if or when people cannot reach their health care provider or do not have one. These sites offer tests and prescriptions from a health care provider (on-site or via telehealth) and dispense medications.
  • Antiviral treatments are available for people with mild to moderate symptoms of COVID-19 who are at high risk of progression to serious illness, hospitalization and death. People are at high risk of disease if they
    • are ≥ 50 years old
    • have an underlying health condition,¶¶¶¶ particularly moderate to severe immunosuppression
    • are not vaccinated
  • Immunocompromised people should discuss a treatment plan with their doctor and identify the COVID-19 treatment that would be best for them. Some people with COVID-19 who are immunocompromised or receiving immunosuppressive therapy may benefit from convalescent plasma therapy.*****
  • The CDC recommends that immunocompromised individuals with COVID-19 self-isolate for ≥10 days and check with their healthcare provider before ending isolation.†††††

Abbreviations: HVAC = heating, ventilation and air conditioning; NIOSH = National Institute for Occupational Safety and Health.



** People who are deaf or hard of hearing can request a transparent mask to help them read lips or see facial expressions. People with sensory impairments or intellectual and developmental disabilities may not be able to wear masks and should consider face shields.

†† Individuals with severe respiratory failure (eg, shortness of breath with minimal exertion or use of supplemental oxygen) should consult a health care provider regarding the use of the N95 respirator. Some N95 respirators may contain latex. People allergic to natural rubber latex should check the manufacturer’s website for information on the specific model.













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