How to Protect Your Immunocompromised Child from Infection

Everyone gets sick once in a while. Fortunately, our bodies have amazing immune systems to fight off bacteria and viruses that make us feel bad.

But when a child’s immune system is weakened because of another illness or medicines they are taking, extra precautions are needed to avoid additional infections, says Eveline Wu, MD, a UNC Health pediatrician specializing in rheumatology, allergy and immunology.

“Children who are immunocompromised are not only more likely to get infections, but they may also be more likely to have more severe symptoms,” Dr. Wu says.

COVID-19 is just one infection risk. The common cold, flu, ear infections, sinus infections and pneumonia are also common in children and can be worse in immunocompromised people.

The Centers for Disease Control and Prevention (CDC) estimates that about 2.6 percent of children in the United States are immunocompromised.

“Some people are born with an immunodeficiency—part of their immune system is missing or doesn’t work properly,” Dr. Wu says. “Others have conditions or they’re taking treatments that may suppress their immune system.”

Reasons a Child’s Immune System May Be Weak

Like adults, children can be immunocompromised because of chemotherapy, medications taken after an organ transplant, heart conditions, HIV infection, and autoimmune conditions such as lupus, rheumatoid arthritis and type 1 diabetes. Certain steroids, given in high doses for an extended time, also may weaken a child’s immune system.

“I would encourage families to talk to their physician to find out if their child is at higher risk of infection,” Dr. Wu says. “It’s important for people to know if their child is more likely to get infections or if they might have worse infections than they normally would.”

It’s also important to know that the immune systems of immunocompromised children may not produce as strong a response to vaccines, including the COVID-19 vaccine and boosters. It’s still important to get all recommended vaccines, but immunocompromised children may not be able to bank on their protection to the same degree.

Strategies for Keeping Your Immunocompromised Child Healthy

Dr. Wu suggests several strategies if your child is immunocompromised:

  • Make sure they’re up to date on all vaccines (before you start other treatments, if possible).
  • Have children wash their hands with soap and warm water often. Use hand sanitizer when soap and water are not available.
  • Clean and disinfect surfaces children are likely to touch, such as the tables at home or in a restaurant, desks at school or work, and armrests on buses, trains and airplanes.
  • Keep children home when they are sick and avoid contact with sick people.
  • Have children wear masks when they are out and about. Masks are highly effective at minimizing the risk of getting COVID-19 and can help reduce the risk of other airborne diseases too. It’s a good idea for other family members to wear masks as well, so they won’t bring home any infections.
  • Make sure indoor spaces are well ventilated or have effective air filtration systems. Avoid crowded spaces.
  • Play outside when possible.

Parents of immunocompromised children should rely on their child’s doctor when they need guidance, Dr. Wu says.

“Talk with your provider and ask whether there are specific treatments that may be available to help protect your child against certain types of infections or minimize symptoms if they get infections.”

For example, some people who are at a higher risk for severe COVID-19 may be candidates for antiviral treatments.

It’s also a good idea to stay informed about what’s going on in your local area. The CDC provides information about outbreaks of several diseases on the county level, including COVID-19 and influenza. If infection rates are low in your area, you may feel safer leaving the house with your child.

And of course, staying healthy by eating a nutritious diet and getting plenty of rest are also very important for immunocompromised children and the whole family, Dr. Wu says.

Talking to Others About Your Immunocompromised Child

It’s important to be open about your child’s risks with anyone who might take care of them or spend a lot of time with them, including teachers, friends and their parents, and extended family members. As your child grows, they can begin to advocate for themselves, too.

“Providers and others in the medical community have resources that can help,” Dr. Wu says. “We often work with schools, camps and others to outline special precautions for immunocompromised individuals.”

These resources include information about what it means to be immunocompromised and what to do if a child becomes ill.

Your doctor also can help you determine if your child is eligible for certain services or support. For example, if your child has asthma or allergies, they might qualify for air filters in their classroom or dormitory.

If you are concerned about your child’s immune system, talk to your doctor, or find one near you.