Weak immune system and COVID-19

Having a weak immune system may put you at a higher risk of serious illness from COVID-19 (coronavirus).

Many things can cause a weak immune system (immunosuppressed).

These include:

  • cancer treatment
  • some treatments for autoimmune diseases, such as rheumatoid arthritis, lupus, multiple sclerosis (MS) and inflammatory bowel diseases
  • HIV - if you're not on effective treatment
  • having an organ transplant or a bone-marrow transplant
  • if you have a chronic kidney disease and are on dialysis or have an eGFR <30ml/min

COVID-19 vaccination

It is especially important that you are vaccinated against COVID-19 if you have a weak immune system.

COVID-19 vaccination for people with a weak immune system

Immunosuppressive treatments and steroids

Being on immunosuppressive treatments is not known to increase your risk of getting COVID-19.

Do not stop or change your medication unless your doctor advises you to. If you stop your medicine without your doctor's advice, you may be more likely to have a flare-up of your condition during this period.

Examples of immunosuppressive medicines are:

  • steroids
  • biologic agents
  • methotrexate
  • azathioprine


If you take steroid tablets every day, you should take extra care to avoid infection. Steroid tablets include prednisolone (Deltacortril).

With steroids, it is always important to take the lowest dose needed to control your condition. Check with your doctor if you have questions about the dose you are taking. Keep taking your steroids unless your doctor tells you not to. Stopping steroids suddenly can make you very unwell.

If you become unwell due to COVID-19 or another infection, continue to take your steroids. Never start taking steroids unless your doctor tells you to.

Other steroids, such as inhalers, do not usually cause immunosuppression. Continue to take these medicines as you normally would.

Immunosuppressive treatments (non-steroid)

There is currently no evidence that most other immunosuppressive treatments put you at higher risk of severe disease with COVID-19.

This includes biologic agents, methotrexate and azathioprine.

If you have any questions about medicines you are taking, talk to your GP, pharmacist or neurology team.

But, other infections can cause severe illness in people who are on immunosuppressive treatment. You should take care to follow the advice on how to protect yourself from COVID-19.

Attend any planned treatment or blood tests unless you are told not to.

If you get COVID-19

If you get COVID-19, ask your GP or consultant if they recommend any changes to your treatment. Do this before taking your next dose of treatments.

Staying safe if you are at higher risk

It may feel harder to take COVID-19 precautions when other people are getting back to normal.

But the things you have been doing all along to protect your health will still work to keep you safer.

These include:

  • keeping active and looking after your general health - this improves your chance of recovery if you get COVID-19
  • avoiding crowded indoor spaces when possible
  • wearing a medical grade or respirator face mask, if you have to be in a crowded space
  • washing your hands properly and often
  • continuing to keep 2 meters away from other people, where possible
  • moving away if you see someone coughing or sneezing

At home, everyone you live with should get vaccinated. Try to keep the number of people who come into your house to a small number of people you trust.

Check that anyone who visits is well when they arrive. Ask them to wash their hands, to wear a medical grade or respirator mask and to keep some distance from you whenever possible.

Continue to use the healthcare services you need. If you have an appointment with your GP or at a hospital or clinic, it is important to attend.

Page last reviewed: 6 September 2023