How To Protect Immunocompromised Family At The Holidays

The holidays are a time to gather with the people you love. But if someone in your family has a young infant or has a weakened immune system, you may also worry about exposing them to the flu, COVID-19, RSV or other easily-shared illnesses. The good news is that a few thoughtful precautions can help your family celebrate together while reducing the risk of infection.

Someone who is immunocompromised has an immune system that may have a harder time fighting infections. This can happen because of certain medical conditions, cancer treatments, an organ transplant or medications that suppress the immune system.

Key Takeaways: Protecting Immunocompromised Family At The Holidays

• Stay home if you're sick, even if your symptoms seem mild.
• Make indoor gatherings safer with space, cleaner air and masking when appropriate.
• Practice good hand and food safety to reduce exposure to respiratory and foodborne illnesses.
• Plan ahead for travel and possible exposures, especially when medications or treatment may be time-sensitive.
• Ask your health care provider about your individual risk because precautions can differ based on the reason you're immunocompromised.

Why Are Holiday Gatherings Riskier If You're Immunocompromised?

During the holidays, indoor gatherings, crowded airports, holiday travel and close contact with family and friends can increase exposure to infectious illnesses. Respiratory viruses, including flu, COVID-19 and RSV, also tend to circulate more during the fall and winter months.

This can put people who are immunocompromised, or whose bodies’ immune systems aren’t working as they should, at risk The CDC estimates that approximately 6 percent of people in the United States are immunocompromised. This means some people may be more vulnerable to infections or severe complications than others. Likely this affects someone in your circle.

The level of risk isn't the same for everyone.

Older adults

As people age, their immune systems naturally become less effective, making it harder for the body to fight off infections and increasing the chances of serious complications from respiratory illnesses. Older adults may also have other medical conditions that put them at greater risk for complications if they do catch an illness. In fact, adults over 65 account for most respiratory virus-related deaths, and the risk tends to rise even further with age.

Pregnancy

Pregnancy causes several changes in the body, including shifts in the immune system and changes to the heart and lungs, which can make pregnant women more vulnerable to severe respiratory infections. Staying up to date on recommended vaccinations during pregnancy can help protect the mother and the developing baby, while also passing some protection to the baby after birth. Staying up to date on recommended vaccinations during pregnancy can help protect the mother while also passing some protection to the baby after birth.

Young children

Young children, especially babies, are more vulnerable to respiratory infections because their immune systems are still developing. In many cases, they may not be old enough to be immunized. Their smaller lungs and airways can also make respiratory viruses more concerning and increase the risk of medical complications.

People with chronic health conditions

According to the CDC, certain chronic health conditions, including heart or lung disease, diabetes and kidney disease, can make someone more likely to develop serious complications from respiratory viruses. These conditions may affect how well the body handles infections or put extra strain on organs that can already be impacted by respiratory illnesses.

Should You Stay Home If You're Sick?

Someone with mild congestion, a sore throat, cough, stomach symptoms or what feels like "just a cold" should consider skipping or postponing the visit rather than deciding that their symptoms aren't severe enough to matter.

Staying home while ill and keeping children home when they are sick can reduce the spread of disease, particularly among the most vulnerable populations, said Erica Kaufman West, MD, an infectious diseases physician with Franciscan Physician Network in Dyer.

“Even if the symptoms are only mild, that virus might cause severe disease in another person,” she said.

Staying home when feeling sick is a thoughtful way to protect loved ones. Encourage guests to communicate openly about any symptoms, such as a cough, fever, sore throat, vomiting or diarrhea, before they attend gatherings.

Should You Avoid Hugs And Kisses With Someone Who Is Immunocompromised?

It’s natural to want to snuggle a newborn or give grandma a hug. During periods of increased respiratory illness, skipping kisses and close face-to-face greetings can provide another layer of protection, particularly around young children who may have mild symptoms.

• Don't feel pressured. Let immunocompromised family members decide what level of physical contact they're comfortable with.
• Be mindful of mild symptoms. A little sniffle or sore throat can still mean you're contagious.
• Keep newborns protected. RSV and other respiratory viruses can be especially dangerous for very young babies.
• Find other ways to show affection. A wave, smile, phone call or air kiss can still make loved ones feel included.

How Can You Celebrate The Holidays More Safely?

Trying to celebrate the holidays with those who are immunocompromised doesn't mean missing out on time with family and friends. With a little planning and a few adjustments, you can make holiday traditions safer and more comfortable for everyone.

Consider making simple changes to where and how you gather, such as spending time outdoors, keeping celebrations smaller or finding alternative ways for loved ones to join in.

You can be mindful of everyone's health and comfort by:

• Choosing smaller gatherings when possible.
• Spend some time outdoors when weather allows.
• Shorten the amount of time spent in crowded indoor settings.
• Celebrate with different groups on different days.
• Find lower-risk ways for an immunocompromised person to participate rather than automatically excluding them.

How Can You Make An Indoor Holiday Gathering Safer?

Indoor holiday celebrations are sometimes inevitable, especially when the weather turns colder or wetter. However, spending time in enclosed spaces with larger groups can encourage the spread of respiratory viruses. Taking a few simple precautions can make indoor gatherings safer and more comfortable for everyone, especially people with weakened immune systems.

Ask guests about symptoms before they arrive

Make it a habit to check in with guests before the gathering and encourage everyone to speak up if they aren't feeling well. Hosts should reassure guests that there's no need to feel guilty about missing the celebration if they're experiencing symptoms of illness.

This is especially important when someone attending has a weakened immune system or is at higher risk of complications.

You can also offer an easy alternative to help loved ones feel included, such as saying, "We'll miss you, but let's FaceTime during dinner." A little understanding and flexibility can go a long way in protecting everyone's health while keeping loved ones connected.

Give everyone a little more space

When hosting a holiday gathering, think about how guests will be seated and avoid overcrowding one area.

If someone in attendance is immunocompromised, consider offering them a seat with a little more space from others or away from high-traffic areas.

Small adjustments can help reduce close contact and allow everyone to enjoy the celebration with greater peace of mind.

Consider masking in crowded indoor spaces

Wearing a mask can be another helpful way to reduce exposure to respiratory viruses, especially in indoor environments. It can offer an added layer of protection for people who are immunocompromised or those spending time around someone at higher risk of infection.

Consider wearing a well-fitting N95 or KN95 mask when traveling through airports, using public transportation, attending religious services or visiting crowded indoor events.

A few additional points:

• Make sure masks fit snugly over the nose and mouth.
• Encourage guests to respect others who choose to wear masks.
• Remember that masks are one layer of protection that work best alongside other precautions.

Improve indoor airflow

When several people are spending time together inside, respiratory viruses can spread through the air, especially in poorly ventilated spaces. Whenever possible, open windows or doors to allow fresh air to circulate throughout your home.

You can also run exhaust fans or use a portable HEPA air cleaner to help filter airborne particles.

Even small improvements to indoor ventilation can make a difference in reducing exposure to respiratory viruses.

How Can You Practice Food Safety During The Holidays?

Holiday meals often include large spreads, shared dishes and family recipes, but it's important to remember that food safety is just as important as the celebration itself. People with weakened immune systems may be more vulnerable to foodborne illnesses.

Whether you're preparing dinner at home or bringing a dish to a family gathering, following safe food-handling practices can help protect everyone at the table.

• Rinse fresh produce under running water before preparing or serving it.
• Cook meat, poultry, seafood and eggs thoroughly.
• Prevent cross-contamination between raw and ready-to-eat foods.
• Refrigerate perishable foods promptly.
• Be cautious with unpasteurized dairy products or juices.

Immunocompromised patients should follow any food-safety restrictions provided by their care team.

How Can You Protect Your Health Throughout The Holiday Season?

The holiday season can make it easy to get caught up in celebrations, travel and spending time with loved ones, but taking care of your health should remain a priority.

Stay up to date on your vaccinations

Family members and caregivers should talk with their health care providers about recommended seasonal vaccinations.

“While no vaccine is 100 percent effective, they help prevent severe disease and hospitalization, especially among pregnant patients and those over 65 with chronic medical conditions and with immunocompromising conditions,” Dr. Kaufman West said. 

Dr. Kaufman West said some vaccine recommendations change over time, making it important to have annual conversations with a primary care physician.

“Your primary care clinician is the best person to help you make decisions on which vaccines are right for you,” she said. “They will take into account your medical history and any medications you are taking and answer your questions.”

Wash your hands regularly

Dr. Kaufman West advises washing hands or using hand sanitizer frequently and avoiding touching the face as much as possible to help keep respiratory illnesses at bay. Wash hands after arriving home, before preparing food and before spending time in close contact with a vulnerable family member.

Practice healthy habits

Maintaining healthy routines during the holiday season can help support your overall well-being, especially if you have a weakened immune system. Between holiday preparations, travel and social events, it can be easy to overlook basic habits like getting enough sleep and staying physically active.

Prioritizing rest, finding time for gentle exercise and keeping a consistent daily routine can help your body function at its best.

How Should You Prepare For Holiday Travel?

Travelers should think ahead about medications, masks, hand sanitizer, insurance information and how to access medical care away from home. Other travel tips include:

• Bring enough prescription medication for the trip and a possible travel delay.
• Keep medications and any needed medical equipment in carry-on luggage when flying.
• Pack masks and hand sanitizer.
• Know how medications need to be stored.
• Bring important medical and insurance information.
• Identify where you could seek medical care at your destination.
• Talk with your care team beforehand if you're unsure whether travel is appropriate.

What Should You Do After Being Exposed To An Illness?

If you're immunocompromised and have been exposed to someone with a contagious illness, contact your care team for guidance. Don't assume you should wait until symptoms become severe.

Recommendations for testing or treatment depend on the infection and the patient's circumstances. Depending on the person's condition, early testing or treatment may be important.

When Should You Talk With Your Doctor About Holiday Plans?

Someone receiving chemotherapy may have different health precautions from someone taking an immunosuppressive medication for a medical condition, an organ transplant recipient or someone with another health condition affecting immune function. Talk to your care team about what precautions are most appropriate for you or your loved ones given your medical conditions.

The goal isn't necessarily to avoid holiday celebrations. It's to understand your individual risk and take reasonable precautions that allow you to participate as safely as possible.