What to Know About Going Back to the Office If You’re Fully Vaccinated and Immunocompromised

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As COVID-19 restrictions are lifted and many people ease back into a pre-pandemic mindset, it can feel like the world is changing overnight. Mask mandates have been lifted in schools in every state — and now, the attention is turning toward the millions of employed Americans who were able to work remotely during the pandemic. 

Many offices are bringing employees back to in-person work (at least part of the week). That said, it’s normal to feel anxious about going back to work, especially if you’re immunocompromised. You may feel leery, for instance, about shedding your mask even if your coworkers do so.

“I can definitely understand the hesitancy from immunocompromised patients,” says rheumatologist Jiha Lee, MD, a Clinical Assistant Professor at Michigan Medicine. “We have data from solid organ transplant patients and inflammatory bowel disease patients who are on immunosuppressant medications, which shows they don’t mount the same degree of vaccine response compared to an immunocompetent person.”

Preliminary research in people with inflammatory conditions, including inflammatory arthritis and inflammatory bowel disease, suggests that taking immunosuppressant medication does reduce the body’s antibody response to the vaccine, but this varies widely by medication type. 

Here are three steps to take if you’re fully vaccinated and immunocompromised, and your company is returning to in-person work.

Ask What Options Are Available for Work from Home

If it’s possible for your field of work, your company may decide to adopt a hybrid model, in which employees go to the office some days of the week but work from home other days. Ask your boss what options are available for working from home — and remember that the less you commute and work in a space with others, the lower your risk for COVID-19 infection.

“Spending four days in a situation where there’s a risk of transmission is, in theory, twice as risky as spending two days in the same situation — assuming everything else is equal,” says David Aronoff, MD, Director of the Division of Infectious Diseases at Vanderbilt University School of Medicine in Nashville, Tennessee. “Because of that, moving toward a hybrid work model is relatively safer than going full steam ahead in person.”

That said, each situation is unique. It’s possible that your workplace has a very low risk of transmission (say, if desks are spaced six feet apart and every employee is vaccinated).

“If you have a desk job at an office where there’s not a lot of foot traffic in your area and everyone you work with is fully vaccinated, that may be a relatively safe environment,” says Dr. Aronoff. “It’s very different from an open space that’s crowded with customers or clients and where not everyone in the workspace is vaccinated.”

Check in with your doctor to discuss your COVID-19 risk if you return to the workplace. Your physician will consider your underlying health conditions, the medications you’re taking, and your work environment.

And even if it feels a little uncomfortable at first, don’t be afraid to start a conversation about remote work with your supervisor. It’s likely that you aren’t the only person asking for flexible work options.

In fact, 60 percent of workers with jobs that can be done from home say they’d like to work from home completely (or most of the time) when the pandemic is over if they’re given the choice, per a 2022 Pew Research Center survey. Some companies even plan to train managers to avoid preferential treatment being given to remote workers, according to the Washington Post.

But of course, what’s possible will be determined by your job and manager, and not everyone will have the same opportunity to work from home.

Get All Vaccine Doses and Follow Mitigation Efforts

Most importantly, make sure you’re fully vaccinated and receive all additional or booster doses you’re eligible for. 

An additional COVID-19 dose appears to have a modest additive effect on cumulative immunogenicity in immunocompromised patients, with median antibody response rates increasing from 41 percent after a standard primary series to 67 percent after the additional dose (though with notable variation among patient groups — so these findings may not apply to all immunocompromised patients), per a 2022 review published in The Lancet. 

An additional dose was also associated with a median antibody response rate of 44 percent among individuals with low or undetectable antibody responses after the standard primary series. Although these findings must be interpreted with caution since there’s no established correlate of “initial protection” or “duration of protection,” the benefits of an additional dose among the immunocompromised are likely to outweigh any potential risks. 

That said, if you’re immunocompromised, you may still need to take additional mitigation efforts beyond full vaccination to protect yourself:

“Many people who are immunocompromised with severe immunosuppression are likely to remain susceptible to COVID-19 even after an additional dose,” note the researchers. “Cumulative antibody response rates after the additional dose in people who are immunocompromised typically fall some way short of the response rates observed after a standard primary series in people who are not immunocompromised.”

If you do need to return to the office, you may not want to shed your mask or join large groups of coworkers for lunch outings quite yet. Depending on your level of immunosuppression and transmission in your community, your doctor may suggest you continue to practice social distancing and avoid crowds when possible — even if you’re fully vaccinated.

You may imagine yourself being the only person in the office wearing a mask, but you likely won’t be alone. Nearly one-fifth of Americans could see themselves continuing to wear a mask in public for some time into the future, even if not mandated, in a March 2021 Consumer Reports survey of 2,144 American adults.

Identify the Areas of Greatest Risk

Avoid common areas where you might have close contact (be within six feet) of others at the workplace. This may include meeting rooms, the office kitchen, or waiting areas. 

“Nothing has changed about how the virus spreads from one person to another person,” says Dr. Aronoff. “The virus can be more easily transmitted when somebody who is contagious is close physically to someone who is susceptible.”

Try to have small-group activities like lunches, breaks, and meetings in outdoor seating areas when possible. Also consider how you get to work: Some companies may offer employees staggered work hours to avoid the busiest times of public transportation.

Ask your boss or HR department what policies are in place to lower the risk of COVID-19 transmission. These may include:

• Screening employees daily for symptoms
• Allowing employees to stay at home and get tested for COVID-19 if they don’t feel well (without counting it as a “sick day” or “vacation day”)
• Encouraging employees to get vaccinated, and perhaps even providing mobile vaccination at work
• Updating the workplace’s air filtration systems
• Implementing physical distancing and mask-wearing policies
• Allowing employees to work part-time or full-time at home

If your company is small and doesn’t have a comprehensive plan for COVID-19 protocols, you could volunteer to lead the process based on your own research, advises Forbes. A good place to start is by referring to recommendations and resources from the CDC.

“See what your local government advises, engage with the workplace, and try to keep yourself protected by wearing a mask and exercising caution,” says Dr. Lee.

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