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Navigating the holidays if you’re immunocompromised

contributed by Mary Clare Fischer

7 tips to follow to celebrate safely.

A woman and man wearing holiday sweaters and masks touch elbows
Getty Images

This article was updated on December 13, 2022.

In mid-September, President Biden declared that the pandemic was over — and many people are living that way. Mask requirements have been lifted in most spaces, COVID-19 testing has plunged and far fewer Americans have received the newest booster than the initial series of the vaccine. In one survey, about half of respondents who hadn’t gotten the updated booster said they were no longer worried about COVID-19.

But with a winter surge on the way, fewer treatments available that are effective against the latest variants and the possibility of large holiday gatherings on the horizon, COVID-19 could still easily cause problems. The concerns remain especially high for those who are at higher risk of developing and dying from the disease, including people older than age 65 and the immunocompromised (people with autoimmune diseases, those who are on medications to prevent organ rejection after a transplant, those who have had certain cancers or taking certain treatments for cancer and many more).

So, how do you stay safe and healthy during this time of year?

Donna Murphy, L.M.S.W., director of the University of Michigan Health Rogel Cancer Center’s Patient and Family Support Services program; Madison McTevia, a certified child life specialist who runs the cancer center’s Families Facing Cancer program; Shama Mehta, a board-certified chaplain at the cancer center; and Devyn Baker, a clinical specialist for the PFSS team, gathered on Zoom with a small group of patients and some of their family members to provide advice about how to handle holiday gatherings if you’re at higher risk of developing COVID-19.

Below are seven key insights that came out of the discussion (with many relevant for the general public, too.)

7 tips for safely navigating the holidays if you’re immunocompromised

1. The safest option: Celebrate virtually. But if you do decide to meet in person, take precautions to reduce your risk — and feel free to get creative

Standard measures — like social distancing, wearing a mask and asking others to do the same, taking an at-home or rapid test before attending a gathering and keeping windows open if possible — still apply. But there are plenty of other inventive ways to keep your get-together safer.

For instance, you may consider gathering at a time of day when you could go for a walk and look at holiday lights in your neighborhood. Or, could you do a meet-up from your cars with the windows open? Could you eat your feast of ham and cheesy potatoes in the garage? If you have some friends or family members who aren’t vaccinated and some who are, perhaps each group could get together and then Zoom with each other. This type of outside-the-box thinking could help you come up with solutions that you and all your guests feel comfortable with.

2. Start to communicate about any precautions you’d like everyone to take before the day of the gathering to make sure everyone knows what’s required of them

Holiday weeks can get busy, but planning and communicating early ensures everyone’s on the same page and reduces the likelihood that a surprised guest grumbles about the added safeguards.

3. Try not to do too much in one day

If you’ve recently been diagnosed with a chronic disease or another condition that leaves you immunocompromised, you may still be discovering how your capacity or, as one patient put it, your “budget for energy” has changed. Your ability to rein yourself in could be tested during the holidays, especially if you previously had traditions like going to four different parties in one day or even one week. Trying not to fill your schedule too much – and asking others to adapt for you as well - is perfectly OK.

One example: If you’re a busy parent who’s wondering how you’ll be able to wrap all the gifts, hide the presents throughout the house instead and ask your children to find them. Or, if the kids are old enough, have them wrap each others’ gifts to give them a little more responsibility and create an expectation that they can participate in the holiday prep (and it can be fun!), too.

4. In that spirit, keep the traditions you love and remove (or adapt) the ones that no longer excite you

If there’s a tradition that feels draining, use this opportunity to come up with one that brings you joy instead. That may involve reflecting and being honest with yourself about your feelings -- and being aware that you may be excited about an upcoming commitment one day and feel overwhelmed about the obligation the next. It may be helpful to find someone to confide in or write down your reservations or conflictions. This could help bring clarity when you have to make decisions.

5. Try to plan time for self-care

This will look different for everyone, but examples could be a midday nap, spending some quiet time to read a chapter of a favorite book or listening to music. Think about where you can place these moments of calm in the coming weeks to help yourself destress.

6. Be mindful of your own budget

If you decide you need to miss a party but then feel like you have to overcompensate with a pricey gift, let us tell you, you do not. There are cheaper and potentially more thoughtful ways to let the host know you’re still thinking about them.

7. Ask others for help

If your community is reaching out to ask how they can help (or if your family or friends aren’t reaching out, perhaps because they don’t know how to help), consider how you can communicate your needs during the coming weeks.

Maybe that’s writing a social media post or sending out a group text message outlining what would brighten your day and reduce your workload, like if your sister’s able to bake and bring over her famous pecan pie or your neighbor could deliver the gifts you’ve bought. It might just be asking your loved ones to respect the difficult decisions you may have to make this season and reminding them that sacrifices now may mean you can make that upcoming wedding or high school graduation in the future.