I have sympathy for people with autoimmune diseases on immunosuppressants who have family in developing countries, where a lot of complicated infections are easier to catch. They solve the problem in the context of our (generally? decreasingly?) sterile world, but not globally.
I take dimethyl-fumarate, and I have been at the hospital for a week getting very high doses of corticosteroid infusions, and thankfully I did not catch anything. I have not had common cold for almost a decade, yet I have been on steroids (both via IV and pills) and I have been on an immunomodulator (not suppressant, however) for almost a decade.
I have not even caught COVID yet been exposed to it (has been quarantined three times with someone with COVID).
These medications for MS are very expensive, but since in Hungary there are subsidies for it, it costs as much as 1 USD instead of 1500 USD per month.
Biologics are phenomenal for this. Especially the selective ones.
Sadly, they are also inaccessible to people of lower socioeconomic status.