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COVID vaccine booster for the immunocompromised
You may have heard or read about the possible need for “booster” doses of COVID vaccine. The FDA and the CDC have granted Emergency Use Authorization for administering a third dose of either the Pfizer or the Moderna vaccines to people who are moderately or severely immunocompromised. This is based on two observations. First, a certain number of people with compromised immune systems have an inadequate response to two doses of these vaccines. A third dose of vaccine produced a better response in some of these people. Second, many of the breakthrough infections in hospitalized people occur in those with compromised immune systems. People with compromised immune systems include the following:
- Active treatment for solid tumor and hematologic malignancies
- Receipt of solid-organ transplant and taking immunosuppressive therapy
- Receipt of CAR-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)
- Moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome)
- Advanced or untreated HIV infection
- Active treatment with high-dose corticosteroids (i.e., ≥20mg prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory.
The third COVID vaccine dose should be the same product (either Pfizer or Moderna) as the first two doses you received. The third dose should be given 28 or more days after the second dose. Side effects have thus far been similar to those experienced after the second dose of either vaccine. COVID antibody testing is NOT recommended either before or after the third vaccine dose.
Right now a third dose of Pfizer or Moderna vaccine is NOT authorized for people other than those with compromised immune systems. Booster doses are NOT authorized for the Johnson and Johnson single dose vaccine. The FDA and the CDC are continually evaluating data to determine whether and when COVID vaccine boosters may be warranted for other groups of people and for people who received the Johnson and Johnson vaccine.
If you are uncertain about whether you meet these criteria please contact your physician. Based on Guidance for the New York State COVID-19 Vaccination Program issued August 16, 2021, authorization or proof from your physician is not required. However, individuals will be required to self-attest to having a moderate or severe condition as outlined above.
Available vaccination locations can be found via the following paths:
CCP patients with emails on file with us also received this message directly via email.
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