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Immune-Compromised Patients to Get COVID-19 Booster Shots

U.S. agencies recommend a third COVID-19 vaccine for primary immunodeficiency patients and organ transplant recipients.

syringe and COVID-19 virus illustration

Two U.S. agencies answered the question of who will be first to get COVID-19 booster shots: It will be immune-compromised patients, including organ transplant recipients and people who have moderate to severe primary immunodeficiency diseases (PID).

The moves by the Food and Drug Administration and an advisory committee to the U.S. Centers for Disease Control come as the Delta variant increases cases around the world, including in the United States.

“After a thorough review of the available data, the FDA determined that this small, vulnerable group may benefit from a third dose of the Pfizer-BioNTech or Moderna Vaccines,” Acting FDA Commissioner Janet Woodcock, M.D., said in a statement. “Today’s action allows doctors to boost immunity in certain immunocompromised individuals who need extra protection from COVID-19.”

Germany and France have plans to do the same, Reuters recently reported.

Following last week’s announcements in the United States, patients have questions about how exactly it will work and how to make arrangements to receive a third vaccine. They had mixed results when trying to set up appointments with pharmacies, some of which said they had not yet been authorized to give third vaccines, according to comments on a Facebook post from the Immune Deficiency Foundation.

The IDF, an advocacy group for patients who have PID, shared details about the two agency actions, including this from the CDC’s Advisory Committee on Vaccination Practices (ACIP):

Attempts should be made to get a third dose that matches the brand/manufacturer you received in the initial two doses. But if that’s not feasible, the other (Pfizer or Moderna) can be administered.

Get the third dose at least 28 days after your second COVID-19 vaccine.

No guidance was given on boosters for those who received the Johnson & Johnson vaccine.

The IDF’s advice on getting your Pfizer or Moderna booster shot?

“Our recommendation is to consult with your physician for guidance regarding your need for an additional dose and, if needed, the best way to access a third shot,” the IDF said.

Read the full update from the IDF

In spring 2021, the U.S. National Institutes of Health launched a 500-person clinical study to determine how well COVID-19 vaccines protected the immunocompromised. A weakened immune system may be less able to fight infection and mount a response even after the two-shot series.

An article in the New England Journal of Medicine explains why a third shot could make a difference for transplant recipients who receive immune system-suppressing therapy to prevent rejection of the transplanted organ. So far, results are encouraging but additional research is needed, the authors said.