Editor’s note: This article is subject to change based on Centers for Disease Control and Prevention (CDC) recommendations.
Booster shots – It’s been a question circling even before the Emergency Authorization Use was given for the initial series of Pfizer BioNTech, Moderna and Janssen (Johnson & Johnson) COVID-19 vaccines.
Centers for Disease Control and Prevention (CDC) continues to monitor COVID-19 vaccine effectiveness, and has stated that, “COVID-19 vaccines are safe and effective at preventing COVID-19, including severe illness and death.” To receive the most protection, CDC recommends people receive all the recommended doses of a COVID-19 vaccine.
How many doses are needed?
As of July 2021, research showed that protection against the virus can last for more than six months for fully vaccinated individuals, which means two weeks after their second dose in a two-dose series or two weeks after a single-dose vaccine. On Aug. 13, 2021, CDC announced recommendations for an additional dose of mRNA COVID-19 vaccine (Pfizer BioNTech and Moderna) for individuals who are moderately to severely immunocompromised.
Marshfield Clinic Health System follows CDC and Food and Drug Administration (FDA) recommendations for COVID-19 vaccinations.
Additional doses vs. booster doses
To understand recommendations, there is a main difference between additional doses and booster doses. People who are moderately to severely immunocompromised are recommended to receive an additional dose of mRNA COVID-19 vaccine because they may not have received adequate protection from their initial two-dose vaccine series.
At this time, there is not enough data to determine whether immunocompromised people who received the Janssen (Johnson & Johnson) COVID-19 also have an improved antibody response with an additional dose. The recommendation only applies to the mRNA COVID-19 vaccines.
A booster dose is a supplemental vaccine dose given to people when the immune response to a primary vaccine series has waned over time. This is similar to why we recommend tetanus, diphtheria booster every 10 years and the influenza vaccine each year.
No booster shots yet
On Aug. 18, 2021, the U.S. Department of Health and Human Services announced a plan to begin offering COVID-19 vaccine booster shots. CDC’s independent advisory committee, the Advisory Committee on Immunization Practices (ACIP), continues to meet and discuss data on the evolution of the pandemic and the use of COVID-19 vaccines. FDA and ACIP will make further recommendations on the use of boosters for the general public after a thorough review of the evidence.
Talk to your provider about an additional dose of COVID-19 mRNA
Currently, CDC is recommending that moderately to severely immunocompromised people receive an additional dose. This includes people who have:
- Been receiving active cancer treatment for tumors or cancers of the blood.
- Received an organ transplant and are taking medicine to suppress the immune system.
- Received a stem cell transplant within the last two years or are taking medicine to suppress the immune system.
- Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome).
- Advanced or untreated HIV infection.
- Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response.
CDC recommends the additional dose of an mRNA COVID-19 vaccine be administered at least four weeks after a second dose of Pfizer-BioNTech COVID-19 vaccine or Moderna COVID-19 vaccine. However, if it has been a longer span of time since you received your two-dose series, it’s still important to schedule the third dose as soon as you can.
“In my discussions with patients who are on immunosuppressant drugs, I emphasize that their response to the COVID-19 vaccine might be blunted as their immune system is suppressed,” said Dr. Thomas Bartow, rheumatology physician with Marshfield Clinic Health System. “A third dose soon seems prudent to help ensure they are protected from COVID-19.”
Dr. Bartow also recommends discussing with your provider the timing of the COVID-19 vaccine and your medication to improve the response. In August 2021, the American College of Rheumatology published guidelines to assist providers and patients in that discussion.
You should talk to your primary or specialty care provider about your medical condition, any questions you have and whether getting an additional dose is appropriate for your health. If you qualify, you can schedule an additional dose with Marshfield Clinic Health System by calling 877-998-0880 to schedule your COVID-19 vaccine.