A healthy living blog from Marshfield Clinic Health System

Another COVID-19 vaccine dose? What you need to know

Editor’s note: This article is subject to change based on Centers for Disease Control and Prevention (CDC) recommendations.

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Will I need another shot? It’s been a question circling even before the Emergency Use Authorization was given for the initial series of Pfizer-BioNTech, Moderna and Janssen (Johnson & Johnson) COVID-19 vaccines.

Will I need another shot? It’s been a question circling even before the Emergency Use Authorization was given for the initial series of Pfizer-BioNTech, Moderna and Janssen (Johnson & Johnson) COVID-19 vaccines.

As of July 2021, research showed that protection against the virus can last for more than six months for fully vaccinated individuals after completion of the initial series. However, additional research has shown that an additional dose of the COVID-19 vaccine can improve a person’s response to their initial vaccine series.

For this reason, the Centers for Disease Control and Prevention (CDC) recently recommended third doses of a COVID-19 vaccine for certain at-risk groups.

These recommendations include:

  • A third dose of COVID-19 mRNA vaccine for people 12 years and older who are immunocompromised.
  • A third dose of the Comirnaty (Pfizer-BioNTech COVID-19 vaccine) six months after the primary series of Comirnaty for people 65 years and older, 18-64 years that have underlying medical conditions and people 18-64 years at increased risk of COVID-19 exposure.

People who are immunosuppressed

On Aug. 13, 2021, CDC announced recommendations for an additional dose of mRNA COVID-19 vaccine (Pfizer-BioNTech and Moderna) for individuals 12 years and older who are moderately to severely immunocompromised because they may not have received adequate protection from their initial two-dose vaccine series.

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 the second dose. 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.

At this time, there is not enough data to determine whether immunocompromised people who received the Janssen (Johnson & Johnson) COVID-19 vaccine also have an improved antibody response with an additional dose. The recommendation only applies to the mRNA COVID-19 vaccines.

Comirnaty booster now available

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 a tetanus, diphtheria booster every 10 years and the influenza vaccine each year.

On September 24, 2021, CDC announced recommendations for a booster dose of the Comirnaty (Pfizer-BioNTech COVID-19 vaccine) six months after the primary series of Comirnaty for:

  • People 65 years and older and residents in long-term care settings should receive a booster shot;
  • People aged 50–64 years with underlying medical conditions should receive a booster shot;
  • People aged 18–49 years with underlying medical conditions may receive a booster shot based on their individual benefits and risks; and
  • People aged 18-64 years who are at increased risk for COVID-19 exposure and transmission because of where they work or live may receive a booster shot based on their individual benefits and risks.

Only people that received the initial two doses of Pfizer six months ago are eligible to receive this booster dose at this time.

There is not enough data to determine whether people who received Moderna or Janssen (Johnson & Johnson) COVID-19 vaccine also have an improved antibody response with a booster dose. The recommendation only applies to the Comirnaty (Pfizer-BioNTech COVID-19 vaccine) at this time.

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.

Marshfield Clinic Health System follows CDC and Food and Drug Administration (FDA) recommendations for COVID-19 vaccinations.

Click here to learn more about the different COVID-19 treatment options that are available.

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