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.

Research has shown that protection against the virus from the COVID-19 vaccines can wane and may not be as effective against COVID-19 variants. However, additional research has shown that more doses 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 more doses of COVID-19 vaccines for groups.

These recommendations include:

  • People 12 and older can receive a booster dose of the COVID-19 vaccine.
  • People five and older who are moderately to severely immunocompromised can receive an additional primary dose of the COVID-19 vaccine.

People who are immunosuppressed

CDC recommends an additional primary dose of mRNA COVID-19 vaccine (Pfizer-BioNTech or Moderna) 28 days after the completion of the initial series. Individuals 5 years and older who are moderately to severely immunocompromised are eligible (individuals 5-17 can only receive Pfizer). This group is eligible for this additional primary dose 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 primary 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 at marshfieldclinic.org/CovidVaccine.

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.

COVID-19 vaccine boosters 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.

The CDC recommends a booster dose of the Pfizer-BioNTech/Comirnaty or Moderna COVID-19 vaccines five months after their initial mRNA series for all individuals 12 and older.

They also recommend either the Pfizer-BioNTech or Moderna COVID-19 vaccine for those vaccinated two or more months ago with the Janssen (Johnson & Johnson) COVID-19 vaccine.

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 and is now offering booster appointments. Click here to learn how you can schedule a vaccine appointment.

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