Covid Vaccines For the Immunocompromised

I got my 2 doses of the Pfizer vaccine in April 2021. When I became eligible for my booster shot it was during the time Omicron was all over the news, so I set up an appointment as soon as possible. When I was getting my booster shot, they asked all the generic questions. Name, age, when was my last dose, did I have any allergic reactions, etc. Then they asked me are you immunocompromised? I answered and said yes. I have lupus. They then shuttled me to another station for those that were immunocompromised.

They then began to give me a speech and let me know that some severely or moderately immunocompromised patients might need 3 doses to be considered fully vaccinated and the booster dose would be something different. I told them about my history with lupus and all the medications that I was currently taking. I also told them my rheumatologist already explained all of this and I had even tested my antibody count against the COVID vaccine. Thankfully my body had reacted well with the vaccine and I did not need the third dose and I was here for my booster shot. I was very tired for the next 2 days and my arm was extremely sore. But, I was glad to know that I had more protection against COVID.

Why is a third dose recommended for some severely or moderately immunocompromised patients?

According to the CDC, an additional primary shot may prevent serious and possibly life-threatening COVID-19 in people who may not have responded to their two-dose mRNA COVID-19 vaccine primary series. The mRNA COVID-19 vaccines (Pfizer-BioNTech or Moderna) have been shown to prevent COVID-19 following the 2-dose series.¹

What’s the difference between a third dose for those who are immunocompromised and a booster shot?

According to the CDC, an additional primary dose is given to people with moderately or severely compromised immune systems. The additional primary dose of an mRNA COVID-19 vaccine is meant to improve immunocompromised people’s response to their original vaccine series. The third dose is usually done 28 days after the second dose of Pfizer (age 5+) or Moderna (aged 18+). At this time, no additional primary shot is recommended if you took the Johnson and Johnson vaccine.¹

A booster shot is administered when a person has completed their vaccine primary series to enhance or restore protection against COVID-19 which may have decreased over time.

Who Is considered moderately or severely immunocompromised?

According to the CDC, People are considered to be moderately or severely immunocompromised if they have:¹

• Received 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 2 years or are taking medicine to suppress the immune system
• Moderate or severe primary immunodeficiency (like as DiGeorge syndrome or Wiskott-Aldrich syndrome)
• Advanced or untreated HIV infection
• Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response

Guidance and new research are evolving every day. All patients should talk to their healthcare provider about whether getting another shot is right for them. Did you need to get an additional third dose or just the booster? What were your experiences?