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COVID Vaccine Update: Booster Shots

A stylized illustration of a COVID-19 vaccine vial with various related doodles in the background.

According to the Centers for Disease Control and Prevention, studies have found evidence of reduced immune response to a 2-dose COVID-19 vaccine series in some groups of immunocompromised individuals. Those who are immunocompromised may also have a higher rate of breakthrough COVID infections than the general population. Studies are showing that an additional mRNA COVID-19 vaccine (Moderna or Pfizer) dose in some immunocompromised people who received a primary mRNA COVID-19 vaccine series may enhance antibody response, increasing the proportion of people who respond.

The FDA has updated its guidance on administering a booster, or third dose, of the Moderna and Pfizer COVID-19 vaccines to individuals who are moderately or severely immunocompromised due to a medical condition or receipt of immunosuppressive medications or treatments. These conditions and treatments include:

  • Active treatment for solid tumor and hematologic malignancies.
  • Receipt of solid-organ transplant and taking immunosuppressive therapy.
  • Receipt of CAR-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy).
  • Moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome).
  • Advanced or untreated HIV infection.
  • Active treatment with high-dose corticosteroids (i.e., ≥20mg prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory.

The booster can be administered at least 28 days after completion of the initial 2-dose vaccine series.

To register for the 3rd dose, please fill out your information on the COVID Vaccine Sign-up form found on the Silver Thread Public Health website:

Once you have signed up, a member of the Silver Thread Public Health team will contact you to make an appointment for your 3rd dose. The CDC stated, “There is not enough data at this time to determine whether immunocompromised people who received the Johnson & Johnson’s Janssen COVID-19 vaccine also have an improved antibody response following an additional dose of the same vaccine.” Therefore booster shots for people who received the J&J Janssen vaccine are not being recommended at this time.

For more information please visit the links below:

CDPHE Press Release on 3rd dose of mRNA vaccines for immunocompromised people.

CDC Update on COVID-19 Vaccines for Moderately to Severely Immunocompromised People.

Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States.

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