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Additional mRNA Vaccine Dose Authorized for ‘Moderately to Severely Immunocompromised’ Individuals

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This post has been archived and contains information that may be out of date.

On Aug. 12, the Food and Drug Administration (FDA) expanded the emergency use authorization (EUA) for both the Pfizer-BioNTech and Moderna mRNA COVID-19 vaccines to allow for the use of an additional dose in certain immunocompromised individuals ages 12 and older. Following that announcement, the Centers for Disease Control and Prevention issued a recommendation that “people whose immune systems are compromised moderately to severely should receive an additional dose of mRNA vaccine after the initial 2 doses.” 

This recommendation was then approved by the Western States Scientific Safety Review Workgroup, which concurrently and independently reviews the FDA’s actions related to COVID-19 vaccines for California and three other western states. This EUA amendment does not apply to the Janssen COVID-19 vaccine or individuals who received Janssen COVID-19 as a primary series.   
The administration of third vaccine doses has been shown to increase protection in this immunocompromised population. Under this latest guidance, it is recommended that moderately to severely immunocompromised people receive an additional dose of the mRNA COVID-19 vaccine they originally received. 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 the immune response 

CDPH has issued FAQs regarding this latest recommendation. According to the FAQs, this third dose should be administered at least 28 days after completion of the primary mRNA COVID-19 vaccine. When possible, mRNA COVID-19 vaccination doses (both the primary series and this additional dose) should be given at least two weeks before initiation of immunosuppressive therapies. Individuals should receive the third vaccine dose from the same manufacturer as their original series when possible. 
People are encouraged to talk to their health care provider about their medical condition and whether getting an additional dose is appropriate for them. Verification of immunocompromised status will not be required. 

These additional vaccine doses are available immediately through all current vaccination channels, including health care providers, clinics, and neighborhood pharmacies. Patients are encouraged to visit the MyTurn website to make an appointment or find a nearby clinic. Those receiving a third vaccine are encouraged to continue other harm-reduction precautions, such as masking and social distancing. 

CHA is analyzing the announcement yesterday that booster shots will be available for individuals eight months after vaccination, beginning Sept. 20, and will provide more information on that shortly.