CDC Says Immunocompromised May Get Fourth COVID Shot


The Centers for Disease Control and Prevention said this week that immunocompromised people may receive a fourth dose of a COVID-19 vaccine.

The new guidance applies to moderately or severely immunocompromised people who have already received their original two shots of the Moderna or Pfizer vaccine as well as a third shot of one of those mRNA vaccines. The immunocompromised may get a fourth booster dose six months after their original COVID-19 vaccination.

“In such situations, people who are moderately and severely immunocompromised may receive a total of four COVID-19 vaccine doses,” the CDC said.

Those who are seriously enough immunocompromised to potentially need a fourth dose include people currently in cancer treatment for tumors or blood cancers, some organ transplant and stem cell recipients, those with an untreated HIV infection, those taking high-dose corticosteroids, and those taking immunosuppressive drugs or who have a moderate or severe immunodeficiency condition.

“Timing of COVID-19 vaccination should take into consideration current or planned immunosuppressive therapies and optimization of both the patient’s medical condition and response to vaccine,” the CDC said.

Earlier this month, the Food and Drug Administration approved booster shots of the Moderna and Johnson & Johnson COVID-19 vaccines as well as a “mix and match” approach to booster shots.

People in high-risk groups who received the Moderna or Pfizer vaccine can get a booster shot of any of the three FDA-approved vaccines at least six months after their original vaccination. The high-risk groups include people age 65 and older, people living in long-term care facilities, and people ages 18 to 64 who are either at high risk of severe illness from COVID or who are at high risk of being exposed to the virus at their jobs.

All adults who received the single-dose Johnson & Johnson vaccine can get a booster shot two months after their original jab, but they are not currently approved for a third or fourth dose.

About 2.7 percent of U.S. adults are immunocompromised, according to the CDC.

Health officials and experts have drawn a distinction between an additional COVID-19 vaccine dose and a booster dose. An additional dose for immunocompromised people is meant to help their weakened immune systems mount a sufficient initial response, while booster doses for the general healthier population are meant to prop up an immune response that has waned since the person’s initial vaccination.

“We know that six months after you reached a good level of protection, your protection has waned … and we need to boost that,” Dr. Dorry Segev, a professor of surgery at Johns Hopkins University who is studying COVID vaccine responses in immunocompromised people told NBC News. “That’s for people with normal immune systems and people who are immunocompromised.”

Segev also clarified to the outlet that not all immunocompromised people will need to go through four vaccine doses.

“Out of the 11 million immunocompromised people in this country, some of them were fine with two doses,” Segev said. “Some of them were not fine with three doses. Some of them do need a fourth dose.”

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