Third COVID-19 vaccine shots available for immunocompromised

Virginia is making third doses of the Pfizer-BioNTech and Moderna COVID-19 vaccines available for moderately and severely immunocompromised Virginians.

This move comes after the CDC updated its vaccination guidelines to recommend third mRNA doses for people who have significantly compromised immune systems. Vaccines are readily available throughout Virginia, and vaccine providers are expected to make third doses available over the next several days as they adapt their processes.

“This is important additional protection for people who have impaired immune systems,” said State Health Commissioner M. Norman Oliver, M.D., M.A. “As COVID-19 cases rise across Virginia and the country, everyone who is eligible should get appropriately vaccinated as soon as they can.”

The CDC’s move is the final step in the authorization process for third doses of the mRNA vaccines for some eligible populations. Studies have shown that people with a compromised immune system can have a weak response to the standard vaccine regimen, and that a third dose is needed to strengthen immunity in these persons and protect them from serious COVID-19 complications.

The FDA evaluated those studies and recommended the change to the CDC on Thursday.

Only Pfizer-BioNTech and Moderna are mRNA vaccines, and therefore the FDA has not recommended additional doses of the Johnson & Johnson vaccine. Additionally, the FDA has not recommended booster vaccines for the general public.

Those immunocompromised who have already received two doses of either Moderna or Pfizer-BioNTech should wait at least 28 days after their second dose before receiving their third dose.  The third dose should be the same manufacturer as the previous two doses when possible, but this is not required.

This EUA expansion is estimated to include approximately 3 percent of people in the United States. Immunocompromised persons are those whose immune mechanisms are deficient because of certain immunologic disorders or immunosuppressive therapy.

As of today, approximately 4,144,080 Virginians have received two doses of an mRNA vaccine and approximately 124,322, or 3 percent of these Virginians, may be immunocompromised and therefore be eligible to receive a third dose.

Individuals with questions about whether they are significantly immunocompromised should consult their healthcare providers.

While available evidence shows that a third dose provides a modest benefit to improving the immune response to mRNA vaccination, it is important to remember that immunocompromised persons might still not have a strong level of protection against COVID-19, even after receiving a third dose of vaccine.

Additional COVID-19 precautions remain important for this population. These include wearing a mask, maintaining physical distance from others outside of the home, and avoiding crowds and poorly ventilated indoor spaces until advised otherwise by their healthcare provider.

Persons who are significantly immunocompromised should also discuss the possibility of monoclonal antibody treatment options with their healthcare provider in case they get infected with or are exposed to COVID-19. Household members and other close contacts of significantly immunocompromised persons should get fully vaccinated to provide increased protection to their loved ones.

VDH, physicians and healthcare workers, and vaccine providers across the Commonwealth stand ready to assist this vulnerable population to obtain the added protection a third vaccine dose will provide against COVID-19.

Just like previous EUA authorizations and CDC ACIP approvals, additional clinical considerations have been published that provide more detailed guidance. These clinical considerations will provide necessary guidance to assist COVID-19 providers in implementing these new recommendations.

In Virginia, providers may begin administration of third mRNA doses for this vulnerable population across the Commonwealth in accordance with these clinical considerations.

For more information on COVID-19 in Virginia, visit vdh.virginia.gov/coronavirus. Anyone age 12 or older can find free vaccination clinics near them by visiting vaccinate.virginia.gov or calling 877-VAX-IN-VA (877-829-4682, TTY users call 7-1-1).