COVID-19 Vaccine Third Dose and Boosters
COVID-19 Booster Shot Eligibility
According to CDC guidance as of October 7, 2021, COVID-19 vaccine booster shots are available for the following Pfizer-BioNTech vaccine recipients who completed their initial series at least 6 months ago and are:
- 65 years and older
- Age 18+ who live in long-term care settings
- Age 18+ who have underlying medical conditions
- Age 18+ who work in high-risk settings
- Age 18+ who live in high-risk settings
COVID-19 Booster Shot Recommendations
In addition to immunocompromised patients, in September 2021, the CDC has updated its recommendations on Pfizer booster doses to include the following individuals:
- People 65 years and older and residents in long-term care settings should receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series,
- People aged 50-64 years with underlying medical conditions should receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series,
- People aged 18-49 years with underlying medical conditions may receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks, and
- People aged 18-64 years who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting may receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks.
Note that persons who received Moderna or Johnson & Johnson vaccines for their primary doses are currently not included in the CDC recommendation, and are not eligible to receive booster doses at this time (with the exception of those who are immunocompromised and received two shots of Moderna, see below).
COVID-19 Third Dose – Recommendations for Immunocompromised
In August 2021, the CDC issued third dose (Pfizer or Moderna) recommendations for individuals who are moderately or severely immunocompromised.
You are eligible to receive a third dose if you are either:
- aged 12 and above and you completed the two shots of the Pfizer-BioNTech COVID-19 vaccine at least 28 days ago; or
- aged 18 and you completed the two shots of the Moderna COVID-19 vaccine at least 28 days ago;
And you are moderately or severely immunocompromised; specifically, that at least one of the following applies to you:
- You have been receiving active cancer treatment for tumors or cancers of the blood;
- You have received an organ transplant and are taking medicine to suppress the immune system;
- You have received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system;
- You have a moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome);
- You have advanced or untreated HIV infection; or
- You are undergoing active treatment with high-dose corticosteroids or other drugs that may suppress your immune response.
If you are unsure if the medication that you take is an immune-suppressing or immune-modulating medicine, which would make you eligible for a third dose of the vaccine, please see this list of medications (this list is not intended to be all-inclusive). You can also speak with your health care provider about your medical condition, and whether getting an additional dose is appropriate for you.
Scheduling is available by phone at 860-679-5589. Please note, we will not take walk-ins for third doses.
What is the difference between a third dose and a booster?
- Third dose is the term for the immunocompromised people who get three doses - their initial vaccine probably should be a three-dose series so they are offered a third dose after 4 weeks (28 days) from their second.
- The booster dose refers to the non-immunocompromised individuals who are given a third-dose “booster” based on the idea that they respond well to two doses but their immunity wanes so they are offered a booster dose after 6 months.
Who is recommending an additional dose of the COVID-19 vaccine and why is this being recommended?
The U.S. Food and Drug Administration (FDA) amended the emergency use authorizations (EUAs) for both the Pfizer and Moderna COVID-19 Vaccines to allow for the use of an additional dose in certain immunocompromised individuals. The Centers for Disease Control (CDC) now recommends an additional dose for these patients. This is as a result of medical studies suggesting a reduced antibody response after the usual two-dose vaccine primary series.
Do I qualify for an additional dose of the COVID-19 vaccine?
The CDC recommends an additional dose for patients with the following conditions:
- Active or recent treatment for cancer
- Previous stem cell transplant or CAR T-cell therapy
- Previous solid organ transplant (such as a kidney or liver transplant)
- Moderate or severe primary immunodeficiency
- Advanced or untreated HIV infection
- Active treatment with immune-suppressing medications, including high-dose corticosteroids, chemotherapy, tumor necrosis factor (TNF) inhibitors, and other biologic agents that suppress or modulate the immune system
This recommendation only applies to individuals who received an mRNA vaccine, in other words, the Pfizer or Moderna vaccine. At this time, the CDC is not recommending an additional dose for patients who received the Johnson & Johnson/Janssen vaccine, even if they are immunocompromised.
If I qualify for an additional dose, how long do I need to wait after my second dose of an mRNA vaccine before receiving an additional dose?
If you have one of the above conditions, you are eligible to receive an additional dose if:
- You received two doses of the Pfizer vaccine, at least 28 days have passed since your last dose, and you are at least 12 years old;
- You received two doses of the Moderna vaccine, at least 28 days have passed since your last dose, and you are at least 18 years old.
If I received the Johnson & Johnson/Janssen vaccine do I qualify for an additional vaccine dose or a dose of an mRNA vaccine?
At this time there is no recommendation for individuals who received a Johnson & Johnson/Janssen vaccine to receive an additional dose or a dose of an mRNA vaccine.
If I qualify for an additional dose of an mRNA COVID-19 vaccine should I have a COVID-19 antibody test prior to receiving an additional dose?
No. The use of antibody (serologic) testing to make a decision about receiving an additional dose of vaccine is not recommended at this time.
If I qualify for an additional dose of an mRNA COVID-19 vaccine and received a Pfizer mRNA vaccine for my initial doses, which vaccine which vaccine should I receive for my additional dose?
The additional mRNA COVID-19 vaccine dose should be the same vaccine product as the initial 2-dose mRNA COVID-19 primary vaccine series (Pfizer-BioNTech or Moderna). If the mRNA COVID-19 vaccine product given for the first two doses is not available, the other mRNA COVID-19 vaccine product may be administered. A person should not receive more than three mRNA COVID-19 vaccine doses.
If I qualify for an additional dose of an mRNA COVID-19 vaccine, do I need to have a doctor’s note to receive the vaccine?
No. Individuals who qualify for an additional dose can self-attest to their qualification and a doctor’s note is not necessary.
How long should people wait between receiving another vaccine (such as a flu vaccine) and a dose of a COVID-19 vaccine?
COVID-19 vaccines and other vaccines may now be administered without regard to timing. This includes simultaneous administration of COVID-19 vaccine and other vaccines on the same day, as well as co-administration within 14 days.
Should individuals with moderate to severe immunocompromised conditions continue to use preventive measures to protect against COVID-19 after receiving an additional COVID-19 vaccine dose?
Yes. People who are immunocompromised (including people who receive an additional mRNA COVID-19 vaccine dose after an initial 2-dose primary mRNA COVID-19 vaccine series) may have a reduced immune response to COVID-19 vaccines and need to continue to follow current preventive measures (including wearing a mask, staying 6 feet apart from others they don’t live with, and avoiding crowds and poorly ventilated indoor spaces) to protect themselves against COVID-19 until advised otherwise by their healthcare professional. Close contacts of immunocompromised people should also be strongly encouraged to be vaccinated against COVID-19 to protect these people.