Craig Press file
Content provided by UCHealth
Medical providers are working quickly to give third doses of COVID-19 vaccines to immunosuppressed patients now that federal health officials have authorized extra protection for people who have had difficulty producing antibodies to the coronavirus.
The third doses no longer are considered “booster” shots for this particular group of people. Instead, three COVID-19 vaccine doses now will be standard for about 3% of the U.S. population. The new, third doses apply to the following people: organ transplant recipients, cancer patients, people who have received stem cell transplants in the previous two years or who are taking medicine to suppress their immune systems, patients with severe primary immunodeficiency such as DiGeorge syndrome or Wiskott-Aldrich syndrome, and people with advanced HIV infection.
UCHealth leaders are expanding vaccine clinics over the coming weeks to provide third doses to qualifying patients as soon as possible.
“I fully support and applaud the decision,” said Dr. Thomas Campbell, who has overseen clinical trials for COVID-19 vaccines at UCHealth University of Colorado Hospital on the Anschutz Medical Campus. “We need to do what we can to protect our immunosuppressed patients.
“Right now, there are surges in cases across the United States, and we know that there are breakthrough cases, meaning people who have been fully vaccinated are getting COVID-19,” Campbell said. “We know that people who are immunosuppressed are disproportionately represented among those who are getting breakthrough cases.”
So far, doctors are not recommending third doses of COVID-19 vaccines for healthy people.
“We know that these vaccines are very safe and effective for healthy people. But, we don’t have a lot of data about third doses in otherwise healthy people,” Campbell said.
So, he is urging people without compromised immune systems to wait for new guidance.
Leaders at the Food and Drug Administration (FDA) authorized third doses for some immunocompromised people on Aug. 12, and a committee of experts at the Centers for Disease Control and Prevention (CDC) endorsed the decision on Aug. 13.
FDA and CDC experts plan to decide soon whether to authorize booster shots — or third shots about eight months after people received their first two doses of a COVID-19 vaccine — for healthy people if research shows that the effectiveness of the vaccines is waning over time.
Frontline health care workers and older adults could be first in line for those booster shots since many received their initial doses of COVID-19 vaccines back in December and January.
CDC experts outlined the following guidelines for the third dose of COVID-19 vaccines for immunocompromised people:
- Get the third dose at least 28 days after receiving the second dose of the Pfizer or Moderna vaccine.
- If possible, try to get a third dose of the same vaccine that you received for the first two doses. So, if you got Moderna for your first two doses, try to get Moderna for your third. The same is true for those who received Pfizer. But, if it’s not possible to get the same type of vaccine for a third dose, health experts said it’s OK to get a different type of vaccine.
- No doctor’s order is needed for the extra dose.
- In order to get the third dose, patients can “attest” that they have a qualifying condition.
- The authorization of a third dose of COVID-19 vaccines for immunocompromised people does not apply to people who received the Johnson & Johnson (J&J) single-dose vaccine. Health authorities said they do not have enough data yet to determine whether immunocompromised people who received the J&J vaccine should get an additional vaccine dose.
- While early research shows that a third dose of a COVID-19 vaccine may give immunocompromised people some additional protection, they still may be at greater risk of getting COVID-19. Therefore, immunocompromised people should continue to wear masks, avoid crowds, practice social distancing and avoid close contact with people who have not gotten their COVID-19 vaccines.
“Patients who have solid-organ transplants, such as liver, heart, kidney and lung transplants, have reduced responses to the vaccine,” said Dr. James Burton, who is the Medical Director of Liver Transplantation at University of Colorado Hospital and also a professor of medicine and gastroenterology at the University of Colorado School of Medicine.
“While normal people have about a 95% chance of being protected from the original strain of COVID-19, people with suppressed immune systems might have only a 50/50 chance of being protected from COVID-19 infection,” Burton said.
Burton is thrilled people with compromised immune systems now will be able to get additional vaccine doses. Still, he urges them to continue to be cautious and vigilant.
“Make sure you’re practicing social distancing and continuing to wear masks,” Burton said. “The delta variant is widespread. If you’re a transplant patient, it could kill you.”
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