CDC, FDA recommend 3rd COVID vaccine dose for immune-compromised


Moderately and severely immunocompromised adults should receive a third dose of a COVID-19 mRNA vaccine, the Advisory Committee on Immunization Practices (ACIP) advised today following the Food and Drug Administration’s (FDA’s) authorization of third shots late yesterday.

A third dose should be given at least 28 days after the initial vaccinations series is complete, and the same vaccine should be used when possible, according to the FDA. In addition, the ACIP said that the additional dose would be given ideally 2 weeks before the start of immunosuppressive therapies.

The ACIP said recent data show third doses significantly boost the effectiveness of mRNA vaccines in this population, which includes those who have had an organ transplant, HIV patients, cancer patients, and people taking high-dose steroids or other immunosuppressive drugs.

During the ACIP meeting, Camille Kotton, MD, of the Massachusetts General Hospital transplant clinic, said she is seeing more immunocompromised, fully vaccinated patients require hospitalization for breakthrough COVID-19 infections.

Currently, immunocompromised people make up 40% to 44% of hospitalized breakthrough infections in the United States, according to a slide shared at the ACIP meeting. Studies have shown that the vaccines are only 59% 72% effective after two doses in this group, as opposed to 90% to 94% effective in healthy adults.

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