COVID-19 Vaccine: Third Doses Now Recommended for Immunocompromised Patients

covid 19 vaccine third doses now recommended

In a recent Facebook Live with Dr. Eddie Stenehjem, infectious disease physician, he discussed where the state of Utah is in regards to COVID-19 as of the end of August 2021. As the situation changes weekly and even daily, check out our most recent Facebook Live conversations to stay up to date.

Why is it important for immunocompromised people to receive a third dose of vaccine?

Immunocompromised patients don’t respond as vigorously to the vaccine as somebody that is not immunocompromised. A third dose increases the likelihood of generating an antibody response, which we suspect is going to make the vaccine efficacy better. That's the reason why a third shot is recommended for immunocompromised patients.

If you are immunocompromised, either on certain immunosuppressive medications, have advanced or untreated HIV, are receiving cancer chemotherapies, or are a transplant patient, you can go to any of our community vaccine sites and get a third dose. We highly recommend that people do that. Go on VaccineFinder and find a local place that will offer vaccines. Don’t mix and match vaccine types. If you got Pfizer, get a third shot of Pfizer. If you got Moderna, get a third shot of Moderna. Sometimes specialists who care for immunocompromised patients may help recommend the right timing for vaccination; however, there are rarely any circumstances when vaccination would not be recommended in immunocompromised patients. For those who haven’t yet received first and second doses, we strongly encourage you to start the initial series of vaccinations.

What are the recommendations for those who are immunocompromised and received the Johnson & Johnson vaccine?

The FDA came out and did not recommend a second shot. The reason they didn't do that is that there's no data on mixing and matching with a J&J vaccine. We should have data on that mixing and matching, especially with J&J in the next few weeks. I highly expect that we will have a recommendation on those that received J&J in the next coming weeks about what that in their case second dose would look like.

At this point, sit tight and continue to practice those public health measures: masking, socially distancing, washing your hands. We need to do that regardless of vaccine status, but those J&J immunocompromised patients likely will be getting a second dose in the coming weeks. We just have to wait on some of the data.

When will a third dose be available for the general public?

Health officials around the world have been investigating the potential need for an additional dose of COVID vaccine for the general population, but to date we have heard no guidance for U.S. healthcare providers. At Intermountain, we continue to focus on helping individuals receive the first and second dose of the COVID vaccine – and most recently a third dose in the primary series for those that are immunocompromised – and would encourage anyone with questions to talk to their healthcare provider.

The comments about potential plans of an additional dose at the federal level demonstrate that the vaccine is being very closely monitored, both for safety and effectiveness. The combination of vaccination with masking, social distancing, and staying home when sick is our best defense against this disease.

Why do we even need this third dose for the general public?

What we're seeing is this step down in vaccine effectiveness over these past couple months, likely due to a combination of waning immunity and the Delta variant. We know from previous vaccine studies that giving another dose will boost your immune response. That's the reason.

Why do you need the vaccine if you've COVID before and have the antibodies?

The recommendation is that even if you've had COVID-19, get the vaccine. We don't know how long you’ll be immune after having had it. We don't know whether or not that's protective against Delta. The studies that we do have shown that prior infection with a positive antibody response is protective for a period of time, but we just haven't had the studies go long enough to say for how long.

What we do know is that people that get vaccinated definitely have protection against Delta. That is the safest method. We highly recommend getting vaccinated, even with a prior history of COVID-19.

Is COVID-19 going to continue to circulate forever?

Currently, COVID-19 is here to stay. I don't anticipate this going away completely. We're going to have to learn how to vaccinate appropriately, likely on a seasonal basis matching the most common viral strains. That can be done, like with the flu.