- Immunocompromised Definition
- Additional Primary Dose vs. Booster Shot
They can get any of the three vaccines available:
- Moderna COVID-19 vaccine (mRNA COVID-19 vaccine): Ages 18 and older
- Pfizer-BioNTech COVID-19 vaccine (mRNA COVID-19 vaccine): Ages 12 and older
- J&J/Janssen COVID-19 vaccine: Ages 18 and older
The COVID-19 vaccine primary series should be administered, which includes one of the following:
- Two-dose mRNA COVID-19 vaccine series
- Single dose of the J&J/Janssen COVID-19 vaccine
What qualifies as immunocompromised?
The term immunocompromised is used to represent a wide variety of conditions and medications that impair immune system function. These include patients with:
- Primary immunodeficiencies present from birth, such as:
- Secondary immunodeficiencies due to medical conditions, such as:
- Organ transplant recipients or those taking medications to suppress the immune system
- Stem cell transplant recipients within the last 2 years or those taking medications to suppress the immune system
What is the difference between an additional primary dose and a booster shot?
- Additional primary dose: A primary vaccine series is administered to induce an immune response in healthy people. However, immunocompromised people cannot build enough immunity from the two-shot primary vaccine series. This can increase their chances of severe illness and death. Therefore, a third dose called an additional primary dose may greatly increase their chances of achieving the necessary protection against COVID-19.
- Booster shot: A booster shot is given when immunity buildup from the primary vaccine series wanes over time. Booster shots enhance immunity.
Do immunocompromised people need both an additional primary dose and a booster shot?
Immunocompromised people need both the additional primary dose and booster shot.
Additional primary dose after receiving the vaccines
If immunocompromised individuals received a Pfizer-BioNTech or Moderna vaccine primary series and have a moderately to severely compromised immune system, they should receive an additional primary dose of the same mRNA COVID-19 vaccine at least 28 days after the second dose.
Additional primary dose after receiving J&J/Janssen COVID-19 vaccine
Currently, the CDC does not recommend an additional primary dose for immunocompromised individuals who received the single dose of the J&J/Janssen COVID-19 vaccine.
Booster dose after receiving mRNA vaccines
Moderately to severely immunocompromised people aged 18 years and older who received the Pfizer-BioNTech or Moderna primary series, as well as an additional primary vaccine dose, may get a booster shot after at least 6 months of completing their primary vaccine series.
Booster dose after receiving J&J/Janssen COVID-19 vaccine
Immunocompromised people aged 18 years and older who received a J&J/Janssen COVID-19 vaccine primary dose should also receive a single COVID-19 vaccine booster shot 4 months after the primary dose.
Selecting the vaccine type for the booster shot
Individuals who are due for booster shots can choose any vaccine for their booster shot. The vaccine can be the same as their primary series or a different COVID-19 vaccine. For example, if an individual has completed the primary series of the Pfizer-BioNTech COVID-19 vaccine, they can opt for a booster shot with any of the available vaccines: Pfizer-BioNTech COVID-19 vaccine, Moderna vaccine COVID-19 vaccine, or J&J/Janssen COVID-19 vaccine.
Many studies suggest an added benefit of taking a cocktail booster. This means taking an mRNA booster after completing the primary Janssen series. People can consult their doctors about which vaccine type may suit them best for their booster shot.
Does an additional primary dose come with any risks?
There is limited data regarding whether receiving an additional primary dose carries any risk for immunocompromised individuals. Research is still underway to determine the safety and effectiveness in these individuals.
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Centers for Disease Control and Prevention. Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html
Centers for Disease Control and Prevention. COVID-19 Vaccines for Moderately to Severely Immunocompromised People. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html