COVID-19 Vaccine Third Dose and Boosters Third Dose for Immunocompromised
The FDA has amended the emergency use authorizations (EUAs) for both the Pfizer-BioNTech COVID-19 Vaccine and the Moderna COVID-19 Vaccine to allow for the use of an additional dose in certain immunocompromised individuals, specifically, solid organ transplant recipients or those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise.
CDC Guidance for Moderately to Severely Immunocompromised People
The CDC definition of immunocompromised:
Been receiving active cancer treatment for tumors or cancers of the blood
Received an organ transplant and are taking medicine to suppress the immune system
Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
Advanced or untreated HIV infection
Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response
The patient received either 2 Moderna vaccines or 2 Pfizer vaccines with the last dose a minimum of 28 days ago
Here are links to updated consents and screening questions that included the immunocompromised language
Prior Infection and Elevated Covid-19 Antibody Titers as Protection Against Ongoing Infection From COVID-19 (information compiled by Gary Greensweig, MD)
Nature Scientific report on predictive values, uncertainty, and interpretation of serology tests for the novel coronavirus
Excerpt from NEJM 05/20 2020: In this placebo-controlled vaccine trial, we found that previous infection with first-wave prototype-like, pre-B.1.351 viruses did not appear to reduce the risk of Covid-19 due to subsequent infection with B.1.351 variants among placebo recipients during the initial 2 months of follow-up. This finding is preliminary and may have public health implications for pandemic modeling, control strategies, and vaccine development and deployment efforts. It is also consistent with the lack of incremental benefit conferred by preexisting immunity in vaccine recipients as evidenced in our trial by consistent levels of efficacy regardless of baseline serostatus for SARS-CoV-2. Although these findings require further confirmation, our observations suggest that vaccination with prototype-sequenced NVX-CoV2373 conferred a degree of cross-protection against an immunologic escape variant.
FDA CDC Guidelines on on Antibody Testing for the purpose of assessing Immunity to Covid-19 Infection
Cleveland Clinic Statement on Previous COVID-19 Infection Research (Updated August 16, 2021): "In June, we shared research that provided insight into how the immune system protects the body after a confirmed COVID-19 infection. The study followed Cleveland Clinic caregivers over five months as the vaccination process was beginning. The data showed that the vaccine was extremely effective in preventing COVID-19 infection. In addition, during the study, none of the employees who had confirmed positive PCR tests and remained unvaccinated were re-infected. It’s important to note that this study was conducted in late 2020 and early 2021, before the emergence of the Delta variant. More research is needed. We do not know how long the immune system will protect itself against re-infection after COVID-19, as our study only looked at individuals over a five-month period, or how well-protected previously infected individuals are against variants. It is also important to keep in mind that this study was conducted in a population that was younger and healthier than the general population. It is safe to receive the COVID-19 vaccine even if you have previously tested positive, and we recommend all those who are eligible receive it."
Best practices from Physician Enterprise Physicians and Advanced Practice Providers on what has worked in their practices to address vaccine hesitancy, uncertainty, and apathy in patients.
Handouts addressing the top six sources of misinformation about COVID-19 and the vaccines including mRNA, safety, side effects, rushed and spreading to others.
A website of resources from our Population Health team to help connect with your communities on vaccination education.
Social media assets addressing vaccine hesitancy are available for your social media channels. Please connect with your local marketing and communications team for more information or to use the content.