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Effective August 13, 2021, CDC recommends that people who are moderately to severely immunocompromised receive an additional dose of an mRNA COVID-19 Vaccine (Pfizer-BioNTech or Moderna) at least 28 days after the completion of the initial mRNA COVID-19 vaccine series.

Available data show that these people don’t always build adequate levels of protection after an initial 2-dose primary mRNA COVID-19 vaccine series. The data also show that they may benefit from receiving an additional dose of an mRNA vaccine to develop as much protection as possible against COVID-19.

Who is Moderately to Severely Immunocompromised?

  • Currently, CDC is recommending that moderately to severely immunocompromised people receive an additional dose. This includes people who have:

  • Active treatment for solid tumor and hematologic malignancies

  • Receipt of solid-organ transplant and taking immunosuppressive therapy

  • Receipt of CAR-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)

  • Moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome)

  • Advanced or untreated HIV infection

  • Active treatment with high-dose corticosteroids (i.e., ≥20mg prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory.

Discuss the patient’s specific situation.

Factor in their medical conditions and level of immune suppression; level of COVID-19 community transmission and personal risk of infection; and current or planned immunosuppressive therapies affecting the patient’s medical condition and potential response to vaccine.

Explain the difference.

  • An additional mRNA dose following an initial vaccine series is given to people who may not have had a strong enough immune response after receiving the initial vaccine series.

  • A booster dose is a supplemental dose given to groups whose immune response has weakened over time. No booster doses are recommended at this time. This may change as more information becomes available.

Use the same vaccine product, when feasible.

People who need an additional dose and received either a Pfizer-BioNTech or Moderna vaccine series should receive a third dose of the same vaccine used.

Explain what Janssen vaccine recipients should know.

What we don’t know at this time is whether people who are immunocompromised who received the Janssen vaccine (Johnson & Johnson) have an improved immune response following an additional dose of the same vaccine.

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