CDC recommends extra COVID vaccine doses for vulnerable Americans

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INDIANAPOLIS — The CDC’s Advisory Committee on Immunization Practices unanimously voted to allow a third dose of COVID-19 vaccines for those with compromised immune systems.

The new guidance comes just one day after the FDA amended its original Emergency Use Authorization to say transplant recipients and others with severely weakened immune systems can get an extra dose of the Pfizer or Moderna COVID-19 vaccines to better protect them as the delta variant continues to surge.

According to the CDC, roughly 7 million American adults are classified as immune-compromised, or roughly 2.7% of the U.S. adult population. The agency said patients with the following conditions would be considered immunocompromised.

  • Active or recent treatment for solid tumor and hematologic malignancies  
  • Receipt of solid-organ or recent hematopoietic stem cell transplants  
  • Moderate or severe primary immunodeficiency (e.g., DiGeorge, Wiskott-Aldrich syndromes)  
  • 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, TNF blockers, and other biologic agents that are immunosuppressive or immunomodulatory
  • Chronic medical conditions such as asplenia and chronic renal disease may be associated with varying degrees of immune deficit

“What we would recommend at Community Health Network, at this time, is if you are an organ transplant recipient, if you are in active chemotherapy, or if you have HIV — those three conditions in particular may make it so that your body does not produce enough antibodies with the first two shots,” said Dr. Robin Ledyard, Community Health Network Chief Medical Officer.

Dr. Ledyard said Hoosiers in these categories should absolutely consider getting a booster shot and it comes highly recommended.

According to data discussed during the CDC’s ACIP meeting, anywhere from 40-44% of hospitalized breakthrough cases across the U.S. are immunocompromised people.

The agency said both vaccines are also less effective in this vulnerable population — dropping to a 59-72% efficacy rate among immunocompromised individuals compared to a 90-94% efficacy rate seen in non-immunocompromised individuals.

“I just want to be able to live my life,” said Lena Harvey who has suffered from sickle cell disease her whole life. “I deserve to be able to go to the movies, to the drive-in, to the – anywhere! Anywhere with my family! I deserve that. We all deserve that.”

Harvey said she jumped at the first opportunity she had to get vaccinated back in March. Unfortunately for her, that first opportunity was the Johnson and Johnson vaccine, meaning despite her condition she is not yet eligible for a booster dose.

“From where I’m at right now, I am expecting for them to say there’s going to be a booster coming soon and so that’s really kind of what I’m waiting for,” said Harvey. “I’m ready for whatever’s going to help me succeed and get to the next level.”

“I would not worry if you had the Johnson and Johnson vaccine. That efficacy has not been studied in relation to the booster – there may be more to come. But at this point in time, with the Johnson and Johnson, we know that you remain safe against COVID19,” said Dr. Ledyard. “If you do have one of the immunocompromised conditions and you got Johnson and Johnson, talk to your doctor if they would recommend any other mitigation strategies.”

The Centers for Disease Control and Prevention revealed roughly 1.1 million people have already gotten at least a third dose of the Pfizer or Moderna vaccines on their own.

The agency said small studies have been done and revealed 33-50% of those who had no detectable antibody response to an initial mRNA vaccine series developed an antibody response after a third dose. No serious adverse events were reported either.

If you are immunocompromised and received either Pfizer or Moderna, the CDC recommends you get that third dose no sooner than 28 days after your second dose. The committee also recommends patients get that third dose at least two weeks before initiation of immunosuppressive therapies.

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