The U.S. Food and Drug Administration (FDA) amended the Emergency Use Authorizations (EUA) for both the Moderna and Pfizer COVID-19 vaccinations to allow third dose administration in individuals who are immunocompromised. The Advisory Committee on Immunization Practices has voted to recommend a third dose of these vaccines for this population under the parameters below, and the Centers for Disease Control has officially adopted these recommendations.

Individuals eligible for a third dose include people with certain medical conditions or people receiving treatments that are associated with moderate to severe immune compromise:1

  • 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, tumor-necrosis (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory.

Verification of Eligibility:
A doctor’s note or prescription for a third dose is not required; self-attestation is all that is necessary to verify eligibility.

Age Criteria:
The age criteria remain the same as for the initial series of the Pfizer (at least 12 years old) and Moderna (at least 18 years old) vaccines.

Timing:
The third dose of either the Pfizer or Moderna vaccine should be administered at least 28 days following the second dose.
Whenever possible, mRNA COVID-19 vaccination doses (including the primary series and an additional dose) should be given at least two weeks before initiation of immunosuppressive therapies.