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.
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.
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.