Submitted by the Washington State Department of Health.

Health care providers can now offer third doses of Pfizer-BioNTech and Moderna COVID-19 vaccines to certain immunocompromised individuals following recommendations from the U.S. Food and Drug Administration (FDA), Advisory Committee on Immunizations Practices (ACIP), and Western States Scientific Safety Review Workgroup.

While authorized vaccines have proven to be more than 90% effective in protecting against most variants, emerging data suggest people with moderately to severely compromised immune systems do not always build the same level of immunity compared to people who are not immunocompromised. The third dose is not considered a booster, rather an additional dose for individuals who did not adequately develop immunities with the initial two-dose series. A full list of conditions is available on the CDC’s website cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html.

“A third dose of Pfizer or Moderna will provide those who need it extra protection and help shield some of our most vulnerable from the highly contagious delta variant,” said Secretary of Health Umair A. Shah, MD, MPH. “Science continues to show vaccines are the best tool we have to protect our communities and slow the spread of COVID-19.”

A person receiving a third dose should get it at least 28 days after dose two. When possible, the individual should receive the same vaccine as the first two doses, but may receive the other mRNA vaccine brand if the other vaccine is not available. At this time, no additional dose is recommended for people who had the Johnson & Johnson (Janssen) vaccine. People who received J&J should not get a second dose of either J&J or a dose of an mRNA vaccine. Additionally, people with competent immune systems should not receive a third dose.

While vaccination is likely to increase protection, people who are immunocompromised should continue to wear a mask, maintain 6 feet of social distancing, avoid crowds, and avoid poorly ventilated indoor spaces to protect themselves and those around them. Close contacts of immunocompromised people are strongly encouraged to be vaccinated against COVID-19 to help place a bubble of protection around them.