As of Friday August 13th, the CDC is now recommending that people with moderate to severe compromised immune systems should receive an additional dose (booster) of the COVID-19 vaccine after the initial two-dose vaccine series. At MOH, many of our patients have moderately to severely compromised immune systems and do not always build the same level of immunity compared to people with normal immune systems. The CDC recommendation identifies people with a range of conditions including:
- Those receiving active cancer treatment for tumors or cancers of the blood
- Those that have had a bone marrow or stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
- Those with advanced or untreated HIV infection
- Those actively being treated with high-dose corticosteroids or other drugs that may suppress your immune response
A full list of conditions can be found on CDC’s website.
Frequently Asked Questions (FAQs)
- Can you mix and match the vaccine type?
For people who received either Pfizer or Moderna’s COVID-19 vaccine series, a 3rd dose of the SAME mRNA vaccine should be used at least 4 weeks after completing the two-dose vaccine series. A person should not receive more than three mRNA vaccine doses.
- What should immunocompromised people who received the J&J vaccine do?
The FDA’s & CDC’s recent amendment only applies to mRNA COVID-19 vaccines from Pfizer and Moderna. There is not enough data at this time to determine whether immunocompromised people who received the J&J vaccine also have an improved antibody response following an additional dose of the same vaccine.
- Do I need a letter from my doctor in order to get the vaccine?
At this time you do not need a letter from your physician in order to get the COVID-19 booster. You will be able to self-attest that you meet criteria.
- If I am immunocompromised and I get the booster, can I stop wearing a mask?
While the Delta variant is surging, an additional vaccine dose for some people with weakened immune systems could help prevent serious and possibly life-threatening COVID-19 cases within this population. Even after vaccination, people who are immunocompromised should continue follow current prevention measures (including wearing a mask, staying 6 feet apart from others they do not live with, and avoiding crowds and poorly ventilated indoor spaces) to protect themselves and those around them against COVID-19 until advised by your provider .
Q – Which vaccines are available?
- At this time, two vaccines have been submitted for United States Food and Drug (FDA) Emergency Use Authorization (EUA).
- Vaccine availability in Maryland will depend on a number of factors including availability as well as vaccine storage capabilities.
- General information published about each vaccine includes:
- The Pfizer-BioNTech vaccine: Contains a tiny fragment of the virus’s genetic code made in the lab – called messenger RNA, or mRNA – that codes for a part of the virus called the ‘spike protein’, which sits on the outside of the virus. When the mRNA is injected into the body it can instruct cells to produce these proteins, priming the immune system to be able to recognize and destroy the coronavirus, without exposing the body to the virus itself. This vaccine must be stored at -70°C (-94 oF). This vaccine received FDA EUA approval on December 11, 2020.
- Moderna vaccine: Like the Pfizer-BioNTech vaccine, the Moderna vaccine contains mRNA that codes for the virus’s spike protein. It can be stored at –20°C
(-4oF; normal freezer temperature) for up to 6 months. This vaccine received FDA EUA approval on December 17, 2020.
Q – Which vaccine is most appropriate for me?
- All the vaccines that are approved by the FDA may be considered.
Q – Is the vaccine effective against COVID-19?
- Detailed information about the effectiveness of each vaccine is available from the respective manufacturers, the FDA and the CDC. Based on clinical trials reviewed by the FDA:
- The Pfizer vaccine is 95% effective 7 days from the 2nd dose.
- The Moderna vaccine is 94.5% effective 14 days from the 2nd dose
- Ongoing studies to assess how well the vaccine works in real-world conditions will continue.
Q – How do we know the vaccine is safe?
- FDA EUA approval requires the same rigorous review of clinical trial data as any other FDA approval.
Q – Is the vaccine safe if I am receiving immunotherapy?
- Based on information studying the influenza vaccines, it appears that vaccines are safe to use in this population of patients. Further information on the COVID-19 vaccines, is not available currently.
- We will continue to monitor for information and guidance on immunization in special populations including patients on immunotherapy.
Q – Has it been studied/is it safe in immunocompromised individuals? What about in pregnancy and children?
- The EUA for the Pfizer-BioNTech vaccine is for ages 16 and older.
- There is no published data in the studies on this; however, we will continue to monitor for published guidance.
- There have been no published studies to include pregnant women or children <12 yrs. of age. These data points are still being collected.
Q – What are the common side effects?
- Each vaccine manufacturer has identified various possible side effects for its respective vaccine. Information about side effects is available from each manufacturer, but some reported side effects include:
- Pfizer-BioNTech vaccine
- Fatigue 3.8%
- Headache 2.0%
- Older adults demonstrated fewer side effects
- Moderna vaccine
- Injection site pain 2.7%
- Fatigue 9.7%
- Myalgia (muscle aches and pains) 8.9%
- Arthralgia (joint pain) 5.2%
- Headache 4.5%
- Pain 4.1%
- Erythema (superficial redness of the skin) 2.0%
Q – Will vaccination help or hinder my response to treatment?
- There is no published data in the studies on this; however, the decision to receive the vaccine should be made after consultation with your health care provider.
Q – What happens if I refuse to receive the vaccine?
- You as a patient always have the right to refuse any treatment. Your provider should provide adequate education to ensure you can make an informed decision.
Q – How soon after I get the vaccine will I become protected from contracting COVID-19?
- According to the manufacturer, the Pfizer vaccine provides optimal immunity 7 days after the second dose.
- According to the manufacturer, the Moderna provides optimal immunity 14 days after the second dose.
- Other COVID-19 precautions such as mask wearing, hand washing, and social distancing should be continued after vaccination. It has not been clearly established at what point after vaccination it is safe to discontinue other COVID-19 precautions.
Q – Can I get COVID-19 from getting the vaccine?
- Per the CDC you cannot develop COVID-19 from vaccines that do not use the live virus.
- There are several different types of vaccines in development. The goal for each of them is to teach our immune systems how to recognize and fight the virus that causes COVID-19. Sometimes this process can cause symptoms, such as fever. These symptoms are normal and are a sign that the body is building immunity.
*These FAQs consolidate into one document information published or otherwise provided by the Centers for Disease Control, the World Health Organization, the US Food and Drug Administration, professional societies, academic centers, and other experts. Any recommended courses of action made by the foregoing agencies or experts and included in this document are only recommendations.