Frequently Asked Questions - COVID-19 Vaccines and Boosters for Immunocompromised People

COVID-19 Vaccine and Booster Information for People who are Immunocompromised

Immunocompromised people ages 5+ who received Pfizer:

  • Dose 1: Pfizer
  • Dose 2: Pfizer, three weeks (21 days) after dose 1
  • Dose 3: Pfizer, four weeks (28 days) after dose 2
  • Dose 4/Booster 1: Ages 12+, three months after third dose, can be Pfizer or Moderna for ages 18+, must be Pfizer for ages 12-17
  • Dose 5/Booster 2: Ages 12+, four months after booster 1, must be Pfizer

Immunocompromised people ages 18+ who received Moderna:

  • Dose 1: Moderna
  • Dose 2: Moderna, four weeks (28 days) after dose 1
  • Dose 3: Moderna, four weeks (28 days) after dose 2
  • Dose 4/Booster Dose 1: Three months after dose 3. This dose can be Pfizer or Moderna
  • Dose 5/Booster Dose 2: Four months after dose 4. This dose can be Pfizer or Moderna

Immunocompromised people ages 18+ who received Johnson & Johnson:

  • Dose 1: Johnson & Johnson
  • Dose 2: Four weeks (28 days) after your first dose; can be Pfizer or Moderna
  • Dose 3/Booster 1: Three months after dose 2; can be Pfizer or Moderna
  • Dose4/Booster 2: Four months after booster 1; must be Pfizer or Moderna

Please review these COVID-19 vaccine recommendations from the CDC for people who are immunocompromised.

FAQs

These FAQs are about third vaccine doses for people who are immunocompromised.

For more information, read the Henry Ford LiveWell Blog article, “Why Should Immunocompromised People Get a Third COVID-19 Vaccine Dose?

I am immunocompromised – when can I get a third dose?

  • Pfizer and Moderna: You can get a third dose of the same vaccine you received for your first two doses 28 days after you get the second dose.
  • Johnson & Johnson: If you received Johnson & Johnson, you can get a second dose of any vaccine two months after the single shot.

What is the difference between a third dose and a booster?

For people who are immunocompromised, it is called an additional or third dose. People who are moderately to severely immunocompromised may not have built enough protection after the first two shots. The third shot dose is intended to improve your immune response.

For people who are not immunocompromised, it is called a booster. It is intended to raise (“boost”) the level of protection when it is has decreased over time so that it will be stronger and last longer.

Is the third dose the same as the first two/original dose?

Yes, for immunocompromised people the third dose of Moderna or Pfizer, or the second dose of any vaccine for those who received Johnson & Johnson, is the same as the original dose(s).

What vaccine should I get for my third dose if I originally had Johnson & Johnson and I’m immunocompromised?

You can get any of the available vaccines for a second dose – Pfizer, Moderna or Johnson & Johnson. You can get the second dose two months after the first one.

Can I “mix and match” vaccines and get a different kind for my third dose?

For people who are immunocompromised, a third dose of the same mRNA vaccine (Moderna or Pfizer) should be used. It is not recommended you mix vaccines. If you are immunocompromised and received Johnson & Johnson, you can mix vaccines. You can get any of the three available vaccines for a second dose – Moderna, Pfizer or Johnson & Johnson.

Can I get a fourth dose?

After completing the primary series, some moderately or severely immunocompromised people should get an additional (third) primary shot of Pfizer or Moderna in 28 days. For some immunocompromised people, a fourth shot/booster may be beneficial. Learn more and talk to your doctor to decide if a fourth shot is right for you. (People who are not immunocompromised should not receive a fourth shot.)

Will another dose increase my protection against COVID-19?

Vaccine studies have found that sometimes immunocompromised people don’t build the same level of immunity after vaccination as non-immunocompromised people. If you are immunocompromised, you will benefit from an additional vaccine dose and a booster to ensure adequate protection against COVID-19.

Why do I need another vaccine dose?

If you are immunocompromised, you cannot fight infections and diseases as well as other people. In addition, your body’s ability to produce protective antibodies after being vaccinated may not be as strong. In studies, some immunocompromised people who had low or no protection after the first two doses of mRNA vaccines (Pfizer and Moderna) had an improved response after an additional dose of the same vaccine. Many people who had low or no antibodies developed protective antibodies after receiving the third shot.

How does being immunocompromised affect me when it comes to COVID-19?

People who are moderately to severely immunocompromised are especially vulnerable to COVID-19 because they are more at risk of serious, prolonged illness.

What are the risks of getting an additional dose?

The safety profile is the same as for the first and second vaccine doses. Studies with immunocompromised people did not show severe adverse effects after a third dose.

Side effects reported after the third mRNA dose were similar to that of the two-dose series: fatigue and pain at injection site were the most commonly reported side effects, and overall, most symptoms were mild to moderate.

Will the third shot and/or booster improve my protection against the Delta and Omicron variants? 

Yes, following the recommendations will improve your protection against all strains of COVID-19, including the Delta variant and the Omicron variant. It will also reduce the chances of getting very sick, if you do contract COVID-19.

Where can immunocompromised people get more information about COVID-19 vaccines?

Please visit this CDC web page for more information.

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