08.26.2021
On August 12, 2021, the FDA modified the Emergency Use Authorization (EUA) to allow for the administration of 3rd dose of an mRNA (i.e., Moderna, Pfizer) COVID-19 vaccine for moderately or severely immunocompromised individuals, which was then supported by the CDC.
In response, Munson Healthcare will be offering the 3rd mRNA dose to be ordered for any current inpatient who meets the current EUA criteria.
Key Notes
- It is recommended that the patient receive the same vaccine (i.e., Moderna, Pfizer) as their first 2 doses, if it is available. If the mRNA COVID-19 vaccine product given for the first two doses is not available, the other mRNA COVID-19 vaccine product may be administered.
- Until additional data are available, the additional dose of an mRNA COVID-19 vaccine should be administered at least 28 days after completion of the initial 2-dose mRNA COVID-19 vaccine series.
- There is no booster (i.e., 2nd dose) of Johnson & Johnson’s Janssen vaccine currently recommended for immunocompromised individuals due to insufficient data to support a recommendation.
- To protect themselves against COVID-19, people who are immunocompromised (including those who have received a 3rd dose of COVID-19 vaccine) should continue to follow prevention measures (e.g., masking, physical distancing from those they don’t life with, and avoiding crowds and poorly ventilated indoor spaces).
Immunocompromised individuals include but are not limited to:
- Active treatment for solid tumor and hematologic malignancies
- Receipt of solid-organ transplant and taking immunosuppressive therapy
- Receipt of CAR-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)
- 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, TNF blockers, and other biologic agents that are immunosuppressive or immunomodulatory
- Some chronic diseases may lower immune response and patients should speak to their primary care physician about whether a 3rd dose is right for them. Factors to consider in assessing the general level of immune competence in a patient include disease severity, duration, clinical stability, complications, comorbidities, and any potentially immune-suppressing treatment.
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