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What you need to know about COVID-19 third doses and boosters

Dr. Adam Weston, an infectious disease specialist at Lowell General Hospital and a clinical leader in the hospitals’ pandemic response discusses the latest updates on 3rd dose and booster shots as well as the outlook for COVID-19 this fall.

Third Doses and Boosters

  • An additional, or third dose, of vaccine is administered when the immune response following a primary vaccine series is likely to be insufficient. This is currently recommended by the Centers of Disease Control and Prevention (CDC) for immunocompromised patients – for example, patients who have been treated for cancer. The goal of a third dose is to help people with weakened immune systems catch up to the same level of protection that most vaccinated people got with two doses.
  • A booster dose is a dose of vaccine that is given when immunity has decreased.
  • The US Food and Drug Administration (FDA) has authorized and the CDC has recommended third doses for patients who are moderately to severely immunocompromised and who received their second dose of the Pfizer or Moderna COVID-19 vaccine at least 28 days prior.
  • The definition of severe immunocompromised (such as those receiving active cancer treatment, or those being treated with high-dose steroids for a condition) can be found on the CDC website.
  • Immunocompromised individuals who received a Johnson & Johnson (Janssen) COVID-19 vaccine are not eligible at this time for additional vaccine doses.
  • If you have one of these conditions or treatments, or others that compromise your immune system, you can contact your doctor or care team to learn more about getting a third COVID-19 dose. Your provider can also help you determine when and where may be best for you to get your next shot.
  • Nobody yet; the FDA has not yet authorized booster doses, and the CDC has not yet recommended booster doses. Therefore, we are not permitted to administer them at this time.
  • Although the Pfizer COVID-19 vaccine has full approval from the FDA, vaccine sites are not allowed to use it “off label” (in ways other than for which it has been officially approved by the FDA). This means that we cannot give additional doses to people who are not moderately to severely immunocompromised, we cannot give boosters, and we cannot vaccinate children under 12 years of age.

We are working closely with the state on booster shot guidance, and the moment booster doses are authorized and recommended for use, we will be communicating information to the public on our website.

Evidence is increasing that the effectiveness of the COVID-19 vaccines we received may be lower with the now predominant Delta variant, and may wane over time. The models show that COVID-19 is unlikely to be 100% eradicated, but we expect it will get down to a much more manageable level that may return seasonally like influenza (flu). If we get sufficient immunity in the population, the overall spread will be much more manageable. Having as many people as possible immunized is critical to getting to that place.

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