CDC Cuts Booster Interval for the Immunocompromised

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The CDC updated its interim guidance on COVID-19 vaccination to give immunocompromised people a shorter wait for their booster shot.

It is now recommended that people who are moderately or severely immunocompromised receive a booster 3 months — down from 5 months previously — after the third dose of an mRNA vaccine, for a total of four doses. Previewed at last week’s meeting of the Advisory Committee on Immunization Practices (ACIP), this change was attributed to concern about the immune response and loss of mRNA protection over time for these patients.

Immunocompromised people who receive Johnson & Johnson’s COVID-19 vaccine are advised to receive an mRNA vaccine dose at least 4 weeks later and a booster dose at least 2 months after that, for a total of three doses (mRNA preferred for the booster as well).

Unchanged is the COVID-19 vaccination schedule for the general population. An 8-week interval between the first and second doses of Pfizer and Moderna’s vaccine was discussed at length at the ACIP meeting.

In addition, CDC’s new guidelines provide more clarity for COVID-19 vaccination for people who receive doses abroad:

  • People who received FDA-approved or -authorized vaccines may complete their primary series and get boosted according to the regular schedule
  • Those who got a World Health Organization (WHO)-listed, but not FDA-authorized/approved vaccine, are recommended to switch to an mRNA vaccine when it is time to complete their primary series or get boosted
  • People who got COVID vaccines not meeting FDA or WHO criteria do not count as being vaccinated in the U.S.; they should start their primary series at least 28 days after the last dose of the unauthorized vaccine

As for vaccination after COVID-19 treatment or post-exposure prophylaxis, it is no longer necessary to delay vaccine doses for people getting monoclonal antibodies or convalescent plasma. “The balance of benefits vs risks favors proceeding with vaccination even considering the possibility of diminished vaccine effectiveness in this situation,” according to the CDC’s interim guidance.

The latest recommendations also strengthen the warning that people who develop myocarditis or pericarditis after mRNA COVID-19 vaccination “should not” get a subsequent dose of any COVID-19 vaccine — though adult men choosing to do so may consider the Johnson & Johnson vaccine.

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    Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow

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