CDC Advisory Committee Endorses Booster Shot for Immunocompromised

The meeting comes a day after the FDA approved a third dose of a COVID-19 vaccine from Pfizer-BioNTech and Moderna in people who have received organ transplants or have other conditions that have damaged their immune systems.

This story has been updated.

The FDA Thursday amended the emergency use authorizations for both COVID-19 vaccine series made by Pfizer-BioNTech and Moderna to allow for a booster shot in individuals who are immunocompromised.

On Friday, the CDC’s Advisory Committee on Immunization Practices (ACIP) voted 11-0 to endorse a third dose.

The FDA said the decision applies to solid organ transplant recipients “or those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise.”

“The country has entered yet another wave of the COVID-19 pandemic, and the FDA is especially cognizant that immunocompromised people are particularly at risk for severe disease. After a thorough review of the available data, the FDA determined that this small, vulnerable group may benefit from a third dose of the Pfizer-BioNTech or Moderna Vaccines,” said Acting FDA Commissioner Janet Woodcock, MD, in a statement.

The decision does not apply to people without such issues, the FDA stressed.

But those who administer the third dose will not have to ask for proof of someone's condition, essentially relying on the honor system.

The ACIP committee is made up of outside experts; after the vote, it began hearing an update from a CDC official about emerging variants, including delta, which is sweeping through unvaccinated populations in the United States.

Those who are eligible for a third dose include:

  • Patients with cancer, including solid tumors and hematologic malignancies
  • Recipients of solid organ or recent hematopoietic stem cell transplants
  • Severe primary immunodeficiency
  • Advanced or untreated HIV infection
  • Active treatment with high-dose corticosteroids, alkylating agents, antimetabolites, tumor-necrosis (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory
  • Some chronic medical conditions, such as asplenia and chronic renal disease

The number of immunocompromised people in the United States is about 7 million, the CDC said. They are more likely to have vaccine breakthrough infections, amounting to as high as 44% of those hospitalized with COVID-19.

Those who are immunocompromised, even if they received a third dose, should continue to wear a mask, practice social distancing, and avoid crowded indoor areas with poor ventilation, the CDC said.