C.D.C. Panel Endorses Third Vaccine Shot for Immunocompromised

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C.D.C. Panel Endorses Third Vaccine Shot for Immunocompromised

An independent panel advising the Centers for Disease Control and Prevention on Friday recommended third doses of coronavirus vaccine for certain people with weakened immune systems, giving more backing to doctors and patients considering the opportunity for extra protection.

The recommendation came a day after the Food and Drug Administration authorized third doses for people with solid organ transplants and others with similarly weakened immune systems.

After nearly three hours of presentations and discussion, the committee of medical experts voted unanimously to recommend third shots for people in this group who have already received the two-dose vaccines made by Pfizer-BioNTech or Moderna.

While the panel’s guidance is nonbinding, it is followed closely by physicians and public health departments. The vote is expected to be followed by a formal recommendation from the C.D.C.

About three percent of Americans have weakened immune systems for a variety of reasons, from a history of cancer to the use of certain medications such as steroids.

The group now eligible for third shots would include people with advanced or untreated H.I.V. infection, those who have undergone certain types of stem cell transplants within the past two years and those receiving certain kinds of chemotherapy, among others, Dr. Neela D. Goswami, a C.D.C. official, said.

Patients slated for treatments that weaken the immune system should get a third dose before they begin, Dr. Goswami said. And everyone eligible for a third shot should wait at least 28 days after their second dose before getting it, according to the C.D.C.

People will not need a doctor’s permission or a prescription to get a third shot, C.D.C. officials said; they will need only to attest that they meet the eligibility requirements for an additional dose. Anyone else, including people with chronic medical conditions, like diabetes or asthma, should not be getting third shots at this point, they said.

The updated F.D.A. authorizations do not apply to patients who received the single-dose Johnson & Johnson vaccine, and the C.D.C. panel did not recommend additional shots for members of that group, leaving them in limbo. Officials say they are waiting for more data from clinical trials.

Dr. Kathleen Dooling, a C.D.C. official, said that patients who qualify for a third dose should ideally seek out the vaccine they already received, but that they could take the other two-dose vaccine if the first was unavailable.

Dr. Dooling emphasized that immunocompromised people who receive a third dose should still wear a mask, maintain social distancing with people they do not live with, and avoid crowds and poorly ventilated indoor spaces. People with weakened immune systems face a higher risk of breakthrough infections and severe Covid-19.

Dr. Dooling said that early studies of how some such patients responded to third doses made clear that there could be some benefit, raising antibody levels.

Studies have also shown that third doses are safe for patients.

The recommendation from the panel, the Advisory Committee on Immunization Practices, comes as health officials are grappling with whether people vaccinated early in the nation’s inoculation campaign may need booster doses soon, a move that scientists and public health experts argue is not yet supported by data.

Some individuals are taking matters into their own hands. Just over a million people who received a two-dose vaccine in the United States have already received a third dose, Dr. Dooling told the C.D.C. panel.

Still, officials at the C.D.C. and F.D.A. have been careful to frame the third-dose authorization for people with weakened immune systems as a separate issue.

“Other individuals who are fully vaccinated are adequately protected and do not need an additional dose of Covid-19 vaccine at this time,” Dr. Janet Woodcock, the acting F.D.A. commissioner, said in a statement Thursday.

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