Sunday, September 19, 2021


Extra doses of coronavirus vaccine are coming for immunocompromised people. Heres what that means.

The Food and Drug Administration on Thursday approved extra doses of coronavirus vaccine for immunocompromised people in the United States, and the Centers for Disease Control and Prevention followed up with its own approval on Friday.



The decision will provide millions of Americans who may have a less-powerful response to coronavirus vaccines an option to boost their bodies' defenses against covid-19, the disease caused by the virus, as the more contagious delta variant drives up infections.

The move could mean additional shots will be available for this vulnerable population as soon as this weekend.

Here's what you need to know.

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What does it mean to be immunocompromised?

The CDC has estimated that about 3% of U.S. adults - or about 7 million people - are immunocompromised, meaning they have conditions or are taking medications that weaken their immune systems.

What conditions can compromise the immune system?

The FDA said the doses would be for certain patients, specifically organ transplant recipients and others with similar levels of immune-system impairment. The agency did not give further details. According to the CDC, the immunocompromised population is broad, including transplant patients taking certain drugs to prevent rejection of new organs and people with HIV/AIDS, rheumatoid arthritis, certain types of cancer and individuals with inherited diseases that affect their immune system. The group can also encompass people who take corticosteroids or other immune-weakening medicines for a prolonged period.

The National Institute of Allergy and Infectious Diseases also lists hundreds of types of primary immune deficiency diseases.

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How does this relate to the coronavirus?

Having a weakened immune system puts people at greater risk of getting severely ill from covid-19, according to the CDC.

"Immunocompromised individuals are vulnerable," Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, told reporters last week. "It is extremely important for us to move to get those individuals their boosters."

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How does the United States compare with other countries?

Israel began offering a third dose of the Pfizer-BioNTech vaccine last month to people older than 60 and to severely immunocompromised adults.

Germany will start offering vaccine booster shots to immunocompromised people starting in September and to the very elderly, nursing home residents and people who have received the AstraZeneca or Johnson & Johnson vaccines, its health ministry has said.

French President Emmanuel Macron said the country was working on rolling out third doses for its elderly and vulnerable in September. The United Kingdom also announced plans for booster shots later this year for people older than 70, nursing homes residents and people who are immunosuppressed or vulnerable.

People in Sweden will be offered a booster shot in 2022, the nation's health authority said this month, while high-risk groups could get a third shot as soon as this fall.

Health authorities in the United Arab Emirates said this month the country would extend booster shots to all fully vaccinated individuals in the Gulf Arab state. The UAE has approved five types of coronavirus vaccines, and in June began offering boosters to people inoculated with vaccines developed by China's Sinopharm.

Chile also began administering booster doses this week to people inoculated with China's Sinovac coronavirus vaccine. Almost 70% of Chile's population has been fully vaccinated, predominantly with the Sinovac shot, but authorities said studies had shown that a booster was necessary to shore up immunity.

Cambodia will begin offering a booster shot, switching between the AstraZeneca and Chinese coronavirus vaccines, prioritizing front-line workers.

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Have we learned the lessons from these countries' experiences?

While Israel was among the first nations to vaccinate most of its population, a recent increase in cases there has raised concerns that immunocompromised people could be less protected.

Israeli Prime Minister Naftali Bennett had said his nation's drive to give third doses would provide vital information to the rest of the world on combating the delta variant. The government has yet to decide on whether to administer third shots to the general adult population.

Meanwhile, the World Health Organization has called for a moratorium on booster shots, pointing to the billions of people in poorer countries who have yet to receive a first dose of the vaccine. WHO officials said they do not necessarily oppose giving additional doses to certain populations not protected by standard doses.

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What does the announcement mean for people who are not immunocompromised?

Fauci said Thursday on ABC's "Good Morning America" that decisions were still being made about booster shots for the wider population. But he noted that, "no vaccine is going to last forever."

Speaking to "CBS This Morning," also on Thursday, Fauci said: "Apart from the immune-compromised, we don't feel we need to give boosters right now."

But he added that in the future, it would be "preferable that you go with the same brand," when it comes to vaccine booster shots, but that "there will be guidance when that time occurs."

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How long do coronavirus vaccines last?

Moderna said in August its coronavirus shot was about 93% effective four to six months after full vaccination, showing hardly any change from the 94% efficacy reported in its original clinical trial. The company warned in a statement, however, that it must "remain vigilant" amid the delta variant threat.

The Johnson & Johnson coronavirus vaccine was 66.3% effective in clinical trials. In July, the company said data showed that "the durability of the immune response lasted through at least eight months, the length of time evaluated to date."

AstraZeneca has said it is looking into how long the vaccine's protection lasts and if a booster dose would be needed, after showing more than 70% efficacy in clinical trials.

The Pfizer-BioNTech vaccine was 95% effective based on evidence from clinical trials, and the company recently said its vaccine remains robustly protective six months after vaccination, but cautioned that boosters would soon be needed.

Published : August 14, 2021

By : The Washington Post · Bryan Pietsch