Should you get the Covid vaccine booster?

On Aug. 13, the U.S. Food and Drug Administration authorized a third dose of COVID-19 vaccine for certain immunocompromised patients.

The authorization was based on the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices’ unanimous decision to recommend a third dose of the two mRNA vaccines for patients who are moderately or severely immunocompromised. This includes the Pfizer and Moderna vaccines.

The COVID vaccine booster was based on findings from a small randomized controlled trial in transplant patients, which found the booster to be beneficial.

Research has shown that immunocompromised patients do not respond optimally to Covid 19 vaccination and could benefit from an additional dose.

The FDA’s authorization permits patients being actively treated with high-dose corticosteroids, alkylating agents, antimetabolites (e.g. methotrexate), TNF inhibitors and other immunosuppressive biologic agents to receive a booster dose of either the Pfizer or Moderna COVID-19 vaccines. The Johnson & Johnson vaccine is not included at this time.

The FDA said third doses should be administered at least 28 days after a second dose of the same vaccine to eligible patients age 18 or older for the Moderna vaccine and 12 or older for the Pfizer vaccine.

You should receive the third dose from the same manufacturer as in your original vaccine series. For example, if you received the Pfizer vaccine initially, your booster dose should be from Pfizer.

Follow this guidance if you are receiving immunomodulatory therapies:

  • Rituxan — Receive the COVID-19 vaccine booster four weeks prior to the next scheduled Rituxan cycle. Delay RTX (Rituxan) two to four weeks after the booster shot.
  • Methotrexate, Xeljanz and Rinvoq — Hold medication one week after the booster shot
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