Who qualifies for a third COVID-19 vaccine?


AUSTIN (KXAN) — Following the Centers for Disease Control and Prevention’s recommendation late last week of a third COVID-19 dose for some immunocompromised individuals, pharmacies in the Austin region have begun offering booster shot appointments.

But who qualifies?

Current doses are limited to “moderately to severely immunocompromised people” and is not recommended for the general public. Approximately 3% of the population classify as moderately to severely immunocompromised, according to the CDC.

The following immunocompromised conditions qualify for a third COVID-19 dose:

  • Active cancer treatment patients for tumors, blood-related cancers
  • Organ transplant recipients who are taking medicine suppressing the immune system
  • Stem cell transplant recipients within the past two years who are taking medicine suppressing the immune system
  • Moderate to severe primary immunodeficiency conditions, including DiGeorge syndrome, Wiskott-Aldrich syndrome
  • Individuals with advanced or untreated HIV infections
  • Patients actively receiving treatment “with high-dose corticosteroids or other drugs that may suppress your immune response,” per the CDC

Why is a third dose recommended?

People with suppressed immune systems do not have an adequate number of white blood cells or antibodies needed to build a proper immune response, leading to a weakened system. Individuals with weakened systems are then more susceptible to pathogens, which include bacteria and viruses.

When it comes to COVID-19, CDC officials said those with suppressed immune systems have a higher risk of contracting more serious cases of COVID-19 if exposed. With emerging COVID-19 variants that exhibit higher viral loads, immunocompromised people are recommended an extra dose to bring them up to the standard people without suppressed immune systems are at, said Dr. Debra Patt of Texas Oncology.

“That focus is around patients that are immunocompromised because they are probably the most vulnerable right now to the new variants of coronavirus,” Patt said. “And their immune system has not mounted the substantial response that otherwise healthy individuals have mounted.”

Some cancer patients qualify — but not all

Following the CDC’s recommendation of a third COVID-19 dose last week, Texas Oncology relayed the information to its patients. But not every person diagnosed with cancer is recommended to receive a third dose at this time.

Qualifying conditions include those actively receiving treatments like chemotherapy, which impacts patients’ antibody response, leading to a weakened immune system.

Other eligible cancer patients include those receiving active treatment for tumors or for cancers of the blood: leukemia, lymphoma and myeloma.

“[Immunocompromised people] are probably the most vulnerable right now to the new variants of coronavirus. And their immune system has not mounted the substantial response that otherwise healthy individuals have mounted.”

dr. debra patt, texas oncology

But patients with solid tumors are not considered immunocompromised if they’re being treated with hormone therapy, targeted therapy, surgery or radiation only, according to the memorial Sloan Kettering Cancer Center.

How do you prove eligibility?

For people with qualifying conditions, major pharmacies such as CVS and Walgreens already offer third dose appointments for immunocompromised individuals. During an initial health pre-screening for appointment bookings, individuals will be asked if they have existing conditions, including immunocompromised conditions.

In a statement, CVS officials said pharmacies will verify with patients their eligibility prior to administering a third dose.

“Patients were able to begin scheduling vaccination appointments on CVS.com starting the morning of August 14. Patients will be required to attest to their eligibility during the scheduling process and at the time of receiving their vaccination,” the statement read in part.

KXAN has submitted a request to Walgreens for additional information regarding its health screening questions for third doses. We will update this story when a response is received.

Is it really a ‘booster shot?’

In healthcare circles, there has been some debate over the use of the term “booster shot.” UT Health Austin said in an August 15 announcement that the third dose isn’t akin to booster shots found in vaccinations for other diseases.

“Though many news and other sources call this 3rd dose of vaccine a “booster,” it actually helps people with certain medical conditions achieve a level of protection that the standard two-dose vaccination provides for non-immunocompromised individuals,” the statement read. “To date, the CDC does not recommend ‘booster’ shots for fully vaccinated, non-immunocompromised patients.”

Individuals with weakened immune systems are at a higher risk of severe infections or breakthrough infections of COVID-19 due to their immunodeficiencies, Patt said.

While “third dose” is the more appropriate term, she said this additional vaccine is designed to “boost” the immunity of immunocompromised individuals, likewise to booster shots administered for childhood vaccinations after an extended time period due to waning immunity.

“Those kinds of booster shots have a lot of evidence behind them about how exactly it will impact your susceptibility to a particular illness. This is really a third dose of the same vaccine that you’ve received previously,” she said. “But we do believe that it does, theoretically, the same thing that other types of booster shots do, and that it boosts the immunity that you will have against the COVID-19 virus.”

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