D-HH Answers Questions about Third COVID-19 Vaccine Dose for Immunocompromised People

COVID-19 vaccine

This third dose is recommended as part of the primary series for people with medical conditions or receiving treatments associated with being moderate-to-severely immunocompromised.

Michael S. Calderwood, MD, chief quality officer at DHMC

On Thursday, August 12, 2021, the U.S. Food and Drug Administration (FDA) authorized the use of a third dose of the Pfizer and Moderna COVID-19 vaccines for immunocompromised people, with the third dose to be administered at least 28 days following the first two doses.

“This is different than a booster dose that is being discussed for the general population. Instead, this third dose is recommended as part of the primary series for people with medical conditions or receiving treatments associated with being moderate-to-severely immunocompromised,” said Michael S. Calderwood, MD, chief quality officer at Dartmouth-Hitchcock Medical Center. “We have data showing that people who are immunocompromised are more likely to develop breakthrough infections resulting in hospitalization, that the vaccine effectiveness and antibody response is lower in people who are immunocompromised after two doses of a mRNA vaccine, and that a third dose of a mRNA vaccine can boost the prevalence of protective antibodies in people who are immunocompromised. As for side effects, these have been reported as similar to prior doses and mostly mild or moderate.”

At this time, the FDA has not approved an additional dose of mRNA vaccine for those who received the Johnson & Johnson one-dose COVID-19 vaccine.  

A third dose is recommended for those who have:

  • Been receiving active cancer treatment for tumors or cancers of the blood.
  • Received an organ transplant and are taking medicine to suppress the immune system.
  • Received a stem-cell transplant within the last 2 years or are taking medicine to suppress the immune system.
  • Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome).
  • Advanced or untreated HIV infection.
  • Active treatment with high-dose corticosteroids or other drugs that may suppress one’s immune response.

Dartmouth-Hitchcock Health patients with an established primary care provider (PCP) or a specialty care doctor, and meet the criteria above, can contact their provider’s office to request a third dose. If a patient meets the criteria, providers will put in an order for a third dose of vaccine and the PCP office will contact patients to schedule a vaccination appointment, generally within five business days.

The mRNA vaccines (Moderna and Pfizer) are also widely available at local pharmacies and other vaccination sites.   

“We strongly recommend everyone to continue to take precautions to protect yourself from COVID-19, even after a third dose of the vaccine,” said Calderwood. “This includes wearing your face mask when in public indoor places (like a grocery store) or in large groups (outside and inside). It is also important to continue to frequently wash your hands or use alcohol-based hand sanitizer and to maintain six feet of physical distance when possible.”

For more information on the COVID-19 vaccine visit: https://www.dartmouth-hitchcock.org/covid19/third-dose-vaccines

About Dartmouth-Hitchcock Health

Dartmouth-Hitchcock Health (D-HH), New Hampshire’s only academic health system and the state’s largest private employer, serves a population of 1.9 million across northern New England. D-HH provides access to more than 2,000 providers in almost every area of medicine, delivering care at its flagship hospital, Dartmouth-Hitchcock Medical Center (DHMC) in Lebanon, NH. DHMC was named again in 2020 as the #1 hospital in New Hampshire by U.S. News & World Report, and recognized for high performance in 9 clinical specialties and procedures. Dartmouth-Hitchcock Health includes the Norris Cotton Cancer Center, one of only 51 NCI-designated Comprehensive Cancer Centers in the nation Children's Hospital at Dartmouth-Hitchcock, the state’s only children’s hospital; member hospitals in Lebanon, Keene, and New London, NH, and Windsor, VT, and Visiting Nurse and Hospice for Vermont and New Hampshire; and 24 Dartmouth-Hitchcock clinics that provide ambulatory services across New Hampshire and Vermont. The D-HH system trains nearly 400 residents and fellows annually, and performs world-class research, in partnership with the Geisel School of Medicine at Dartmouth and the White River Junction VA Medical Center in White River Junction, VT.