New Guidance On COVID Booster Shots From FDA Advisory Panel


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CHARLOTTE – Food and Drug Administration (FDA) advisory panel has recommended a third dose of Pfizer’s COVID-19 vaccine for people 65 and older, and those at high risk of severe disease, who received their second dose at least six months ago.

Dr. David Priest
Dr. David Priest

Health care workers, teachers, emergency responders and others whose jobs put them at special risk should also be eligible for the booster shots, the panel said last week.



A final word on eligibility is expected soon from the FDA, which sets vaccine policy. While it usually follows advisory committee recommendations, it’s not required to.

Updated guidance on COVID boosters will also come from a Centers for Disease Control and Prevention (CDC) advisory panel. The job of defining who qualifies as “high risk” may be decided by this CDC panel.

Dr. David PriestNovant Health chief safety, quality, and epidemiology officer, offers the following guidance. As always, contact your doctor with specific questions about your condition.

Who is eligible for a third dose?

An emergency authorization enabled certain immunocompromised individuals to get their third dose now. Those with medical conditions or people receiving treatments that are associated with moderate to severe immune compromise include patients with:

  • Active or recent treatment for solid tumor and hematologic malignancies, including blood cancers.
  • Receipt of solid-organ or recent hematopoietic stem cell transplants.
  • Moderate or severe primary immunodeficiency such as DiGeorge syndrome and Wiskott-Aldrich syndrome.
  • Advanced or untreated HIV infection.
  • Active treatment with high-dose corticosteroids and other drugs that suppress the immune system, including alkylating agents, antimetabolites and tumor-necrosis (TNF) blockers.
  • Asplenia, the absence of a spleen.
  • Chronic renal disease, a condition characterized by a gradual loss of kidney function over time.

The CDC and FDA acted on this after data indicated those groups’ immunity could wane over time, making it worthwhile to give them a third vaccine dose.

How do you schedule a third dose?

If you’re a Novant Health patient, you can call your medical provider and schedule a vaccination. Novant Health also has walk-in clinics that administer the vaccine.

Is the third dose any different from what was in the original first two shots?

No. It’s the same as the products that people were given before.

Do you need to get the same vaccine brand for your third dose as you got for the first two shots?

If you got Pfizer the first two times, they recommend Pfizer for the third dose, but it’s not a hard and fast rule. If the vaccine brand you got the first time is not available, you can mix mRNA doses or brands. In other words, if you had Pfizer before, and you only have access to Moderna, you can get Moderna for your third dose. There currently is no guidance on Johnson & Johnson, but it’s expected soon.

What’s the timing for the third dose?

If you’ve had two doses, right now the guidance is eight months after your second shot. And it appears we are heading towards six months after the second shot.

While others (groups besides those 65+ or at high risk) may also benefit from a third dose, the FDA panel said most Americans do not need a booster shot just yet, media reports confirm.

We keep hearing about the delta variant. Is the vaccine really working?

  • As we’ve preached from the beginning, the reason we need to get people vaccinated and to take precautions is that the longer we let this drag out, the more likely one of those variants is going to arise, and it’s going to be more difficult to deal with. So, it behooves us to get as many people vaccinated as possible.
  • Remember, early in the pandemic, the typical COVID patient might infect two or three other individuals around them. But with the Delta variant, they’re likely to infect five to nine individuals around them today.
  • Over 99% of those who are vaccinated have not had a breakthrough case resulting in hospitalization or death. We also know that 96.7% of COVID deaths this summer occurred in unvaccinated individuals. The vaccine remains incredibly effective at keeping you out of the hospital, and it tells us that we should all get vaccinated to protect those around us who are not yet eligible (kids under 12), or immunocompromised and need further protection.
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