The FDA and the CDC authorized third doses of the Pfizer and Moderna COVID vaccines on August 13, 2021 for patients who are moderately to severely immunocompromised.  They made this decision after research studies found that a third dose improved the immune response to the vaccine in some immunocompromised patients.  This is not considered a "booster," which is a dose of a vaccine given because immunity has decreased over time.  Instead, it appears that some people need three vaccine doses instead of two as part of their initial vaccination, in order to have the best possible protection against getting COVID-19.

We have provided additional information below about who should consider receiving a third dose in discussion with their healthcare provider.  If you qualify, the third dose should be from the same manufacturer as your first two doses (e.g. if you previously received Pfizer, the third dose should also be Pfizer), and it should be given at least 28 days after the second dose.  You can receive a third dose regardless of whether you have been diagnosed with COVID-19 infection, although you must meet criteria to stop isolating at home prior to coming to any healthcare facility or pharmacy to receive a vaccine.  If you received a monoclonal antibody or convalescent plasma as part of the treatment for a COVID-19 infection, you should wait 90 days prior to receiving any COVID-19 vaccination.  

We encourage patients who qualify to get their third dose wherever it is easily available and convenient, including at retail pharmacies and the health department.  You can find a location and appointment at vaccines.gov.  We will also be offering third dose vaccines at some Emory Healthcare sites, and will contact patients about available times and locations for administration.  

If you do not meet the qualifications below, we do not recommend receiving a third dose of the vaccine at this time.  More information about the timing and type of potential future booster doses for all patients is pending, and Emory Healthcare will continue to follow FDA and CDC guidance.  If you have any questions about whether you need a third dose now, you should talk to your healthcare provider.  

Per the CDC guidance, the following patients should receive a third dose of the Pfizer or Moderna vaccines: 

  •  If you have received chemotherapy or radiation for treatment of cancer within the last year
    • We recommend not getting vaccinated while you are at your lowest blood counts after a cycle of chemotherapy.
    • If you will finish active treatment in the next three months, discuss the timing of your third dose with your provider. 
  • If you have had a solid organ transplant and you still take medication for immune suppression
    • If you have been treated for rejection in the last three months, discuss the timing of your third dose with your provider. 
  • If you had a stem cell transplant in the last two years, or if you had a stem cell transplant more than two years ago but still need medication for immune suppression.
  • If you have a history of a primary immunodeficiency, such as Wiskott-Aldrich syndrome, DiGeorge syndrome, or CVID.
  • If you have HIV with a CD4 count of less than 200 or you are not on antiretroviral medications.
  • If you take 20 mg or more of prednisone per day, or the equivalent dose of another steroid.
  • If you take another immune-suppressing medication for treatment of an autoimmune, rheumatologic, neurologic, or inflammatory disease:
    • Examples of these types of medications include: biologic agents such as rituximab, infliximab (Inflectra/Remicade/Truxima), satralizumab (Enspryng), adalimumab (Humira), and ustekinumab (Stelara); immune-suppressing non-biologic agents such as azathioprine (Imuran), mycophenolate (CellCept), methotrexate, and tofacitinib (Xeljanz); and some multiple sclerosis medications (not including any of the interferons or glatiramer acetate). 

      If you are on one of these medications, we recommend discussing the ideal timing of a third dose relative to when you last received the medication with your healthcare provider, particularly if you are taking rituximab.

It is also important to remember that some patients who are significantly immunocompromised may not have a good immune response to the COVID vaccine even with a third dose.  Therefore, you should also continue to mask in indoor public places, to practice social distancing, to wash or sanitize your hands frequently, and to encourage your close contacts to get vaccinated.