March 27, 2023

Dr. Jose U. Scher, a rheumatologist at NYU Langone Health who has studied the effects of vaccines on the immunocompromised, said the CDC’s vote – and guidance from its experts – would help patients tormented whether or not after a third Shot. In the past, he said, when people tested for antibodies after vaccination and came back empty-handed, “we had no tools for us to respond to.”


Aug. 14, 2021, 4:41 p.m. ET

“We now know that this population has been left behind,” he said.

Immunocompromised people don’t need a doctor’s permit or prescription to get a third vaccination, CDC officials said. All you need to do is confirm that you qualify for an additional dose. Everyone else, including people with chronic conditions like diabetes or asthma, shouldn’t get a third vaccination at this time, they said.

Dr. Scher predicted that this honor system approach could be messy. “I don’t know if there is any way to back up anyone’s claim,” he said, of being immunocompromised. It would be a better process to ask for evidence, such as a medical certificate, he said.

The updated FDA approvals do not apply to immunocompromised individuals who received the single-dose vaccine from Johnson & Johnson. The CDC panel did not make recommendations for additional admissions for this group, believed to be small. But the lack of guidance from the FDA or the CDC has left this group in limbo.

Understand the state of vaccination and masking requirements in the United States

    • Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of vaccination status, wear masks in public places indoors in areas with outbreaks, reversing the guidelines offered in May. See where the CDC guidelines would apply and where states have implemented their own mask guidelines. The battle over masks is controversial in some states, with some local leaders defying state bans.
    • Vaccination regulations. . . and B.Factories. Private companies are increasingly demanding coronavirus vaccines for employees with different approaches. Such mandates are legally permissible and have been confirmed in legal challenges.
    • College and Universities. More than 400 colleges and universities require a vaccination against Covid-19. Almost all of them are in states that voted for President Biden.
    • schools. On August 11, California announced that teachers and staff at both public and private schools would have to get vaccinated or have regular tests, the first state in the nation to do so. A survey published in August found that many American parents of school-age children are against mandatory vaccines for students but are more likely to support masking requirements for students, teachers and staff who are not vaccinated.
    • Hospitals and medical centers. Many hospitals and large health systems require their employees to have a Covid-19 vaccine, due to rising case numbers due to the Delta variant and persistently low vaccination rates in their communities, even within their workforce.
    • new York. On August 3, New York City Mayor Bill de Blasio announced that workers and customers would be required to provide proof of vaccination when dining indoors, gyms, performances, and other indoor situations. City hospital staff must also be vaccinated or have weekly tests. Similar rules apply to employees in New York State.
    • At the federal level. The Pentagon announced that it would make coronavirus vaccinations compulsory for the country’s 1.3 million active soldiers “by mid-September at the latest. President Biden announced that all civil federal employees would need to be vaccinated against the coronavirus or undergo regular tests, social distancing, mask requirements and travel restrictions.

“We understand the challenges here and will therefore continue to work very conscientiously on a solution,” said Dr. Peter Marks, the FDA’s lead vaccine regulator, at the panel meeting. The FDA is waiting for more data to come this month, including Johnson & Johnson clinical trial data on the safety and efficacy of two doses.

Dr. Kathleen Dooling, a CDC official, said that patients who qualify for a third dose should ideally find the vaccine they already received, but that they could take the other two-dose vaccine if needed.

Dr. Dooling presented studies that supported third-dose administration, emphasizing that immunocompromised people receiving a third dose should continue to wear a mask, maintain social distance from people they do not live with, and avoid crowds and poorly ventilated indoor spaces should. She said that people with compromised immune systems have also been shown to be at greater risk for a breakthrough infection.