People with weakened immune systems are now advised to get four shots of a COVID-19 vaccine in a time period that may be as short as 140 days.
A second booster shot is now recommended as soon as three months after the third dose.
If a person with a weakened immune system follows the advised vaccination schedule closely, they would end up with four shots of the Pfizer or Moderna vaccines in less than six months.
For recipients in the population who received the single-shot Johnson & Johnson COVID-19 vaccine, the updated guidance says they should get a second dose at least 28 days after their vaccination, and a third dose as soon as two months later, with no fourth dose advised, at least currently. These people are advised to get the Pfizer or Moderna vaccines for their additional doses.
Some institutions, including the Mayo Clinic in Minnesota, have already begun allowing immunocompromised people to get booster doses based on the new schedule.
Moderately and severely immunocompromised people include those receiving treatment for tumor malignancies, those with certain immunodeficiencies such as DiGeorge syndrome, and those with advanced or untreated human immunodeficiency virus.
Immunocompromised, including those not covered by the updated guidance, make up about 2.7 percent of the U.S. adult population.
The guidance is for all Americans 12 and older.
Most people in the United States are currently told to get a primary series of the Moderna or Pfizer vaccine and a single booster, but the immunocompromised population was advised to get four shots in the fall of 2021 because their immune systems respond poorly to the initial regimen. Until the new change, though, CDC officials said the population should receive the second booster at least five months after the first.
"The rationale for this decision was out of an abundance of caution to help this population that may not be as well protected get their booster dose sooner, particularly with concerns about initial immune response, loss of protection over time, and high community transmission due to the Omicron variant," Elisha Hall, a health education specialist at the CDC, told the panel.
Panel members informally backed the change.
“In the past two months, I’ve seen many of these immunocompromised patients, who had followed all the rules, still have significant breakthrough infections. And I really think that this will help dramatically,” said Dr. Camille Kotton, a clinical director and infectious-disease specialist at Massachusetts General Hospital in Boston.
The fourth dose can be the same as the initial doses. People can also switch from Moderna to Pfizer or vice versa if they choose.
A second booster could ultimately be advised for all Americans, Biden administration officials have indicated.
Dr. Anthony Fauci, President Joe Biden's chief medical adviser, noted at a briefing on Feb. 16 that "the potential future requirement for an additional boost ... is being very carefully monitored in real time," adding that, "recommendations, if needed, will be updated according to the data as it evolves."
A CDC spokesperson, meanwhile, indicated in an email to The Epoch Times that a proposal outlined at the recent meeting by the agency—widening the interval between the first and second doses for the general population, which some other countries have done to address the elevated risk of heart inflammation after vaccination—may become formal guidance in the future.
The timing remains unclear for when that may happen.
Males up to 49 and females between 18 and 29 have a higher than expected rate of heart inflammation after getting two shots of the Moderna or Pfizer vaccines, and some experts have been urging the U.S. government for months to support a wider interval between the initial doses.
The current interval is 21 days for Pfizer's regimen and 28 days for Moderna's regimen.
Canadian officials told the panel that they've seen lower rates of heart inflammation after widening the interval.
"I think in many ways it's a win-win, it's not only the reduction of adverse events, but it's also the improvement in immunogenicity," said Dr. Helen Talbot, a panel member, referring to data that suggests spreading out the doses provokes a better immune response. "As we approach these new variants, the higher the antibodies and the more diverse these antibodies are, the better protected people will be."
