The CDC recommends that health care providers implement the FDA update. It explains in detail who should be considered "moderately or severely" immunocompromised. These patients include people who are receiving treatment for cancerous tumors, blood cancers, stem cell transplant recipients within the last two year, and those with untreated HIV.The FDA's update gave the task of defining immunocompromised to both the CDC panel as well as individual doctors. Despite the CDC's guidance, it is unclear how providers will decide when they should give a third shot. Camille Kotton from the CDC, a member of the transplant clinic at Massachusetts General Hospital noted that she anticipates immunocompromised patients will begin to seek additional doses as early as this weekend.Americans who want to get an additional dose of Covid-19 vaccine won't require a prescription or doctor’s note. This raises questions about how vaccine providers will determine who is eligible. Kathleen Dooling, CDC spokesperson, said that pharmacists might ask patients if they have any eligible moderate or severe conditions. However, they do not need to "self-attest" to confirm their eligibility.Amanda Cohn, Senior Advisor for Vaccines at the CDC's National Center for Immunization and Respiratory Diseases, stated that the CDC aims provide information to health care providers about these individuals while allowing them some flexibility to determine if the patient's immunosuppression level is moderate or severe. She said that residents of long-term care facilities, people with diabetes and heart disease, "are not the intended here."The CDC panel recommended a third shot to be used as an update of the initial dose regimen and not as a booster shot. This is for people who have not had an adequate immune response to the first two doses. Panel members recommended that eligible patients stick with the original vaccine brand if they are eligible, but it is possible to switch to another type.All cases are eligible for a third dose if the patient has waited at least 28 days since their last two doses.Peter Marks, FDA's top vaccination advisor, warned that these patients might only be moderately effective in boosting their immune responses to the vaccine with a third dose. Health officials advised that these people continue to take physical measures such as masking, distancing, and avoiding crowded indoor areas even after the third shot. Close friends and family members should also be fully vaccinated against Covid.Dooling, CDC, stated that the FDA and agency "are actively involved" in ensuring that Johnson & Johnson vaccine recipients with immunocompromised status, who lack sufficient data to expand their EUA, have "optimal vaccine protection."Marks stated that we had to do what we did based on the data available to us. He also said that public health officials believe they will have a "solution for" the very few immunocompromised J&J recipients in a not-too distant future.Federal officials stated that they believed that few people with immunocompromised conditions received the J&J shot. This is despite the fact that most were in the first line to get vaccinations and that the J&J vaccine was approved long after Moderna and Pfizer.The Centers for Medicare & Medicaid Services did not wait for the CDC panel to vote. They announced Friday morning that patients with immunocompromised Medicare may be eligible for an additional vaccine at no cost.Panel members also discussed how they will approach evaluating when and if booster doses are needed for the rest of society as vaccine-induced immunity wanes and new variants emerge. On Aug. 24, the CDC committee will hold its next meeting. It will be focusing on data about boosters. In the weeks ahead, the panel will meet regularly to consolidate its process of deciding when and for whom boosters are needed.According to Sara Oliver, CDC, seniors, long-term care residents, and health care workers will be the first people to be assessed for booster needs.Oliver stated that boosters should be considered for preventing serious illness, hospitalization, and death. This is not the same as preventing infection. She also mentioned that global vaccine equity is an important consideration, noting the possibility of variants emerging from low-vaccine coverage or high transmission regions.
