- The Food and Drug Administration (FDA) is expected to develop a plan for COVID-19 vaccine boosters by early September.
- Immune compromised patients are at greater risk of not only more severe COVID-19 illness but also “breakthrough infection.”
- Experts say some of the U.S. vaccine stockpile used for booster shots could supply countries with limited access to the vaccines.
As COVID-19 cases have continued to surge, experts are looking at the benefits of COVID-19 vaccines and booster shots, specifically for people who are immunocompromised.
The Food and Drug Administration (FDA) is expected to develop a plan for COVID-19 vaccine boosters by early September. The plan will reportedly explain when and which vaccinated individuals should receive booster shots, according to people familiar with discussions within the agency. This is according to news reports, including those from The Wall Street Journal.
For people with suppressed immune systems, getting clarification can’t come soon enough. These people are eligible for a vaccine, but it may not provide robust protection if their immune system is suppressed.
As a result, many people who are immunocompromised want to know if they can get a booster a shot.
According to Dr. Robert Bollinger, professor of infectious diseases at the Johns Hopkins University School of Medicine and founding member of emocha Health, due to a weakened immune system, immunocompromised patients are at higher risk of serious illness from many infectious diseases.
“In addition, some immunocompromised patients also have weaker responses to many available vaccines, including the COVID-19 vaccines,” Bollinger told Healthline.
He emphasized that immune-compromised patients are at greater risk of not only more severe COVID-19 illness but also “breakthrough infection,” which could lead to hospitalization or death.
Bollinger noted that while hospitalization or death are extremely rare among the fully vaccinated, “When they do occur, these rare severe breakthrough infections are more likely in immunocompromised patients. This is another reason why getting vaccinated is important.”
Bollinger explained that when we’re vaccinated, we are also helping to protect our unvaccinated family, friends, and neighbors, “as well as those in our families and community that have been vaccinated but are immunocompromised, such as cancer patients, transplant patients, and other patients receiving medications that could weaken their immune systems.”
Dr. Len Horovitz, internist and pulmonary specialist on staff at Lenox Hill Hospital and Weill Cornell Medical Center in New York and clinical instructor in medicine at Weill Cornell Medical College, said immunocompromised people include patients with underlying metabolic diseases, malignancies, on cancer chemotherapy, have HIV that’s not well controlled, and multiple myeloma.
“Immunocompromised people often don’t respond to make antibody or T-cell response because of their underlying disease,” he said. “So they make an inadequate response to usual vaccination, and they may need a booster for that reason.”
However, no confirmed data is available regarding vaccinating these patients because they were excluded from clinical trials.
Horovitz cautioned that because this group didn’t respond to vaccination in the first go around, they still might not have a “great” response to a booster shot. Still, he believes “it’s certainly worth a shot.”
Asked whether a booster shot presents any risks for the immunocompromised, Bollinger said past research has proven there is little reason for concern.
“Many research studies are currently underway to assess the safety and immunogenicity of boosters,” he said. “I don’t anticipate major safety concerns with boosters.”
As for people with healthy immune systems, Bollinger noted that we give boosters routinely for many other vaccines, but the safety data on COVID-19 vaccine boosters are not yet available.
He said he wouldn’t recommend anyone seek out a third unapproved vaccine dose.
“Until those data are available, I am not recommending [an] “unauthorized’ third dose,” he continued. “However, I would encourage those that are interested to volunteer for one of the research studies to help us get these data ASAP.”
“Accessing vaccines remains the single greatest challenge that developing countries face in protecting their people from the health, social, and economic impacts of the COVID-19 pandemic,” according to World Bank President David Malpass, reported Reuters.
Asked if providing booster shots could strain the supply of vaccines available, Horovitz underscored the global nature of the pandemic, the threat of variants, and the need to defeat the virus worldwide.
“Well, you’re asking me a question about supply and stockpile, and I don’t know the answer to that,” he acknowledged. “Some of what might be used for people in this country, one could argue, should be used for the global situation, because we know this is a global pandemic.”
He warned that if we don’t properly vaccinate the world, “then some other mutation may come back to bite us, even though we’re all boostered up.”
He concluded that without a global solution, “some other variant will come back that will evade the vaccines.”
The Food and Drug Administration (FDA) anticipates having a strategy by September about who should receive COVID-19 vaccine booster shots. Currently, the FDA has not recommended that immunocompromised people get a booster dose.
Experts added that booster doses for other vaccines have not posed a safety risk.
They also noted that COVID-19 is a global pandemic, and some of the U.S. vaccine stockpiles used for boosters could be better used to supply countries with limited access to the vaccines — or we risk a variant developing that might evade vaccination entirely.