• The Centers for Disease Control and Prevention (CDC) recommended Pfizer COVID-19 vaccine booster shots for adults over 65 and other high-risk individuals.
• People who are immunocompromised may be eligible to receive a third vaccine dose now.
• If you are on multiple sclerosis (MS) treatment, consult with your health care provider before presenting for a booster shot, since some MS treatments should be timed around vaccinations.

The Centers for Disease Control and Prevention recommended booster shots of the Pfizer COVID-19 vaccine at least six months after a second dose for the following groups:

• People 65 and older
• Residents of long-term care facilities
• People ages 50 to 64 with underlying medical conditions that place them at high risk for severe COVID-19

The CDC recommendations state that people ages 18 to 49 with underlying medical conditions and people ages 18 to 64 who are at risk of COVID-19 exposure due to their work or living arrangements “may receive a booster shot” of the Pfizer vaccine “based on their individual benefits and risks.”

The CDC’s Sept. 24 recommendations align with the Pfizer booster shot authorizations from the U.S. Food and Drug Administration (FDA) released on Sept. 22.

President Joe Biden confirmed in a speech on Sept. 24 that eligible individuals who received their second dose of the Pfizer vaccine in March or earlier can receive a booster dose of the vaccine now, free of charge.

The CDC and FDA did not release recommendations about the Moderna vaccine or the single-dose Johnson & Johnson vaccine. Moderna announced that a booster shot of its COVID-19 vaccine improved protection against the delta variant in a press release on Sept. 1. Johnson & Johnson released a statement on Sept. 21 sharing that data from a phase 3 study demonstrated the benefits of a booster vaccine dose.

Both companies have submitted data on booster shots to the FDA for review.

Boosters vs. Additional Doses for Immunocompromised People

A COVID-19 vaccine booster is administered when someone developed adequate immunity after the initial vaccine doses, but that immunity has decreased over time. However, an additional dose of the vaccine may be recommended for those who did not develop an adequate immune response after the two-dose vaccination series.

The FDA amended the Pfizer and Moderna vaccines’ emergency use authorizations on Aug. 12 to allow a third vaccine dose for certain immunocompromised individuals. The new recommendations from the FDA and CDC do not change this eligibility. There is not yet guidance from the FDA or CDC on additional doses for immunocompromised people who received the Johnson & Johnson vaccine.

Individuals defined as immunocompromised include people in cancer treatment, people who received a stem cell transplant in the last two years, people who are organ donor recipients and taking immunosuppressive drugs, people taking high-dose steroids or other immunosuppressive drugs, as well as those with certain other health conditions.

The CDC did not release a comprehensive list of every condition or treatment that would make a person immunocompromised. Instead, the agency recommends individuals consult their doctors to determine if a third dose is appropriate for them.

The CDC recommends a third dose of the COVID-19 vaccine for moderately to severely immunocompromised people at least 28 days after their second vaccination with the Pfizer or Moderna vaccine.

Additional Doses for People With Multiple Sclerosis

As MyMSTeam previously reported, having multiple sclerosis does not necessarily mean that someone is immunocompromised. However, the National Multiple Sclerosis Society notes that people taking the following disease-modifying therapies (DMTs) for MS may have a reduced or absent response to the COVID-19 vaccines:

• Gilenya (fingolimod)
• Mayzent (siponimod)
• Zeposia (ozanimod)
• Ponvory (ponesimod)
• Lemtrada (alemtuzumab)
• Ocrevus (ocrelizumab)
• Kesimpta (ofatumumab)
• Any biosimilars of these medications — in some cases, the same drug is available under a different brand name

The National Multiple Sclerosis Society offers guidance on timing MS medications and COVID-19 vaccines, depending on the DMT. If you believe you may be immunocompromised, it’s important to speak with your doctor to find out whether you might benefit from an additional dose of a COVID-19 vaccine.