Who is eligible for a third COVID-19 vaccine dose in the U.S.? An explanation

FILE PHOTO: Coronavirus disease vaccination event hosted by Miami – Dade County and Miami Heat,at FTX Arena in Miami
REUTERS/Marco Bello/File Photo

U.S. health officials have authorized a third dose of COVID-19 vaccines from Pfizer and Moderna for people with compromised immune systems, based on evidence that the standard two shots offered less robust protection in such populations.

Here’s what we know about who will be eligible for the additional shots:

How is immunocompromised defined?

The Food and Drug Administration updated the emergency use authorization given to the shots from Pfizer, developed with German partner BioNTech, as well as the vaccine from Moderna to allow a third dose for people who have received organ transplants, or those with a similarly weakened immune system.

Health officials have estimated that less than 3% of American adults would be candidates for a third dose.

The U.S. Centers for Disease Control and Prevention said a third dose is recommended for people who are moderately or severely immunocompromised. They included people who are receiving treatment for solid tumor cancers and cancers of the blood, such as lymphoma or leukemia; patients who have undergone within the last two years a bone marrow transplant or are still taking drugs to suppress their immune system; and patients with advanced or untreated HIV infection.

The CDC guidance also includes people who are currently taking high-dose steroids and immune system-suppressing biologic drugs, including medicines for Crohn’s disease, rheumatoid arthritis and plaque psoriasis.

Do I need a prescription? What about insurance?

The CDC said on Friday that people seeking a third vaccine dose will not need a prescription or recommendation from a healthcare provider. They would self-attest that they are eligible at a vaccination site.

The vaccines themselves have been purchased by the federal government and are being distributed free of charge, but hospitals, pharmacies and other providers can bill insurers for administration costs. People covered by Medicare, the government health plan for people over the age of 65, who qualify for an additional vaccine dose can receive it at no charge. Medicare will continue to pay vaccine providers an average of $40 for each administration of a COVID-19 vaccine.

America’s Health Insurance Plans, the trade group representing most private health insurers, said health insurance providers will continue to cover all administrative costs for COVID-19 vaccines as required.

What are other countries doing?

A growing number of countries have begun to offer a third vaccine dose to vulnerable populations based on evidence that vaccine protection may wane over time or may not be robust enough against the fast-spreading Delta variant.

Israel began offering a third shot of the Pfizer/BioNTech vaccine to people aged over 60 in July. On Friday, the country lowered that age limit to 50 and said it will also offer an additional dose to health workers.

Health clinics in Moscow started offering booster shots in July to people who were vaccinated six or more months ago. Indonesia started giving booster shots produced by Moderna to medical workers in July and is considering extra doses for wider use. Britain, Germany and France plan to begin rolling out boosters for the elderly and vulnerable in September.

The World Health Organization has called for a halt to COVID-19 vaccine boosters until at least the end of September to allow for the inoculation of at least 10% of the population of every country.