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Should you get a third dose of COVID vaccine? – Medical Xpress

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They’re cancer patients. Transplant recipients. People with lupus, rheumatoid arthritis, HIV/AIDS, sickle cell disease, kidney failure and Crohn’s disease. Plus millions of others who have conditions or take medications that weaken their immune systems.

That makes them—millions of teens and adults—what doctors call .

And that puts them at much higher risk of serious illness if they get COVID-19, which is why many states prioritized them for vaccination early this year.

Now, most of them are now eligible for even more protection.

The FDA and CDC have just approved and recommended an additional dose of mRNA COVID-19 vaccines as part of a primary series for moderately and severely immunocompromised people.

The additional dose should be the same mRNA COVID-19 vaccine as the first two shots the person received before, and should be administered at least 28 days after completion of the initial primary series of two shots. Specifically, those who have had two doses of the Pfizer vaccine can get a third dose of that vaccine, and those who have had two doses of the Moderna vaccine can get a third dose of that vaccine.

This is not considered a “booster shot,” but rather an additional dose to the recommended use of COVID-19 vaccines in these individuals. It’s being recommended because they have likely not produced an adequate immune response after getting the first two doses of COVID-19 vaccine.

Currently there is not data to support giving a dose of mRNA COVID-19 vaccine to immunocompromised people whose previously received the one-dose Johnson & Johnson/Janssen vaccine. A recommendation for immunocompromised people who got that vaccine is still being developed.

Immunocompromised people are more likely to get severely ill from COVID-19, are at higher risk for prolonged viral infection and shedding of the virus, are more likely to transmit the infection to people they live with, and show a lower immune response to vaccination compared to non-immunocompromised people, says Pamela Rockwell, D.O., a Michigan Medicine family physician and associate professor at the University of Michigan Medical School.

She represents the American Academy of Family Physicians on the CDC advisory panel that just approved the new recommendation.

“As COVID-19 surges across the country, vaccinated people who are immunocompromised and have completed a two-dose series of either the Pfizer or Moderna COVID-19 vaccine series should obtain a third dose of the same mRNA vaccine that they have already received, at least 28 days from their second vaccine dose. This includes children and adolescents 12 and older who are immunocompromised,” said Rockwell.

“If you aren’t sure if you or your child falls into this group, talk with a trusted health care provider,” she added. “And if you fall into the third-dose group, but you haven’t gotten vaccinated at all yet, or haven’t finished your two-dose series, now’s the time to do it.”

Other steps immunocompromised people should take

Vaccination is not all people in this group should do, she adds.

“It’s important for immunocompromised people to wear masks in public, maintain social distancing of at least 6 feet from people they do not live with, avoid crowds and poorly ventilated indoor spaces until advised otherwise by their healthcare provider, and to encourage everyone over the age of 12 who interacts with them closely to get vaccinated if they aren’t already,” she said.

“They may not realize how much they are putting you at risk, or that your immunocompromised state puts you at high risk of severe COVID-19,” she added. “Ask them to help protect you.”

Rockwell also encourages people who get a third dose of COVID-19 vaccine to sign up for the CDC’s V-safe system, which will text them occasionally to ask them to report any reactions to the vaccine. This will help collect data that will guide the vaccination process and look for any rare effects.

Surging spread poses risk to immunocompromised people

The new approval couldn’t have come at a better time, given the fact that nearly the entire country is now experiencing high levels of spread of the coronavirus because of the highly contagious Delta variant.

It’s also a reminder of the fact that immunocompromised people remain vulnerable to severe cases of COVID-19 even after they’ve gotten vaccinated.

And some of them may not have gotten vaccinated yet, because their doctors are following recommendations that advise them to wait a certain amount of time after they finish a or get a transplant.

While the overwhelming majority of people hospitalized for COVID-19 right now are unvaccinated adults and children, many of the rest of those in hospitals for COVID-19 care have a condition or take a medication that affects their .

Advanced age can also affect immune response, but the new recommendation is not age-based. And a recent study by a U-M team found that nearly 3% of insured United States adults under the age of 65 take medications that weaken their immune systems. The findings, made using data from over 3 million patients, focused on people taking chemotherapy medications and steroids such as prednisone.

Who’s eligible for a third dose?

Here’s a partial list of the conditions and treatments that could qualify someone for a third dose of COVID-19 .

If you have one of these conditions or are on one of these treatments, or have another condition or take another medication that affects your immune system, contact your health provider or your child’s provider to see what they recommend.

  • Primary immune deficiency diseases
  • Cancers ( or blood cancers like leukemia and lymphoma) currently being treated with any treatment that reduces immune response, or treated in the past two years with a stem cell (bone marrow) transplant or CAR-T therapy
  • Organ transplant for any condition (liver, heart, kidney, lung, pancreas) now taking anti-rejection medications
  • HIV infection or AIDS
  • Chronic use of corticosteroids such as prednisone, especially high doses equivalent or larger than 20 milligrams of prednisone per day
  • TNF blockers such as Remicade, Enbrel, Humira, Cimzia, and Simponi, and other biologic agents that suppress or modify the immune response in order to treat an autoimmune diseases such as lupus, rheumatoid arthritis, Crohn’s disease, ulcerative colitis, psoriasis or other condition
  • People with end-stage kidney disease and people on dialysis
  • Anyone who has had their spleen removed for any reason

Other options for all at-risk teens and adults

Rockwell said that individuals whose health providers do not yet recommend a third dose for them should refrain from seeking a third dose at this time.

But, she adds, recommendations could change in future to include them as well. The CDC committee she serves on will also examine the issue of booster shots for other individuals.

She also noted another new FDA approval that could help immunocompromised people, and others over the age of 12 who aren’t fully vaccinated and have risk factors for severe COVID-19.

The FDA just approved the use of monoclonal antibody therapy as a preventive therapy, for high risk people who know they’ve been exposed to an infected person or live in a facility where someone has gotten COVID-19.


Explore further

CDC advisers to discuss third COVID-19 vaccine dose for immunocompromised


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Should you get a third dose of COVID vaccine? (2021, August 17)
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Polio vaccine boosters offered to kids in London as virus linked to New York case detected – ABC News

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Children in London are being offered polio vaccine boosters after sewage samples with the virus were found in multiple areas across the city.

The U.K. Health Security Agency announced Wednesday that all children between ages 1 and 9 across the British capital will be eligible to receive an inactivated polio vaccine booster.

“This will ensure a high level of protection from paralysis and help reduce further spread of the virus,” the agency said in a statement.

“While the majority of Londoners are protected from polio, the [National Health Service] will shortly be contacting parents of eligible children aged 1 to 9 years old to offer them a top-up dose to ensure they have maximum protection from the virus,” Jane Clegg, chief nurse for the NHS in London, added.

There are more than 1 million children between those ages who live in London as of mid-2020, the latest year for which data is available, according to the U.K. Office of National Statistics.

This 2014 illustration made available by the U.S. Centers for Disease Control and Prevention depicts a polio virus particle.

Sarah Poser, Meredith Boyter Newlove/CDC via AP, FILE

Between February 8 and July 5 of this year, poliovirus has been detected in 19 sewage samples across nine boroughs including at Beckton Sewage Treatment Works in London, which is the largest sewage treatment plant in the U.K.

Recently, a report indicated a polio case in New York was genetically linked to the samples found in the U.K.

Polio vaccines are part of routine immunizations for children. In the U.S., vaccinated children are not recommended to get a booster shot at this time.

According to the UKHSA, the booster program will begin in the areas where the virus has been detected and where vaccination rates are lowest before being rolled out across the city.

“The NHS in London will contact parents when it’s their child’s turn to come forward for a booster or catch-up polio dose — parents should take up the offer as soon as possible,” the agency’s statement read.

On July 21, health officials reported a case of polio was discovered in Rockland County in New York — just north of New York City — in a 20-year-old unvaccinated man.

The man contracted vaccine-derived polio, which means he was infected by someone who received the oral polio vaccine, which is no longer used in the U.S. or the U.K.

The oral vaccine uses a live weakened virus, which — in rare cases — can spread through fecal matter and infect unvaccinated individuals. Comparatively, the injectable polio vaccine, uses an inactivated virus.

As of Aug. 5, 11 samples were genetically linked to the Rockland County patient including six samples collected in June and July from Rockland County and five samples collected in July from nearby Orange County, health department data shows.

However, health officials have said the majority of the population is not at risk for polio because most were vaccinated as part of their regular childhood immunizations, but that it’s important for those who are unvaccinated to get their shots.

The New York State Health Department told ABC News its focus would be on ensuring immunizations.

“Our current focus is to ensure unvaccinated New Yorkers and children get immunized against polio and that they are up to date with their polio immunization schedule,” the department said.

The Centers for Disease Control and Prevention is the organization in the U.S. that makes vaccine recommendations, but has not suggested any such move to add a fifth dose of polio vaccine to the current vaccine schedule underway.

The CDC did not immediately respond to a request for comment from ABC News.

The agency recently told ABC News the U.S. health agency is deploying a team to New York to investigate the case in Rockland County. The team will also administer vaccines in the county.

“These efforts include ongoing testing of wastewater samples to monitor for poliovirus and deploying a small team to New York to assist on the ground with the investigation and vaccination efforts,” the agency said in a statement.

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Monkeypox: Manitoba's top doctor gives vaccine update | CTV News – CTV News Winnipeg

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Manitoba will be offering more vaccination appointments for monkeypox.

A news release from the province Thursday confirmed that additional appointments will be available “soon,” but no dates were listed.

Appointments can be made online or by calling Health Links-Info Santé at 204-788-8200 or toll-free at 1-888-315-9257.

Manitoba recently expanded eligibility for the monkeypox vaccine, but on Monday, tweeted all appointments were booked.

To date, no monkeypox cases have been found in Manitoba.

Dr. Brent Roussin, Manitoba’s chief provincial public health officer, said the province has a “scarce resource” of the monkeypox vaccine.

“It has to be stored properly, and it’s scarce because there are outbreaks happening in other jurisdictions,” he said. “We want to do whatever we can to avoid any wastage.”

While infections have primarily been reported in the gay, bisexual, and other men who have sex with men (gbMSM) population, Roussin said it is important to avoid stigmatizing populations.

“There is a balance between risk communication and doing whatever we can to avoid stigmatizing those populations,” he said.

Roussin added the province will be releasing data on total monkeypox vaccines administered next week.

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Canada to start testing some wastewater for polio 'as soon as possible' – CBC News

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After new reports of polio cases abroad, and virus samples in the wastewater of several other developed countries, Canada intends to start testing wastewater from a number of cities “as soon as possible,” CBC News has learned.

The Public Health Agency of Canada (PHAC) already works to monitor polio activity around the world, a spokesperson said in an email response to CBC News questions.

Currently, PHAC’s National Microbiology Laboratory in Winnipeg does have the diagnostic tools available to test samples for poliovirus. Any suspected positive Canadian samples of poliovirus will be sent to that lab for further laboratory analysis and confirmation, with results shared with the respective local health authorities “so appropriate public health measures can be taken if necessary.”

According to the statement, PHAC has been communicating with national and international partners who are experts in this field to finalize a wastewater testing strategy. It will be testing wastewater samples that were collected earlier this year from “key high-risk municipalities” to determine if polio was present prior to the reported international cases. 

PHAC will also be sending samples to the U.S. Centers for Disease Control and Prevention for additional confirmation.

“However, it is important to acknowledge that accurately testing wastewater for poliovirus is a developing science,” the statement continued. “For example, wastewater detections can be affected by extreme precipitation events, such as flooding in a community.”

WATCH | 100s could be infected with polio in New York state: 

100s could be infected with polio in New York, health officials say

2 days ago

Duration 2:19

A health official in New York State says hundreds of people could be infected with the polio virus.

Reports of polio in U.S., U.K., Israel

On Wednesday, British health authorities announced they will offer a polio booster dose to children aged one to nine in London, after finding evidence the virus has been spreading in multiple regions of the capital.

The agency said it was working closely with health authorities in the U.S. and Israel, as well as the World Health Organization, to investigate the links between polio viruses detected in those two countries. 

In July, Israel announced a recent outbreak of polio infections appeared to be under control, after multiple people became infected, including a Jerusalem girl who was paralyzed and now requires rehabilitation, according to the Jerusalem Post.

More recently, in the state of New York, one unvaccinated young adult suffered paralysis after a polio infection in Rockland County — an area known for low vaccination rates — which marked the first case reported in the U.S. in nearly a decade. 

Outbreaks also remain common in Afghanistan, Pakistan, and parts of Africa — areas of the world where vaccination efforts have not yet eradicated the virus.

Polio can often be asymptomatic, but in some cases, the viral infection can lead to paralysis or death.

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