US approves fourth jab as booster for vulnerable

NEW YORK • Some US adults with weakened immune systems who received a third dose of either the Pfizer-BioNTech or Moderna coronavirus vaccine authorised just for them will become eligible for a fourth shot as a booster next year, according to updated guidelines from the Centres for Disease Control and Prevention (CDC).

"In such situations, people who are moderately and severely immunocompromised may receive a total of four vaccine doses," with the fourth coming at least six months after the third, the CDC guidelines said.

In August, federal regulators in the United States cleared a third dose of the Pfizer-BioNTech and Moderna vaccines for some immunocompromised recipients of those shots, instructing them to get it at least 28 days after their second shot.

Federal agencies said studies have shown that those people may not be adequately protected by just two shots. The earliest that immunocompromised people who received a third mRNA vaccine shot can get a fourth shot as a booster would be February.

The agency said that people could select that booster from any of the three coronavirus vaccines available in the US.

The CDC also recommends that moderately and severely immunocompromised adults who received Johnson & Johnson's one-dose vaccine get another dose of any one of the three vaccine brands, at least two months after their initial shot.

The agency updated its guidelines on Monday, adding the possibility of a booster dose for many people who are immunocompromised, including those undergoing chemotherapy, recovering from a solid organ transplant or facing certain other medical issues, such as HIV infection.

The new recommendations also specified that a fourth dose of Moderna's vaccine should be half the size of a normal dose.

Many health officials and experts in the US and other countries have made a distinction between additional shots for immunocompromised people, who may not have mounted a strong immune response after their initial doses, and broader booster programmes intended to shore up other people's immunity, which can wane against infection naturally over time.

NYTIMES