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CDC recommends people with weakened immune systems get booster doses after three months instead of five

A patient receives a fourth dose of the Pfizer-BioNTech coronavirus vaccine in Israel in December. (Kobi Wolf/Bloomberg News)

The Centers for Disease Control and Prevention updated its guidance on Friday for some people with weakened immune systems, recommending they get a booster dose of the coronavirus vaccine three months after completing the initial series of the Pfizer-BioNTech or Moderna shots, rather than the current interval of five months.

The guidance also said immunocompromised people who received the one-shot Johnson & Johnson vaccine should get an additional dose. That means two doses, at least 28 days apart, followed by a booster dose of one of the mRNA vaccines.

“Although COVID-19 vaccines continue to work well to prevent severe illness, hospitalization, and death, we have seen reduced protection against mild and moderate disease,” the agency said in a statement. “With the number of cases of COVID-19 still high across the United States and globally, this guidance helps to ensure that people have optimal protection against” the virus that causes the disease.

The updated guidance also says it is no longer necessary for people to delay coronavirus vaccination after receiving treatments with monoclonal antibodies, a treatment authorized for early stage covid-19, or with convalescent plasma, which is taken from blood donated by people who have recovered from covid-19.

Agency officials had presented the anticipated changes Feb. 4 during a meeting of the CDC’s outside vaccine experts on the Advisory Committee on Immunization Practices.

Recommendations for some immunocompromised people are already different than those for the general population because those with frail immune systems are at increased risk for severe covid-19 and more likely to be infected even when fully vaccinated. Once infected, they can also potentially harbor mutations that could lead to more virulent new variants, experts say.

The CDC recommends people with weak immune systems receive three primary shots of the mRNA vaccines plus a booster for a total of four doses. But given the less-than-optimal immune response that these individuals typically have with their first three doses, a booster at three months may provide better protection, especially amid high transmission of the omicron variant, officials have said.

The CDC estimates that about 2.7 percent of adults — 7 million people — are immunocompromised, a group that includes patients with medical conditions that weaken their immune response, as well as people taking immune-suppressing drugs because of organ transplants, cancer or autoimmune diseases. Also on the list are people with advanced or untreated HIV infections, and those who have chronic medical conditions that can weaken immune response, such as chronic kidney disease.

Coronavirus: What you need to know

Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot designed to target both the original virus and the omicron variant. Here’s some guidance on when you should get the omicron booster and how vaccine efficacy could be affected by your prior infections.

Variants: Instead of a single new Greek letter variant, a group of immune-evading omicron spinoffs are popping up all over the world. Any dominant variant will likely knock out monoclonal antibodies, targeted drugs that can be used as a treatment or to protect immunocompromised people.

Tripledemic: Hospitals are overwhelmed by a combination of respiratory illnesses, staffing shortages and nursing home closures. And experts believe the problem will deteriorate further in coming months. Here’s how to tell the difference between RSV, the flu and covid-19.

Guidance: CDC guidelines have been confusing — if you get covid, here’s how to tell when you’re no longer contagious. We’ve also created a guide to help you decide when to keep wearing face coverings.

Where do things stand? See the latest coronavirus numbers in the U.S. and across the world. In the U.S., pandemic trends have shifted and now White people are more likely to die from covid than Black people. Nearly nine out of 10 covid deaths are people over the age 65.

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