dr. Jose U. Scher, a rheumatologist at NYU Langone Health who has studied the effect of vaccines on immunocompromised people, said the CDC vote — and the guidance from its experts — would help patients worried about whether or not to seek a third shot. Previously, he said, when people tested themselves for antibodies after vaccination and were left blank, “there were no tools for us to respond to that.”
“We now know that this population was left behind,” he said.
Immunocompromised people don’t need a doctor’s approval or a prescription to receive a third injection, CDC officials said. They only have to prove that they meet the conditions to be eligible for an extra dose. Everyone, including those with chronic medical conditions, such as diabetes or asthma, should not get a third shot at this time, they said.
dr. Scher predicted that this honor system approach could be messy. “I don’t know if there is any way to corroborate someone’s claim” that he is immunocompromised, he said. Demanding some sort of proof, such as a doctor’s note, would be a better process, he said.
The updated FDA authorizations do not apply to immunocompromised people who have received the Johnson & Johnson single-dose vaccine. The CDC panel made no recommendations for additional shooting for that group, which is reportedly small. But the lack of guidance from the FDA or CDC has left that group in the dark.
Understand the State of Vaccine and Mask Mandates in the US
- Mask Rules. The Centers for Disease Control and Prevention recommended in July that all Americans, regardless of vaccination status, wear masks in indoor public places in areas with outbreaks, a reversal of the guidance it offered in May. Find out where CDC guidelines apply and where states have their own masking policies. The battle over masks has become controversial in some states, with some local leaders defying state bans.
- Vaccine rules. . . and Buselessness. Private companies are increasingly mandating coronavirus vaccines for employees, taking different approaches. Such mandates are permitted by law and have been confirmed in court proceedings.
- College and universities. More than 400 colleges and universities are demanding that students be vaccinated against Covid-19. Nearly all of them are in states that voted for President Biden.
- schools. On August 11, California announced that teachers and staff at both public and private schools should be vaccinated or tested regularly, the first state in the nation to do so. A survey published in August found that many U.S. parents of school-aged children are opposed to mandatory vaccines for students, but were more in favor of mask mandates for students, teachers and staff who have not received their injections.
- Hospitals and Medical Centers. Many hospitals and major health systems require workers to receive a Covid-19 vaccine, citing the increasing caseload fueled by the Delta variant and persistently low vaccination coverage in their communities, even within their workforce.
- New York. On August 3, New York City Mayor Bill de Blasio announced proof of vaccination would be required from employees and customers for indoor meals, gyms, performances and other indoor settings, becoming the first U.S. city to require vaccines for a wide variety of activities. . City hospital employees should also receive a vaccine or be tested weekly. Similar rules apply to employees in New York State.
- At the federal level. The Pentagon announced it would aim to make coronavirus vaccinations mandatory for the country’s 1.3 million active-duty troops “by mid-September.” President Biden announced that all civilian federal employees would be required to be vaccinated against the coronavirus or undergo regular testing, social distancing, mask requirements and restrictions on most travel.
“We understand the challenges here and so we will continue to work very diligently to try and find a solution,” said Dr. Peter Marks, the FDA’s chief vaccine regulator, during the panel meeting. The FDA is waiting for more data it expects to receive this month, including data from Johnson & Johnson clinical trials on the safety and efficacy of two doses.
dr. Kathleen Dooling, a CDC official, said patients who qualify for a third dose should ideally seek out the vaccine they have already received, but can take the other two-dose vaccine if necessary.
dr. Dooling presented studies that supported giving third doses, stressing that immunocompromised people receiving a third dose should still wear a mask, maintain social distancing with people they don’t live with, and avoid crowds and poorly ventilated indoor spaces. She said people with weakened immune systems were also at greater risk of a breakthrough infection.