3rd COVID-19 Vaccination Proceeds for Severely Immunosuppressed

Public Health England (PHE) confirmed on September 1, 2021, a third COVID-19 dose should be offered to people over 12 who were severely immunosuppressed at the time of their first or second dose, including those with leukemia, advanced HIV, and recent organ transplants.

These people may not respond fully to vaccination and therefore may be less protected than the wider population.

Furthermore, people with severe immunosuppression are more likely to be severely ill if they do catch COVID-19.

Some studies have shown that many immunosuppressed people have lower levels of antibodies after the COVID-19 vaccination (Comirnaty, SpikeVax).

Preliminary data from the OCTAVE trial showed that almost everyone immunosuppressed mounted an immune response after 2 vaccine doses, as indicated by either antibodies or T cells.

However, in around 40% of people, the levels of antibodies were low. It is not clear how much this may affect protection against COVID-19 as antibodies represent only part of a person’s immune response.

This PHE statement is separate from any potential booster program.

The PHE's Joint Committee on Vaccination and Immunisation (JCVI) is still deliberating the potential benefits of booster vaccines for the rest of the population. It is awaiting further evidence to inform this decision.

Professor Wei Shen Lim, Chair of COVID-19 Immunisation for the JCVI, said in the press release, "We want people with severely suppressed immune systems to have the best chance of gaining protection from COVID-19 via vaccination."

"Therefore, we are advising they have a third vaccine dose on top of their initial 2 doses, as we hope this will reduce their risk of severe outcomes such as hospitalization and death.'