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US allows extra COVID vaccine doses for some. What now?

The Food and Drug Administration has ruled that transplant recipients and similar immune-compromised people can receive a third dose of the Pfizer vaccine or Moderna vaccine. But the decision offers an extra dose only to those high-risk groups -- not the general public.

Patients have been calling for better protection for months, with some crossing state lines or lying to obtain another dose. The Centers for Disease Control and Prevention reported that around 1.1 million people have received at least three doses of the Moderna or Pfizer vaccines. However, it is not known how many were able to do so due to a weaker immune system.

Friday's discussion by CDC advisors was about who qualifies, before they unanimously endorsed the FDA decision.

These are some facts to be aware of:

WHY DOES SOME PEOPLE NEED A SPECIAL DOSE?

Moderna and Pfizer vaccines provide powerful protection for healthy individuals. However, people who are on immune-suppressing medication or have diseases that weaken their immune system generally receive less benefit from the two standard doses. According to the CDC, a study showed that between 40% and 44% of patients admitted for a "breakthrough case" -- an infection following vaccination -- were immune-compromised.

According to Dr. Camille Kotton, a CDC adviser, the hospitalized patients did "all the right things" and are just suffering from a lack vaccine protection.

Who QUALIFIES

Approximately 7 million Americans are immune-compromised. However, the FDA only included transplant recipients and other individuals with immune suppression of similar severity. The FDA did not specify who fell into these other categories. The CDC says that people with blood cancers, certain cancer chemotherapies and people taking certain medications, such as rituximab, for rheumatoidarthritis, tend to respond poorly to vaccinations.

ARE THERE ANY AGE RESTRICTIONS?

The new policy allows children under 12 years old to receive a third dose. Adults are not allowed to receive a third Moderna vaccine. The reason is that the Pfizer vaccine is currently the only approved option for Americans below 18. If Moderna's vaccine is eventually allowed for teens, that could change.

Will I need a DOCTOR'S NOTICE OR A BLOOD TEST

Patients will only need to inform the vaccine provider why they are seeking another dose. The government won't require either. "We would like to make it as simple as possible," Dr. William Schaffner of Vanderbilt University, an infectious disease expert.

What will a third dose cost?

FDA emergency use authorization shots are free.

Is MIX-AND MATCH PERMITTED?

While the government encourages that the third dose be the same as the previous two, it doesn't require it.

WHAT WORKS A THIRD DOSE?

It is helpful for at least some people. Canadian researchers this week reported 55% of transplant recipients given a third dose two months after standard vaccination had good antibody levels compared to 18% who were given a dummy third shot for comparison. Experts advised these high-risk patients that they continue to take precautions and mask their symptoms as there is no guarantee that a third dose of vaccine will work.

What if a THIRD DOSE DOES NOT WORK?

Although it is not intended to replace vaccination, the FDA has approved an antibody treatment to be used as a preventive measure in the event that high-risk patients become exposed. It is important that family members and other close relatives of fragile patients are vaccinated.

To better understand if some patients with compromised immune systems need other options, more research is being done.

WHAT IF THE SINGLE-DOSE JOHNSON AND JOHNSON VACCINE WAS MADE?

Although there is little information on the effectiveness of another dose in high-risk individuals who have received the vaccine, it is likely that this small group has not been affected by the J&J shot. CDC still counts at least 90,000.

Dr. Peter Marks, chief FDA vaccines officer, stated that the FDA is currently working to obtain more information on immune-suppressed J&J patient but that the evidence for the moment only supports a recommendation for extra doses for Pfizer recipients with fragile immune systems and Moderna recipients.

Is THIS A BOOOSTER?

It's not true, boosters are only for those whose immunity has declined over time. These high-risk individuals didn't receive enough protection to begin. The second shot was given 28 days ago, so they will be eligible for the third dose. This is part of the initial prescription. This is similar to the way France has dealt with vaccinations for immune-compromised patients since April.

WHAT ABOUT BOOSTERS - FOR EVERYONE!

U.S. health officials insist that it is not the right time to give booster doses to the general population.

"We believe that sooner or later, you will require a booster to durability of protection," Dr. Anthony Fauci, the top expert in infectious diseases, said this week.

The CDC closely monitors COVID-19 hospitalizations, deaths and long-term studies to determine how many vaccinated workers are infected with the extra-contagious Delta variant. Any decision will be based on this evidence.

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