NITAG recommends third dose for immunocompromised people

Reaching vaccination to remote places for people with mobility issues and the elderly population

The committee also recommended a booster dose of mRNA for people aged 60 and older, active frontline workers, and individuals with chronic medical conditions



Considering the higher risk of breakthrough infections after standard immunization, the National Immunization Technical Advisory Group (NITAG) recommended ‘immunocompromised people be given a third dose of the mRNA Covid-19 vaccines.’ 

People who are immunocompromised,despite being vaccinated, might not have had a strong immune response to their initial vaccine series. This additional dose is intended to improve the level of immunity of immunocompromised people.

The NITAG committee recommended the third dose of mRNA Covid-19 vaccine at least four weeks after the second dose for all severely immunocompromised people are complete.

A NITAG member, referring to people with lower immunity, said that the recommendation is based on the evidence showing that immune response weakened over time, reduced protection against variants of concern, and inadequate protection from the initial vaccine series for some risk groups.

The member said that studies have found that immunocompromised people are especially vulnerable to Covid-19 even after getting the currently recommended standard primary vaccine series because they are more at risk of serious diseases.

“They would not have developed enough antibodies with the initial two doses. To develop the antibody we need good immunity. So, for better antibody development, the third dose is required,” said the NITAG member.

Studies show Moderna vaccinesare 93 percent effective after six months of having received the second dose, while Pfizer vaccine efficacy declined to about 84 percent six months after the second dose.

Immunocompromised people includethose who have had a solid organ transplant and those taking immunosuppressive therapy, and receipt of chimeric antigen receptor (CAR) T-cells or hematopoietic stem cell transplant.

It also includes people with moderate or severe primary immunodeficiency, advanced or untreated HIV infection, and active treatment with high-dose corticosteroids.

Besides, the committee also recommended that people aged 60 and older, active frontline workers, and people with chronic medical conditions should get a booster dose of mRNA vaccine after six months of receiving the second dose.

The recommendation follows a discussion by NITAG on 22 September on the third and booster dose of the Covid-19 vaccine. However, they were asked to resubmit their proposal with detailed scientific evidence and justification.

“A final recommendation will be submitted to the health ministry containing the numbers of immunocompromised people and doses required for the third vaccination,” the member said, adding that their recommendations are based on the currently available scientific information.

The World Health Organization (WHO), U.S. Food and Drug Administration (FDA), and Centers for Disease Control and Prevention (CDC) recommended that moderately to severely immunocompromised people who have been vaccinated should receive an additional dose.