The New Mexico Department of Health (NMDOH) on Monday, August 16 announced guidance for a third COVID-19 dose for some immunocompromised populations.
Key points include:
- The approval applies only to mRNA vaccines - Moderna or Pfizer. The federal government has not approved an additional dose for the single-shot Johnson & Johnson vaccine.
- Providers should make every effort to administer a third shot of the same type (Moderna or Pfizer) that patients received for their initial two shots.
- Providers should make every effort to administer the third shot more than 28 days after the second shot. The additional dose of an mRNA COVID-19 vaccine should be administered at least 28 days after completing the initial two-dose mRNA COVID-19 vaccine series.
- New Mexico COVID-19 vaccine providers can start providing the third dose to eligible patients immediately. Those patients include:
- Active treatment for solid tumor and hematologic malignancies.
- Receipt of solid-organ transplant and taking immunosuppressive therapy.
- Receipt of CAR-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)
- Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome).
- Advanced or untreated HIV infection.
- Active treatment with high-dose corticosteroids (i.e., ≥20mg prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory.
- Eligible patients are encouraged to schedule the third dose with their medical team - their primary care physician, specialist or pharmacy provider.
- The statewide registration app - vaccineNM.org - allows third-dose scheduling for people who have selected an immune-suppressing condition in their medical profile.
- NMDOH understands that not all providers or patients use the registration app. Patients can schedule either through usual methods with their medical team or through the registration app.
- Proof of qualifying condition is not required; however, patients should be able to provide verbal information about their medical condition.
- NMDOH encourages medical teams to reach out to their eligible patients to inform them of the additional dose recommendations.
- New Mexicans receiving third shots are not eligible for the $100 August incentive.
“We encourage New Mexicans with immune-related health conditions to speak directly to their primary care physicians and specialist teams, or their pharmacists - and to get the third shot if appropriate,” said DOH Acting Secretary David R. Scrase, MD.
Background
On August 12, the federal Food and Drug Administration modified the Emergency Use Authorizations (EUAs) for the two currently authorized mRNA vaccines, Pfizer BioNTech and Moderna, to allow for administration of an additional dose (i.e., a third dose) of an mRNA COVID-19 vaccine after an initial 2-dose primary mRNA COVID-19 vaccine series for certain immunocompromised people (i.e., people who have undergone solid organ transplantation or have been diagnosed with conditions that are considered to have an equivalent level of immunocompromise). The age groups authorized to receive the additional dose are unchanged from those authorized to receive the primary vaccination series:
- Pfizer-BioNTech: aged ≥12 years
- Moderna: aged ≥18 years
On August 13 the federal Centers for Disease Control and Prevention Advisory Committee on Immunization Practices (CDC/ACIP) met to weigh evidence to support a recommendation for a third dose in certain immunocompromised patients. After review, ACIP concluded that although the clinical benefit of an additional dose of an mRNA COVID-19 vaccine in immunocompromised people who received a primary mRNA COVID-19 vaccine series is not precisely known, the potential to increase immune response coupled with an acceptable safety profile, supports use of an additional mRNA COVID-19 vaccine dose after an initial two-dose primary mRNA COVID-19 vaccine series in this population.