A third dose of COVID-19 vaccine is recommended for some people with compromised immune systems. Some people do not develop a strong immune response from two doses of vaccine because of the use of certain medications and treatments, as well as some health conditions.
For this group, it takes an additional dose to have a reasonable level of immunity and protection against COVID-19. Studies show that giving a third dose to complete the initial vaccine series can help individuals with compromised immune systems creates a stronger immune response to protect them from COVID-19. Individuals in this group will be invited through the provincial Get Vaccinated system to get a third dose of vaccine.
This recommendation aligns with the recommendations from the National Advisory Committee on Immunization.
WHO IS ELIGIBLE FOR A 3RD DOSE?
People who are moderately to severely immunocompromised should receive a third dose of vaccine. The group includes:
Solid organ transplant and taking immunosuppressive therapy
- People who have had a solid organ transplant. May include a heart, lung, liver, kidney, pancreas or islet cells, bowel or combination organ transplant.
Treatment for solid tumour or malignant hematologic conditions
- People who have received an anti-CD20 drug for a malignant condition since January 2020.
- People who are receiving or received systemic therapy (including chemotherapy, molecular therapy, immunotherapy, targeted therapies including CAR-T, monoclonal antibodies, hormonal therapy for cancer) in March 2020 or later. This includes solid tumours as well as hematologic cancers within this time period.
- People who are receiving or received radiation therapy for cancer in October 2020 or later.
Bone marrow or stem cell transplant
- People who had bone marrow or stem cell transplant in September 2019 or later, or are still taking immunosuppressant medications related to transplant.
Moderate to severe primary immunodeficiency
- People with combined immune deficiencies affecting T-cells, immune dysregulation (particularly familial hemophagocytic lymphohistiocytosis) or those with type 1 interferon defects (caused by a genetic primary immunodeficiency disorder or secondary to anti-interferon autoantibodies).
- People with moderate to severe primary immunodeficiency which has been diagnosed by an adult or pediatric immunologist and requires ongoing immunoglobulin replacement therapy (IVIG or SCIG) or the primary immunodeficiency has a confirmed genetic cause (e.g. DiGeorge syndrome, Wiskott-Aldrich syndrome).
Prior AIDS defining illness or Prior CD4 count ≤ 200/mm3 or Prior CD4 fraction ≤ 15% or any detectable plasma viral load since January 2021 or HIV infection and ≥ 65 years old or perinatally acquired HIV infection.
Active treatment with the following immunosuppressive therapies:
- People who received treatment since January 2020 with any anti-CD20 agents (such as rituximab, ocrelizumab, ofatumumab, obinutuzumab, ibritumomab, tositumomab).
People who have been treated since January 2020 with b-cell depleting agents (such as epratuzumab, MEDI-551, belimumab, BR3-Fc, AMG-623, Atacicept, anti-BR3, alemtuzumab).
People who have been treated with biologics since December 15, 2020: abatacept, adalimumab, anakinra, benralizumab, brodalumab, canakinumab, certolizumab, dupilumab, etanercept, golimumab, guselkumab, infliximab, interferon products (alpha, beta, and pegylated forms), ixekizumab, mepolizumab, natalizumab, omalizumab, resilizumab, risankizumab, sarilumab, secukinumab, tildrakizumab, tocilizumab, ustekinumab, or vedolizumab.
- People who have been treated with oral immune-suppressing drugs since December 15, 2020: azathioprine, baricitinib, cyclophosphamide, cyclosporine, leflunomide, dimethyl fumerate, everolimus, fingolimod, mycophenolate, siponimod, sirolimus, tacrolimus, tofacitinib, upadacitinib, methotrexate, dexamethasone, hydrocortisone, prednisone, methylprednisolone, or teriflunomide.
People who have been treated with steroids orally or by injection on an ongoing basis since December 15, 2020: dexamethasone, hydrocortisone, methylprednisolone, or prednisone.
People who have been treated with immune-suppressing Infusions/injections since December 15, 2020: cladribine, cyclophosphamide, glatiramer, methotrexate.
Dialysis and/or with severe kidney or renal disease
- People on dialysis (hemodialysis or peritoneal dialysis) or have stage 5 chronic kidney disease (eGFR <15ml/min) or have glomerulonephritis and receiving steroid treatment
HOW DO I GET THE 3RD DOSE?
You will receive an invitation by text, email, or phone call through the Get Vaccinated system about how and when to book a third dose.
You must wait at least four weeks after your second dose to get your third dose.
People who are not eligible and who did not receive an invitation through the Get Vaccinated system will not be able to get a third dose.
If you believe you meet the criteria to get a third dose and have not been contacted by October 8, get in touch with your health care provider. Your health care provider can complete the Attestation Letter to confirm your eligibility for a third dose.
You do not need a third dose to be considered fully vaccinated on your BC Vaccine Card.
For more information, please visit BC CDC or the Doctors of BC website.