Fully vaccinated, immunocompromised patients should keep masking up as experts probe booster shots: CDC panel

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Immunocompromised patients fully vaccinated against COVID-19 should continue to wear face masks, maintain 6 feet of distance and take preventive steps as researchers continue to weigh booster doses in the fragile population.

Dr. Sara Oliver, member of the CDC’s Epidemic Intelligence Service (EIS), presented slides during the Advisory Committee on Immunization Practices (ACIP) meeting Thursday, which read, "now, immunocompromised people should continue to follow infection prevention measures: wear a mask, stay 6 feet apart from others, avoid crowds and poorly ventilated spaces."

HIV and cancer patients, organ transplant recipients and those taking immunosuppressant drugs comprise about 2.7% of the U.S. adult population, and some evidence has suggested the population doesn’t respond as well to COVID-19 vaccines, inducing lower levels of protective antibodies. Emerging data suggests an additional dose could boost the antibody response, and small studies indicated a third dose resulted in side effects similar to those seen after the initial vaccination series.

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Oliver added that there hasn’t been data sent to the FDA to support amending emergency approvals (EUAs) of COVID-19 vaccines among immunocompromised patients, but the CDC and independent experts "will closely monitor for any updates to the data and to regulatory mechanisms."

Close contacts of fragile patients were also advised to receive COVID-19 vaccinations. Aside from immunocompromised patients, the FDA and Centers for Disease Control and Prevention (CDC) previously said fully vaccinated Americans "do not need" an extra dose at this time. The health agencies said the U.S. "is fortunate to have highly effective vaccines that are widely available" to eligible populations. 

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Some immunocompromised patients have already sought out additional doses unsupervised and ahead of any regulatory approval, said Dr. Camille Kotton, clinical director of Transplant and Immunocompromised Host Infectious Diseases at Massachusetts General Hospital.

"I have major concerns about equity because, from my experience, I have noted that it is patients who tend to be more educated and more empowered to take care of their own healthcare who are getting these additional doses, so I worry that some are being left behind," Kotton said.