Fourth COVID Shot? Those At-Risk In FL May Be Eligible

FLORIDA — Some Floridians should get a fourth COVID-19 vaccine, according to the Centers for Disease Control and Prevention, with the agency now recommending a fourth shot for some immunocompromised people.

The CDC endorsed a third dose of the Moderna and Pfizer vaccines in August for moderately or severely immunocompromised people but said it would be part of the primary immunization, rather than a booster shot. In October, the agency said the at-risk population could receive a booster — a fourth dose — six months after their third vaccine.

The federal agency shortened the six-month wait to five months in January, hoping to stem the impact of the omicron-variant surge.

The recent surge hit the Sunshine State hard with record numbers of new COVID-19 cases reported weekly and daily. Florida repeatedly reported more than 50,000 to 70,000 cases in a day during the omicron surge, which started picking up in mid-December, and broke its record for the number of cases reported in a single day multiple times. The state's highest single-day number of cases ever came Jan. 8 when 77,075 were reported, according to CDC data.

Numbers have gone down since, though they remain high. Nearly 133,000 new coronavirus cases and an 18 percent new case positivity rate were reported in the state from Jan. 28 to Feb. 3, according to the Florida Department of Health's COVID-19 Weekly Situation Report. And more than 19,000 cases were reported Monday, the CDC said.

Recently, several “stealth omicron” cases, a subtype of the omicron coronavirus variant known as BA.2, were detected in Florida for the first time. It's still unclear whether it's more of a concern than its highly transmissible parent, but experts say it’s also highly contagious.

The CDC hasn't said whether people at lesser risk of severe COVID-19 infection should get the fourth vaccine dose, and the Food and Drug Administration hasn't considered authorizing one.

Additionally, the CDC's recommendations for more doses puts the agency at odds with the World Health Organization. The WHO acknowledges that data indicates the COVID-19 vaccines' waning effectiveness over time. But the organization believes increasing vaccine access for the entire world needs to be the top priority for ending the pandemic.

“Blanket booster programs are likely to prolong the pandemic, rather than ending it, by diverting supply to countries that already have high levels of vaccination coverage, giving the virus more opportunity to spread and mutate," said WHO Chief Tedros Adhanom Ghebreyesus told media in December.

But for Floridians who want to know whether they're eligible for a fourth dose, here's what the CDC says:

Additional Primary Shot

The primary COVID-19 vaccine course consists of two doses of the Pfizer and Moderna shots and one Johnson & Johnson shot.

• If you received Pfizer: People 5 and older who are moderately or severely immunocompromised should get an additional primary shot, given 28 days after their second dose, according to the CDC.
• If you received Moderna: People 18 and older who are moderately or severely immunocompromised should get an additional primary Moderna shot, given 28 days after their second dose, the CDC says.
• If you received Johnson & Johnson: The CDC doesn't recommend an additional primary shot at this time.

Booster Shot for Immunocompromised

• If you received Pfizer: Teens ages 12-17 should only get a Pfizer booster. Adults should get either the Pfizer or Moderna vaccine in most situations. The booster should be given five months after the additional primary shot, according to the CDC.
• If you received Moderna: People 18 and older can get a booster shot of the Pfizer or Moderna vaccine, given give months after the additional primary shot, the CDC says.
• If you received Johnson & Johnson: Adults can get the Pfizer or Moderna vaccines as a booster shot in most situations, given two months after their first shot, according to the CDC.

Who Is Moderately or Severely Immunocompromised?

The CDC considers people to be moderately or severely immunocompromised if they have:

• been receiving active cancer treatment for tumors or cancers of the blood
• received an organ transplant and are taking medicine to suppress the immune system
• received a stem cell transplant within the last two years or are taking medicine to suppress the immune system
• moderate or severe primary immunodeficiency, such as DiGeorge syndrome, Wiskott-Aldrich syndrome
• advanced or untreated HIV infection
• active treatment with high-dose corticosteroids or other drugs that may suppress your immune response

The agency recommends talking to their health care provider about their medical condition and whether getting a fourth shot is appropriate.

But even some pharmacies turned people away from getting a fourth COVID-19 vaccine, according to Kaiser Health News. As a result, the CDC contacted pharmacies Jan. 26 to reinforce the message that people moderate to severe immune suppression should receive a fourth dose.

Ronald Klain, the White House's chief of staff, reiterated the message in a Jan. 26 tweet.

"Immune-compromised people should get the shots they need: @CDCgov is going to send stronger messages to pharmacies to make sure this happens," Klain tweeted.