A third dose of vaccine against COVID-19 is limited to immunocompromised for now

FAR WEST TEXAS — Healthcare providers in Far West Texas have begun giving COVID-19 booster shots to immunocompromised people, and in anticipation of new federal guidance, many West Texas residents are looking to get a third dose booster to improve their immunity against the virus that has continued to infect, hospitalize and kill Americans this summer.

Last month, President Joe Biden announced a plan to roll out third dose boosters to the general public beginning September 20. As the president’s rollout draws near, state health officials and local providers say they are holding out for Food and Drug Administration approval of Pfizer and Moderna booster doses before moving forward on boosters for the general public.

Pfizer and Moderna booster doses were approved by the FDA for immunocompromised people as of August 12, and in the Big Bend region, some providers have already begun administering those.

Sul Ross State University gave 130 shots of Pfizer and Moderna at a vaccine drive last Thursday, providing boosters for immunocompromised patients, along with first and second doses for the general public. 

The Prescription Shop and Highland Drug in Alpine both said this week that they are offering boosters of the Moderna vaccine for those who have weakened immune systems, and Walmart in Fort Stockton is offering Pfizer boosters to immunocompromised people. Preventative Care Health Services, which operates clinics in Presidio, Alpine and Marfa, was unavailable to comment on their vaccine offerings.

At the region’s only hospital, boosters are not currently available for immunocompromised individuals, but Big Bend Regional Medical Center does plan to open a booster clinic later this month, pending recommendations of boosters for the general public by the CDC. Once the CDC guidance is clear, “We will offer both third doses to immunocompromised and booster shots,” hospital spokesperson Ruth Hucke said, and information on how to sign up will be made available.

The Centers for Disease Control and Prevention began recommending a third dose of mRNA COVID-19 vaccines at least 28 days after a second dose of Pfizer or Moderna for people with moderate to severe immunocompromisation. That includes people receiving cancer treatments, organ transplant recipients who take immunosuppressant drugs, stem cell transplant recipients, moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome), advanced or untreated HIV infection, and anyone receiving an active treatment with high-dose corticosteroids or other drugs that may suppress your immune response.

“CDC recommendation is that the additional dose be the same vaccine as the first two doses they received. People should talk with their personal physician or healthcare provider about whether they should receive an additional dose,” a spokesperson for the Texas Department of State Health Services said this week. 

For those who received the Johnson & Johnson vaccine, studies are ongoing, but there is not yet enough data about whether they would benefit from an additional dose, the DSHS spokesperson said.

There have been hiccups since Biden announced a September 20 rollout date for boosters to the general public. The FDA has not yet said it is safe and useful to have a third dose, and the CDC has not recommended the booster.

Last Friday, officials from the two government agencies, speaking anonymously, told The New York Times that at first, boosters for the general public may only be available to people who received the Pfizer vaccine. With 11 days until the planned start date, trial data for the Pfizer Comirnaty vaccine is still under review by the FDA and an advisory committee meeting isn’t scheduled until September 17. Data review from Moderna’s third dose trials are further behind.

The Pfizer vaccine has received full FDA approval while Moderna is still being administered under an Emergency Use Authorization, which may inform which booster is available first.

“A transparent, thorough and objective review of the data by the FDA is critical so that the medical community and the public continue to have confidence in the safety and effectiveness of COVID-19 vaccines,” the FDA wrote in a news release on September 1. “The FDA will review the supplemental application as expeditiously as possible, while still doing so in a thorough and science-based manner.”

According to the White House plan, people who aren’t immunocompromised and who have received two doses of Pfizer or Moderna would be eligible for a third booster dose of their vaccine eight months after receiving their second dose. By sticking to that schedule, those who were highest risk and eligible earliest when the vaccines first rolled out would also be the first to get the booster dose.

Since December 2020, tri-county healthcare workers have administered more than 21,800 doses of the Pfizer, Moderna and Johnson & Johnson vaccines to residents in the area. While the bulk of those vaccinations took place in the spring of 2021, each of the three counties in the area saw slight increases in vaccination starting after the first week of July, coinciding with news of the delta variant spreading. 

Sul Ross State University is planning to offer monthly vaccine events, as long as turnout remains high, said SRSU’s Mike Pacheco, the chief of staff in the office of the president. While the school is planning another vaccine event in late September, they will give first and second doses to anyone, but only give third boosters to immunocompromised people, unless guidance from the CDC changes and opens the booster up to the general public.

The vast majority of the tri-county’s vaccinated general population do not yet qualify for a booster, even if it were approved for the general public, since eight months have not elapsed since their second dose. And while some tri-county residents are eager to get a third dose to boost their immunity against COVID-19, for now, only immunocompromised West Texans can get vaccinated with a third dose.