You got both your COVID-19 shots — and you may need another. But unless you’re moderately to severely immunocompromised and your doctor says you need a third dose of Pfizer or Moderna, don’t roll up your sleeve just yet.
While third doses are currently available for certain immunocompromised people, it’s not immediately clear when boosters for the general public will be available, despite the White House’s initial target date of Sept. 20.
That’s because, back in August, when President Biden promised boosters “for every fully vaccinated adult," he added one big condition: “pending approval from the Food and Drug Administration and the CDC’s Committee of outside experts.”
And that approval isn’t quite wrapped up yet.
An FDA advisory panel on Sept. 17 shot down Pfizer boosters for everyone 16 and older, opting to instead support limiting eligibility to people who are 65 and older or who are “at high risk of severe COVID-19.” And the CDC committee has yet to make its recommendations.
Confused? Here are the basics:
- People 12 and up who have compromised immune systems can get a third shot of an mRNA vaccine right now (more on this below). In this case, that additional shot is called a third dose.
- For those who are not immunocompromised, boosters are intended to help protect against the highly contagious delta variant, which has caused caseloads across the U.S. to surge. It’s not formulated specifically for delta, but a third shot could help with any waning effectiveness of the previous shots in the general population. Rollout of those boosters was expected to begin Sept. 20, though that was dependent on the necessary FDA and CDC authorizations and recommendations, which have not happened yet.
- Johnson & Johnson vaccine recipients may also need an additional dose or booster but officials are still reviewing the data.
- Access to vaccines will continue to be free regardless of health insurance or immigration status.
- Talk to your health provider before getting a third dose or booster. It may not be right for everyone.
We know it’s a lot to keep track of, so we’ll keep updating this guide with what you need to know — whether you’re immunocompromised or not — about getting a third shot here in Southern California.
Here’s what we know so far.
(And if you still have a lingering question after reading through this guide, ask us below!)
Can I Get A Third Shot?
It depends, and can get a bit complicated.
For clarity’s sake: If you are immunocompromised, we’ll call your third shot a third dose. Third doses for immunocompromised people are available now (we'll share more about how to get one in a second).
If you’re not immunocompromised, a third shot is considered a booster. These aren't available yet, but might be, for certain individuals, soon.
“Third doses are meant to elicit an antibody response where there has been an inadequate antibody response before,” Los Angeles County Department of Public Health director Barbara Ferrer explained. “While booster doses are meant to increase antibody levels that have waned, after a robust increase in the months after vaccination.”
So first, you’ll need to determine if you’re considered immunocompromised or not. You should talk to your doctor about that.
What If I Am Immunocompromised?
If you have certain conditions that make you "moderately to severely immunocompromised," third doses are available now.
That's because the Food and Drug Administration (FDA) amended the emergency use authorizations for the Pfizer and Moderna vaccines to allow for "an additional dose" for certain immunocompromised people who may need them, including "solid organ transplant recipients or those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise."
Which means — if you have one of the following conditions — then the CDC considers you “moderately to severely immunocompromised” and recommends you get a third dose:
- 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 2 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
An additional dose is recommended if you have one of these conditions because you’re more at risk for serious illness if you get COVID-19.
"Studies have shown these people may not have sufficient immunity to head off the more serious complications of COVID-19 after the standard vaccine regimen,” NPR reported last month.
But before you head straight to the first vaccine site you can find, talk to your doctor.
Your health care provider will be the most familiar with your personal health situation, and if it would be appropriate for you to get your third dose, given the treatments you’re likely undergoing.
Be sure to ask them about the timing, and when would be best for you to get the additional shot.
What If I Am NOT Immunocompromised?
If you don’t fall into one of the CDC’s moderately to severely immunocompromised categories, you can’t get a third shot just yet. Don’t panic. Don’t feel like you have to lie and say you're immunocompromised if you're not.
Experts are currently weighing the pros and cons of a booster for you.
Back in August, the White House COVID-19 Response Team and public health officials from the U.S. Department of Health and Human Services announced that third shot boosters would be available “beginning the week of September 20 and starting 8 months after an individual’s second dose.”
But that was contingent on the FDA and CDC giving boosters green light, and that hasn’t happened quite yet, aside from the previously mentioned third doses for immunocompromised people. Instead, an FDA advisory committee supported narrowing the pool of people who are eligible for boosters to those who are 65 or older or who are “at high risk of severe COVID-19.”
So we don’t know yet if everyone who is fully vaccinated will need a booster. Studies are ongoing. The CDC Advisory Committee on Immunization Practices will issue booster dose recommendations “based on a thorough review of the evidence.”
FDA supports the administration’s work to plan for the deployment of additional vaccine doses, or boosters, this fall. FDA will undertake an independent scientific evaluation of the safety and efficacy of boosters for each vaccine. https://t.co/Dam7SMuXBv— Dr. Janet Woodcock (@DrWoodcockFDA) August 18, 2021
We’ll update this section as officials share more specifics.
Should I Mix Vaccines?
So far, the CDC is recommending you stick to the same type. Which means:
- If you got Pfizer for your first two doses, the CDC recommends that your third jab is Pfizer, too.
- Likewise, if you got Moderna for the first two, then Moderna should be your third.
Is The Third Dose For Immunocompromised People Smaller?
No. The third dose of the Pfizer of Moderna vaccines are exactly the same shot you got the first two times. The dosage and ingredients are unchanged.
What If I Got Johnson & Johnson?
At this time, the FDA has not updated the emergency use authorization for the one shot Johnson & Johnson vaccine, so the CDC is not recommending any additional doses if that’s what you got initially.
“There is not enough data at this time to determine whether immunocompromised people who received the Johnson & Johnson’s Janssen COVID-19 vaccine also have an improved antibody response following an additional dose of the same vaccine,” the CDC explains.
When Should I Get My Third Shot?
If you’re immunocompromised, the CDC recommends you wait at least four weeks — or 28 days — after your second shot before getting your third dose.
The L.A. Department of Public Health emphasizes you should consult your healthcare provider about the specific timing of the third dose if you are immunocompromised.
“Ask about the best timing based on your current treatment plan,” the county’s vaccine portal reads. “This is especially important if you are about to start or restart immunosuppressive treatment.”
If you’re not immunocompromised, the CDC has not yet made a recommendation about if you should seek out a booster.
“CDC’s independent advisory committee, the Advisory Committee on Immunization Practices, will continue to meet and discuss data on the evolution of the pandemic and the use of COVID-19 vaccines,” the CDC writes on its website. “ACIP will make further recommendations on the use of boosters for the public after a thorough review of the evidence.”
What Should I Bring With Me To Get My Third Shot?
You’ll need to bring many of the same things you had to bring to your second dose, including:
- Your CDC Vaccine Card showing your prior doses. Note: Bring the actual card. They will write on again.
- If you have health insurance, your health insurance card (though COVID-19 vaccines are free regardless of insurance status)
- Some type of proof of your age, like something from this list provided by the L.A. County Department of Public Health:
- Driver's license or permit (foreign country or expired ID okay)
- California ID card or REAL ID card (from the DMV)
- Consular ID (Matricula Consular)
- Medicare card
- Military ID
- Membership card (foreign country okay if written in English)
- Passport (foreign country or expired okay)
- Birth certificate
- Medical document/records (including immunization records) from medical provider, clinic, or doctor
- Any official document that includes name and date of birth (for example, school record)
If you’re immunocompromised, some vaccine sites will also require you to self-attest that you have a qualifying medical condition (more about those self-attestation forms below).
12-17 Year Olds
If you're a minor, you need to get the Pfizer vaccine because it’s the only one authorized for your age group.
According to the L.A. County Department of Public Health, minors should bring:
- Your CDC Vaccine Card showing your prior Pfizer doses
- A responsible adult with an ID (see list above) and a signed consent form from your parent or legal guardian (more on that below.)
- If you have health insurance, bring your health insurance card (though COVID-19 vaccines are free regardless of insurance status.)
- Proof that you are 12 or older, such as a birth certificate, medical documents or school ID.
- "16 and 17-year-olds should be accompanied by their parent or legal guardian if possible." If that’s not possible you need to bring a consent form signed by your parent or legal guardian.
- "12 through 15-year-olds must be accompanied by their parent, legal guardian, or a responsible adult. If you bring a responsible adult, the consent form must name the responsible person and be signed by the parent or legal guardian," according to LACDPH.
- A Public Health signed consent form, which is available in English, Spanish, and additional languages on the county vaccine portal.
Consent forms are also available at the vaccination site.
We’ve reached out to the California Department of Public Health to find out if immunocompromised children and teens can self attest that their medical condition qualifies them for a third dose. We’ll update when we have more information. Getting a shot through your health care provider may be easiest since they have access to your medical history.
What Are The Side Effects Of The Third Shot?
“There is limited information about the risks of receiving an additional dose of vaccine, and the safety, efficacy, and benefit of additional doses of COVID-19 vaccine in immunocompromised people continues to be evaluated,” according to the CDC.
The CDC reports that most of the reported side effects of the third dose have been “mild to moderate” and resemble those reported after the first and second shots of the mRNA vaccines, like “fatigue and pain at injection site.”
Do I Still Need To Take Any Precautions — Like Wearing A Mask — After My Third Shot?
Even a third dose “may still not provide full immunity to COVID-19 in people who are immunocompromised,” according to the FDA’s emergency use authorization fact sheets for the Pfizer and Moderna vaccines.
So, the L.A. County Department of Public Health recommends that you keep taking precautions, which means even after a third dose or booster, you should:
- Avoid crowds and locations with poor ventilation or airflow
- Try to stay six feet away from people
- Wear a mask
- Consider double masking (surgical mask + cloth mask) or wearing a N95
- Ask the people around you to get vaccinated too
How Do I Get My Third Shot?
It … depends. We’re listing some of the big vaccine distributors here — including local health departments — to give you an idea of how they’re handling third doses and boosters, but it’s not an exhaustive list.
The state’s vaccine appointment portal MyTurn has been updated to allow for additional doses for immunocompromised people.
Scroll down to where it says “Additional doses available for eligible patients” and click on the “Schedule now” button.
There, you will be asked about your age and which vaccine — Pfizer or Moderna — you received. When you indicate you are seeking an “additional dose,” you will be asked to certify that you meet the immunocompromised criteria, and that your second dose was at least a month ago.
You can also call the state's COVID-19 hotline to make a vaccine appointment over the phone. The number is 833-422-4255.
If you cannot physically get to a vaccine location due to your health condition or mobility challenges, you do also have the option of requesting an “in-home visit” through MyTurn. Just indicate that you need one while filling out the form, and someone should call you to follow up.
L.A. County Department of Public Health
While the L.A. County Department of Public Health’s vaccination sites have been providing third doses for immunocompromised people, director Barbara Ferrer said the “primary priority is vaccinating those not yet vaccinated.”
That said, if you are immunocompromised and you want to get your third dose from a county-run vaccination site, you'll need to bring or fill out a self-attestation form to show that you are immunocompromised and that is why you are seeking a third dose. The form is also available in Spanish and 10 other languages on the county’s vaccine portal — click on “Doses for Immunocompromised” on the left hand side.
As for boosters (for people who are not immunocompromised) in L.A. County, Ferrer said the department is prepared to start administering them to people in nursing homes, once they get the green light from the CDC.
“Efforts are currently ongoing at these sites to provide third doses to immunocompromised residents, and we anticipate no issues being able to ramp up at all of our nursing homes once we’re clear that those residents would be eligible for a booster dose,” Ferrer told reporters on Sept. 17.
If you are homebound and need an in-home vaccination, you can call the county Vaccine Call Center at 833-540-0473 between 8 a.m. and 8:30 p.m. You can also fill out an online request form, which is available in English and Spanish, and twelve other languages on the county’s vaccine portal (just click on “In-home vaccination” on the left side).
As of Sept. 12, more than 67,600 people have gotten an "additional dose" from a vaccine provider in Los Angeles County, according to the public health department.
Long Beach Health and Human Services
If you’re immunocompromised, you won’t need to bring a doctor’s note, but you will need to fill out a form that will be available at any of the Long Beach vaccination sites. It asks questions about your health history, including if you’ve had an allergic reaction to any ingredients in the vaccine and if you’ve had COVID-19 in the past as well as your race and ethnicity. If you have mobility issues you can request a mobile vaccination visit here.
As for boosters, the department says it’s “preparing to offer ample opportunities to get free booster shots when they become available.”
Pasadena Public Health Department
If you are homebound, you can call the Pasadena Citizen Service Center at 626-744-7311, Monday through Friday, 8 a.m. at 4 p.m. to request in-home vaccination.
The city will wait until the CDC gives its recommendation and guidance on eligibility, and the Western States Scientific Committee reviews that recommendation, before distributing boosters, according to a spokesperson.
Orange County Health Care Agency
Orange County Health Care Agency director Clayton Chau told reporters that third doses are available for immunocompromised people now.
“It’s a self-attestation, meaning you don’t need to go to your doctor for any proof,” Chau said on Aug. 20.
If you are homebound, you can request an at home vaccination through the county’s booking portal, Othena.
Riverside County Public Health
Mobile sites run by the county department of public health are administering third doses to moderately to severely immunocompromised people, though you will not be asked for a note from a doctor or medical records proving your condition.
“The additional vaccine dose is critical to protect those whose health is already compromised,” county Public Health Officer Dr. Geoffrey Leung said in the news release. “This additional protection will save lives.”
You can also book an appointment through MyTurn, which has the option of requesting a homebound vaccination.
San Bernardino County
The county has set up a separate page dedicated to third doses and boosters.
If you are seeking a third dose because you are immunocompromised, the county will accept a self-attestation that you meet the requirements (linked here in English and here in Spanish) at its vaccination sites.
If you are getting a third dose because you meet the immunocompromised criteria, you can go to any of the county-run vaccination sites. Just tell the staff working at your vaccination clinic that you are immunocompromised. You will not be asked for any proof, a county spokesperson confirmed.
If you call and make an appointment or walk into a Kaiser Permanente vaccine clinic in search of a third dose, the staff will ask you if you are immunocompromised or if your health care providers have told you you’re immunocompromised. You won’t have to bring a form — but they’ll take it if you do.
If you are immunocompromised, you can get your third dose at a Kaiser Permanente site, even if you are not a member.
As for boosters — they’re not available yet, but when they are, both members and non-members will be able to get them at KP vaccination sites.
We are aware that @HHSGov now supports a COVID-19 booster shot for fully vaccinated people starting Sept. 20. We will share info about how to schedule those shots as soon as we receive guidelines from Federal and state health agencies. Pls see https://t.co/1kks1VAepw for updates.— Kaiser Permanente (@KPMemberService) August 18, 2021
Here are some of the big pharmacy chains — and how they're handling third doses — in alphabetical order.
Albertsons Companies, including Albertsons, Vons, and Pavilions, among others
You won’t be asked to provide “a prescription or signoff” to prove you are immunocompromised, but you will be expected to bring your CDC vaccine card showing your first two doses. If you don’t have your card, the pharmacist will look up your record in the state vaccination registry, according to a company spokesperson. You can walk in or make an appointment.
“Immunocompromised patients are required to attest to their eligibility [for a third dose for immunocompromised people] during the scheduling process and at the time of receiving their vaccination,” a spokesperson told LAist.
You will be asked to self-attest that you are immunocompromised before you will be given a third dose, according to a company spokesperson.
You will have to “verbally self-attest” that you are immunocompromised and therefore eligible for a third dose before it will be administered, according to a spokesperson.
You will be asked to sign and date an attestation form confirming you are eligible for a third dose. That form “is then filed with the patient’s vaccine record,” a corporate spokesperson told LAist.
Walmart and Sam’s Club
“While Walmart and Sam's Club pharmacies are currently administering third doses to immunocompromised individuals, we will only administer booster shots to eligible fully vaccinated Americans once recommendations have been issued by the CDC and FDA,” according to a corporate blog post.
What Else Do You Want To Know About These Third Shots?
Is there something about the third doses or boosters that you want to understand better?
Is there something you want to tell us about?
Did you already get your third shot and have a completely different experience than what we described here?
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