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Immunocompromised may need a 4th COVID-19 vaccine booster, CDC says

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Anyone with moderate or severe pre-existing conditions or illnesses may require a fourth booster shot to keep them adequately protected from COVID-19, updated guidelines from U.S. Centers for Disease Control and Prevention say.

The guidelines — made public on Monday — said that a fourth dose could be administered with any vaccine that had been approved for use, including Janssen’s one-shot dose and mixed-dose regimens.

“After completion of an mRNA primary series and an additional mRNA vaccine dose, moderately and severely immunocompromised people are eligible for a booster dose,” the updated guidelines read.

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Anyone eligible for the booster should wait at least six months between their third and fourth shot, the CDC added.

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Health Canada has not authorized a third booster shot administered under any vaccine, although the National Advisory Committee on Immunization (NACI) has recommended that seniors and long-term care residents be offered a third dose of an mRNA vaccine at least six months after finishing their two-shot series. NACI has also backed a third shot for some immunocompromised individuals.

As such, Health Canada called the recommendation “off-label,” in an emailed statement to Global News.

“Informed consent should include discussion about what is known and unknown about the risks and benefits of providing a booster dose, including the off-label status of NACI’s recommendation,” Health Canada’s statement read.

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The CDC recommended a third mRNA dose — rather than a booster shot — for immunocompromised people who were at least 18-years of age earlier this month, advising they be administered at least 28 days after completing their two-dose series.

“Studies have found that some immunocompromised people don’t always build the same level of immunity after vaccination the way non-immunocompromised people do and may benefit from an additional dose to ensure adequate protection against COVID-19,” the CDC said.

Several provinces in Canada have also adopted the policy for seniors, based on the NACI’s recommendation.

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Clinics in British Columbia began doling out third doses to groups of people who were most likely to be hospitalized on Tuesday. In Manitoba, seniors a long-term care residents, front-line health-care workers and anyone living in a First Nation community are eligible for a booster. Alberta began offering third doses to seniors living in congregate care and immunocompromised individuals last month.

Quebec has also begun administering third doses to people living in long-term care facilities and in private seniors’ residences. Meanwhile, Nova Scotia is also offering a third dose to those who are “moderately to severely immunocompromised or who are taking medications that substantially suppress their immune system”.

Prior to NACI’s recommendations in September, Ontario became the first Canadian province in August to start doling out booster shots for the vulnerable population, including those who received transplants, patients with hematological cancer and residents in long-term care homes.

— with files from Saba Aziz 

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