CDC Asks Pharmacies to Give 4th COVID Shot to Immunocompromised Patients

On Wednesday, the Centers for Disease Control and Prevention reached out to pharmacists to confirm the message that people with moderate to severe immunosuppression are eligible for a fourth COVID shot.

The conference call came a day after KHN reported that immunocompromised people were being turned away by pharmacy staff who were unfamiliar with the latest CDC guidelines.

White House Chief of Staff Ron Klein tweeted on Wednesday morning that “Immunocompromised people should get the shots they need,” adding that the CDC is “going to send stronger messages to pharmacies to make sure this happens.”

The pharmacists who joined the call said it happened Wednesday afternoon, hours after Klein’s tweet.

The CDC “repeated the recommendations, giving case examples,” said Mitchel Rotholz, head of government and government affiliates of the American Pharmacist Association, who joined the CDC’s call.

Rotholz said he “requested a prepared document… that clearly sets out the recommendations… so that we can get the message across clearly and consistently. They said they would, but they don’t know how long it will take.”

The CDC is recommending another shot for 7 million American adults whose weak immune systems make them more vulnerable to contracting COVID-19 and dying. This group includes people with diseases that impair their immune response to infection, as well as people taking immunosuppressive drugs for organ transplants, cancer, or autoimmune diseases. While people with obesity or diabetes are at high risk of developing severe illness or dying from COVID, they are not considered immunocompromised people.

For other people aged 5 years and older, the CDC recommends a two-dose primary vaccine series of mRNA vaccine. Adults can also get a single dose of the Johnson & Johnson vaccine, which the CDC says may be safer for people who have had a severe allergic reaction to the mRNA vaccine.

Anyone over the age of 12 can get one booster dose to fight weakening immunity five months after the last shot in their main series, regardless of which vaccine they received. Vaccines are not yet approved for children under 5 years of age.

The CDC first recommended a fourth shot for immunocompromised people in October. Since then, the agency has been working to educate pharmacists and other healthcare professionals, CDC spokeswoman Kristen Nordlund said. These efforts included a conference call with health officials from every state, which was attended by thousands of people, as well as an additional call to doctors. The CDC has optimized its booster tips website several times. In its guidelines for pharmacists, the CDC notes that patients do not need to provide evidence that they are immunocompromised.

Alison Smith, who was turned down by Walgreens after she booked her vaccine appointment online, said she’s glad the CDC is trying to help.

“I appreciate that the CDC is listening to the concerns of patients and physicians, and I hope they look into their processes for clear communication and comprehensive dissemination of information,” Smith said.

In a statement ahead of the release of the first KHN story, Walgreens said it keeps its pharmacists updated on new vaccine guidance.

Some leaders said the CDC should have done better to publicize its recommendations for booster shots for immunocompromised people.

The call with pharmacists “should have been made many weeks ago,” said Dr. Eric Topol, founder and director of the Scripps Research Translational Institute. “I’m glad the White House team is finally moving forward on this.”

Dr. Amit Keeney, professor of pathology and laboratory medicine at Loyola University’s Stritch School of Medicine in Chicago, hopes the big pharmacies that are turning people away will issue press releases and update their websites “bluntly stating that they offer fourth doses.” “immune-compromised people. He said pharmacies also need to update their patient portals and provide “clear guidance to their pharmacists.”

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