COVID-19 vaccine for severely immunocompromised people

People with compromised (weakened) immune systems are at higher risk of getting serious infection from COVID-19 and therefore their COVID-19 vaccine requirements are different from that of a person with a healthy immune system.

On this page, you can find the following information:

For severely immunocompromised people having your booster doses as well as your 3-dose primary course will give you the best protection against COVID-19.

What are the criteria for being severely immunocompromised?

You can be severely immunocompromised by having a medical condition causing a weakened immune system, or through taking medicines used to treat a range of conditions. Learn more about criteria for severely immunocompromised.

What are the vaccine requirements for severely immunocompromised people?

Having a weakened immune system means that you may not build the same level of immunity after vaccination and you will require additional vaccine doses to adequately protect you against COVID-19. These doses are additional to your primary vaccination course AND to your booster doses. Learn more about COVID-19 vaccine in severely immunocompromised people.  

Primary vaccination course
Most people receive 2 primary doses of a COVID-19 vaccine. But anyone aged 5 years or older who is severely immunocompromised needs 3 doses for their primary vaccination. This extra dose is often called their third primary dose.


Booster dose 
Anyone aged 16 years plus will need 2 booster doses. The timing of your booster following your third primary dose differs depending on your age, clinical circumstances and what type of COVID-19 vaccine you’re getting. Read more about COVID-19 vaccine booster. 

Note: People under the age of 16 years are not eligible for a booster.  Your healthcare provider may consider a booster dose for those aged 12–15 years old who are at higher risk of severe COVID-19.

How long after getting my initial COVID-19 vaccines can I get my third primary dose?

The Ministry of Health recommends the third primary dose of the Pfizer COVID-19 vaccine be given more than 8 weeks after the second dose.

When considering the timing of your third dose, your doctor will also pay special attention to whether you are currently receiving or planning to get immunosuppressive therapies. The third dose can be given from 4 weeks if advised by your health care provider – this may be because of current or planned immunosuppressive therapies.  

Should I get the COVID vaccine after I have had COVID?

Yes, you should still get the COVID vaccine if you have had COVID. The vaccine can provide a stronger immunity response than the natural immunity you get from a COVID-19 infection. 

Are there any side effects from a third vaccine dose?

So far, reactions reported after the third vaccine are similar to that of the second dose – tiredness and pain at the injection site were the most commonly reported side effects and, overall, most symptoms were mild to moderate. As with the first and second dose, serious side effects are rare, but may occur. Read more about the Pfizer vaccine.

References

  1. Third primary dose of the Pfizer/BioNTech vaccine policy statement and clinical guidance Ministry of Health, NZ
  2. COVID-19 vaccine – severely immunocompromised people Ministry of Health, NZ, 2022

Useful resources for Healthcare Professionals

  1. Coronavirus disease (COVID-19) Immunisation Handbook 2020 Ministry of Health, NZ (Table 5.1 provides guidance on types of immunocompromise for which a third primary dose is recommended)
Credits: Health Navigator Pharmacists. Reviewed By: Maya Patel, MPharm PGDipClinPharm, Auckland Last reviewed: 09 May 2022