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Statement on third dose vaccination for severely immunosuppressed

02 September 2021

​Deputy Medical Officer of Health, Dr Ivan Muscat said:

"We welcome the news from the Joint Committee on Vaccination and Immunisation (JCVI) that people with severely weakened immune systems should have a third vaccine dose as part of their primary COVID-19 vaccination schedule.

"The JCVI has confirmed that this third dose should be offered to people over 12 who were severely immunosuppressed at the time of their first or second dose, including those with leukaemia, advanced HIV and recent organ transplants.

"It is now clear that individuals who are severely immunosuppressed, due to underlying health conditions or medical treatment, may not mount a full immune response to two doses of COVID-19 vaccination, and a third dose of the vaccine will improve their chances of developing a good antibody response.

"Preliminary data from the OCTAVE trial showed that almost everyone who was immunosuppressed mounted an immune response after 2 doses, as indicated by either antibodies or T cells. However, in around 40% of people, the levels of antibodies were low. It is not clear how much this may affect protection against COVID-19 as antibodies represent only part of a person's immune response.

"The JCVI has advised a preference for an mRNA vaccine as the third primary dose, which means the Pfizer or Moderna vaccines will be offered, with the option of the AstraZeneca vaccine for specific individuals who have received this vaccine previously, where this would facilitate delivery.

"We will be working with hospital specialist teams and GPs to identify groups who are eligible for a third dose. We advise that if you think you're eligible, you contact your specialist team or GP, who will ensure that the Vaccination Team are notified. You will then be contacted for an appointment.

"We are still awaiting the final guidance from the JCVI on the separate mass booster programme for autumn, and will issue further information once we have the guidance."

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