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Dr. Friedman: COVID-19 Vaccine Third Shots vs Booster Shots


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Dr. Friedman is getting a lot of emails on booster shots versus third shots. Third shots are for immuno-compromised patients that the FDA is recommending for a small group of patients The FDA also has the intention to soon make booster doses widely available to all healthy individuals. I am writing to clarify the difference between booster shots and third doses.

Third Doses for Immuno-Compromised Patients
The purpose of a third dose of mRNA vaccine is to give immuno-compromised patients the same level of protection that two doses provide someone who has a normal immune system.
It is recommended that the following people get a third dose

  • Been receiving 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 two years or are taking medicine to suppress the immune system
  • Been diagnosed with moderate or severe immunodeficiency conditions (such as DiGeorge syndrome, Wiskott-Aldrich syndrome) 
  • An advanced or untreated HIV infection
  • Been under active treatment with high-dose corticosteroids (> 20 mg of prednisone or 100 mg of hydrocortisone) or other drugs that may suppress immune response

Dr. Friedman thinks it is unlikely that any of his patients have these conditions.
Patients with Cushing’s syndrome, Addison’s, diabetes or thyroid disorders do not qualify.

In contrast, a Booster Dose is for Patients With Healthy Immune Systems
A booster dose—which is different from a third dose for immuno-compromised patients—is for healthy patients and is meant to enhance immunity and may protect against new variants of the virus. The Biden administration has announced that it intends to make booster doses available for people with healthy immune systems in September 2021, after they are authorized or approved by the FDA. This has not happened yet, but when it happens, Dr. Friedman would encourage his patients to get it.

Dr. Friedman is expecting a booster shot against the Delta variant to be released in the fall of 2021 and would recommend that for his patients.
Dr. Friedman wishes everyone to stay healthy.

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