Table 3.

Recommendations for additional COVID-19 vaccine doses in immunocompromised individuals

Country or region	Issuing body	Date of recommendation	Recommendation
France [98, 99]	Government of France	April 11, 2021	Third dose 4 weeks PD2 in severely immunocompromised individuals
	Government of France	January 28, 2022	Administration of a fourth dose in severely immunocompromised individuals within 3 months of the third dose
Israel [100]		December 30, 2021	Fourth dose in individuals who have undergone organ or stem cell transplants, with hematologic cancers, autoimmune diseases, and who are receiving specific immunosuppressive medications Those with breast, lung, or colon cancer do not qualify
Global [96]	WHO	October 26, 2021	Additional dose recommended in moderately to severely immunocompromised individuals 1–3 months after the primary series. This recommendation applies to individuals with active cancer, solid organ and stem cell transplant recipients, individuals with immunodeficiency, HIV, and those receiving immunosuppressive therapies Homologous additional doses are recommended, but heterologous platforms may be considered because of vaccine supply and access
USA [97]	CDC	February 17, 2022	Individuals 5–11 years old who are moderately or severely immunocompromised should receive a primary series of three doses of BNT162b2, with the second dose given 3 weeks after the first dose and the third dose given ≥ 4 weeks after the second dose; a fourth dose is not recommended at this time Individuals 12 years and older (for BNT162b2) and 18 years and older (for mRNA-1273) who are moderately or severely immunocompromised should receive a third dose ≥ 4 weeks after receiving their second dose; a booster dose ≥ 3 months after the third dose is recommended; mRNA COVID-19 vaccines are preferred This recommendation extends to individuals receiving cancer treatment, who have received an organ transplant and are using immunosuppressive therapies, who received a stem cell transplant in the past 2 years or are taking immunosuppressive therapies, with moderate or severe primary immunodeficiency, with advanced or untreated HIV infection, or receiving active treatment with high-dose corticosteroids or other immunosuppressive therapies
EU [101]	EMA	October 4, 2021	An additional dose of BNT162b2 or mRNA-1273 may be given to individuals with severely weakened immune systems ≥ 28 days after the second dose
UK [102, 103]	MHRA	September 9, 2021	One dose of BNT162b2 may be administered as a third dose ≥ 8 weeks after the second dose of an mRNA or adenovirus-vectored COVID-19 vaccine if the potential benefits are greater than any potential risks
	UK Health Security Agency	February 11, 2022	For those 12 years and older, a reinforcing dose 3 months after the third dose is recommended

CDC US Centers for Disease Control and Prevention, COVID-19 coronavirus disease 2019, EMA European Medicines Agency, MHRA Medicines and Healthcare Products Regulatory Agency, PD2 post-dose 2, SOT solid organ transplant, WHO World Health Organization