• Welcome to Crohn's Forum, a support group for people with all forms of IBD. While this community is not a substitute for doctor's advice and we cannot treat or diagnose, we find being able to communicate with others who have IBD is invaluable as we navigate our struggles and celebrate our successes. We invite you to join us.

CDC approved booster of COVID 19 for immunosp

my little penguin

Moderator
Staff member
Who Needs an Additional COVID-19 Vaccine?
Currently, CDC is recommending that moderately to severely immunocompromised people receive an additional dose. This includes people who have:

  • Been receiving active 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 2 years or are taking medicine to suppress the immune system
  • Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
  • Advanced or untreated HIV infection
  • Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response
People should talk to their healthcare provider about their medical condition, and whether getting an additional dose is appropriate for them.
 
  • Like
Reactions: pdx

Maya142

Moderator
Staff member
This is for 12 and up, right? My daughters are excited LOL - even though the younger one flared with the first 2 vaccines.
 

my little penguin

Moderator
Staff member
It’s for anyone who got moderna (18 & up ) or Pfizer (12 & up ) that can state they are on immunosuppressive medicine .
Already talked it over with the pharmacist.
 

my little penguin

Moderator
Staff member
Third shot in and done
Easy
Once the pharmacy worked out the computer program side of things
Which was tricky
But given all of Ds meds today made the most sense timing wise
Otherwise he would have waited till next month for spacing between two biologics and mtx
 

Maya142

Moderator
Staff member
My kiddo is a tough one - we have to find time between steroid shots, a hospitalization and to stop one of her biologics and of course MTX for a week. Both her IBD and arthritis flared with the first shot (IBD flare was worse) and her arthritis flared with the second shot. So she's half excited, half scared to get it.
 

crohnsinct

Well-known member
Our GI has T waiting to get the third shot until there are consensus papers written about IBD. Many of the docs I follow on social media are also advising that IBD patients “in general” do not fall into this category and that GI’s should make the recommendation on a case by case basis ie: on anti tnf (studies show little affect on immunity) but work in high risk environment or live with severely immune or high risk person, then get third shot etc.

He recommended O get hers based on the two biologics (even though Entyvio is gut specific), attending school in a high risk state with no mask mandates, and her constant flare state and the fact that she is at high risk of needing steroids at some point this semester.

No spacing shot between meds or holding meds.
 

Maya142

Moderator
Staff member
Interesting - our rheumatologist recommended for both our girls, as did M’s GI. But both are on MTX which is known to reduce antibody formation. And of course M is also on two biologics - an anti-TNF (which is not so bad but does make a difference - there are a couple studies of IBD patients on Remicade) but a JAK inhibitor which really compromises immunity, which she actually has to stop for a week (possibly two). MTX also has to be held for a week.
 
This is interesting. I’m in Toronto Canada and third shot is not being given to anyone with IBD taking any meds. My GI is watching things closely and hopes soon it will be recommended.
 

my little penguin

Moderator
Staff member
The hospital system my kiddo goes to sent out the canned messages “based on our records your child is immunocompromised “ and the hospital recommends the third shot COVID.

So I really think is does vary
Granted my kiddo is on two biologics and mtx so no studies on anyone with that and COVID .
 

Maya142

Moderator
Staff member
Yes, we were told the reason they did not recommend that for the two dose mRNA vaccines was because they were 3-4 weeks apart. So if you held MTX 2 weeks after each vaccine, it would be held a long time (4 weeks) and would put patients at risk for a flare. Since J&J was only 1 vaccine, two weeks was recommended. The 2 week recommendation comes from the studies done on Rheumatoid Arthritis patients for the flu vaccine.

Here is the explanation:

For MTX, the panel recommended that MTX be withheld 1 week after each mRNA vaccine dose for those with well-controlled disease, based on data from influenza vaccines (38, 41, 42, 80, 81) and pneumococcal vaccines (82, 83). The recommendation to withhold MTX for only a single week, rather than the 2-week interruption tested in an RA influenza vaccine trial, was based upon practical considerations for the complexity of withholding MTX for 2 weeks around each of the 2 vaccine doses that are spaced 3–4 weeks apart and the potential for flare associated with withholding MTX for this long. For that reason, interrupting MTX for only 1 week around the time of each of the vaccine doses was recommended. In contrast, for single-dose COVID vaccine, the task force recommended that MTX be withheld for 2 weeks, which is consistent with the influenza vaccine MTX guidelines. Guidance was given for JAK inhibitors based on concern related to the effects of this medication class on interferon signaling that may result in a diminished vaccine response (84, 85). Given the immunologic considerations related to this concern (86), withholding JAK inhibitor therapy was recommended regardless of the patient’s underlying disease activity. Emerging evidence regarding the influence of MTX and JAK inhibitors on vaccine response against COVID-19 was recognized by the task force as supporting the above guidance statements (87).
 

my little penguin

Moderator
Staff member
Yep we could only hold one week before and one
Week after due to timing of mtx and two other biologics - never an ideal time but it was the best scenario given the limitations of other meds
 
3rd dose for immune compromised is now being offered in Canada. If any Canadians are wondering. H is still too young. C is eligible (weekly dose Humira) but I want to discuss with GI first.
 
3rd dose for immune compromised is now being offered in Canada. If any Canadians are wondering. H is still too young. C is eligible (weekly dose Humira) but I want to discuss with GI first.
I spoke to my GI and it is not being offered to people taking humira for any IBD
 
This was Ontario and listed anti-tnf meds as eligible.
Yes, I’m in Ontario and yes the meds are on the list but the people that have had transplant or other serious medical issues are able to get booster, IBD patients are not eligible yet.
 

Maya142

Moderator
Staff member
That's odd because anti-TNFs are mostly used for autoimmune diseases - RA, Crohn's, UC, Ankylosing Spondylitis, Uveitis etc. They're not used for transplant patients as far as I know (though perhaps I'm wrong).
So if anti-TNFs make you eligible, then any person, including a child over age 12 on anti-TNFs should also be eligible. That's how it worked here and anti-TNFs did make you eligible in the US. My daughter is finally going to get her third dose in the next couple of days. Her rheumatologist and GI both told her to get the third dose.
 
That's odd because anti-TNFs are mostly used for autoimmune diseases - RA, Crohn's, UC, Ankylosing Spondylitis, Uveitis etc. They're not used for transplant patients as far as I know (though perhaps I'm wrong).
So if anti-TNFs make you eligible, then any person, including a child over age 12 on anti-TNFs should also be eligible. That's how it worked here and anti-TNFs did make you eligible in the US. My daughter is finally going to get her third dose in the next couple of days. Her rheumatologist and GI both told her to get the third dose.
Ya, I’m not sure. He just told me that I’m not eligible yet. He said everyone is going to need a booster soon. He also mentioned people taking drugs like Imuran and Methotrexate are more immune compromised and would possibly qualify. But I only take humira.
 
  • Those undergoing active treatment with the following categories of immunosuppressive therapies: anti-B cell therapies (monoclonal antibodies targeting CD19, CD20 and CD22), high-dose systemic corticosteroids, alkylating agents, antimetabolites, or tumor-necrosis factor (TNF) inhibitors and other biologic agents that are significantly immunosuppressive.
Individuals in these groups can receive their third dose at a recommended interval of eight weeks following their second dose and will be contacted by their health care provider such as their primary care provider, specialist, or their hospital specialty program when they are eligible to receive the vaccine.

Locations and timing for third doses may vary by public health unit and high-risk population based on local planning and considerations, with third doses mainly to be administered at transplant clinics and cancer clinics.
 

Maya142

Moderator
Staff member
MTX falls under anti-metabolites by the way. Just in case anyone has a kiddo also on MTX.
 

my little penguin

Moderator
Staff member
Covid prevent study now is getting antibody levels after the 3rd shot
Ds just got the email
I will update once he gets the antibody test results back
He got his third shot in August after it was fda recommended
 
Top