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Pfizer Booster while on Humira

Thoughts/research on the Pfizer booster while on Humira?
I see the booster is now available for 16 & 17 year olds.
I’m trying to decide if my 17 year old son should get it. I worry a little about the myocarditis that’s been happening from the vaccines in young men.
 
Location
San Diego
I got my booster a couple of months ago. I recommend that all Crohn's patients get immunized and boosted against COVID-19 as soon as they are eligible.

As for the risk of myocarditis, it's very low. And getting COVID disease is far more likley to induce myocarditis than the vaccine is. So if you want to play the myocarditis odds you are better off to get the booster and avoid the disease than the other way around
 
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my little penguin

Moderator
Staff member
Your child is immunocompromised
So they qualify for the FULL third dose of the Covid vaccine if they were on humira for the first two Covid vaccine shots

And then are recommended a “booster “ shot 6 months after the third shot

my kiddo got all three Pfizer doses -age 17 while on Stelara and mtx
No issues
He will get a “booster “ in 6 months or whatever the advice is at that time

Fwiw Pfizer vaccine is the same for the THIRD DOSE for immunocompromised as the booster
But how they mark it on the vaccine card differs.

Moderna is the only one that has a FULL THIRD DOSE - but a HALF DOSE BOOSTER

so that’s important to note
 
I got my booster a couple of months ago. I recommend that all Crohn's patients get immunized and boosted against COVID-19 as soon as they are eligible.

As for the risk of myocarditis, it's very low. And getting COVID disease is far more likley to induce myocarditis than the vaccine is. So if you want to play the myocarditis odds you are better off to get the booster and avoid the disease than the other way around
Great point, thank you!
 

Maya142

Moderator
Staff member
The myocarditis cases were in patients that got Moderna...at least, that is what we were told. We were told by my daughter's GI and rheumatologist that they STRONGLY recommended a third vaccine for immunocompromised patients. That is a full dose of the vaccine - for Moderna, boosters are a half dose but a third shot is a full dose. For Pfizer, it's the same dose for both.

My older daughter got the Moderna third dose with no issues. Same with the younger one - she actually got Pfizer for her first two doses but got Moderna for her third because she flared with Pfizer (which is uncommon according to her docs). She did also have an arthritis flare with Moderna but her IBD was ok!!

We were told Myocarditis is much more common with COVID vs. with the vaccine, so the benefit of the vaccine far outweighs the risks.
 
So are you pro vaccine/booster or no?
Also, I should mention that my son got COVID 3 days after his 2nd Pfizer vaccine.
Since he’s already had COVID, I’m trying to decide if adding additional vaccines would benefit or not…
 

my little penguin

Moderator
Staff member
Please talk to your child Gi
To determine what your child needs with their history and Covid vaccines

CDC has recommendations that immunocompromised receive three full doses

vaccines however - especially Covid vaccines
Have folks on either side who are for or against the two doses or just the booster or the combo

talk to your kiddos Gi
They have the most experience in this area

I have seen what my kiddos body does with flu in the past when He was not not vaccinated at age 2 and then at age 6(H1N1)
Respiratory viruses are not his friend so
For him - worth the risk per all his specialists

for others - a decision best made with their Gi
 

my little penguin

Moderator
Staff member
Also the reason cdc approved booster shots for 16-17 year olds is the new variant omnicron of covid which folks who already had covid or two shots were getting break through infections

the third shot IS recommended for immunocompromised because most do not mount a normal response to the vaccine with just two shots and were getting a break through infection such as your son

your child’s immune system is not normal right now
That is completely different than a regular 17 year old or adult who got the vaccine

immunocompromised means there is a higher risk of secondary infections
So if your child gets the flu - they may weather the flu ok - but the immune system is in such a weakened state after fighting the flu (no reserves ) they are more likely to “catch” pneumonia afterwards

that is the concern of any bigger Virus attack
And the concern of covid for immunocompromised

my non medical opinion is not worth that risk to get covid (new variant is still being studied on what it causes ) and be immunocompromised

your child’s Gi will help you determine if there is any MEDICAL benefit since the Gi is the doctor
Not us
 

Maya142

Moderator
Staff member
A third dose is different from a booster - depending on the biologic and whether he's on MTX, he may not have made enough antibodies to the vaccine or have enough T cell mediated immunity. The third dose guidelines for immunocompromised individuals specifically mentioned those on anti-TNFs or an anti-metabolite drugs like Methotrexate. They do not have the same immune response as people not on those meds, so the third dose is necessary just to get them as protected as a healthy individual who gets two vaccines.

Biologics like Entyvio and Stelara are much less immunosuppressive, so whether a third dose is needed for patients on those drugs depends on what their doctor recommends.

But for those on an anti-TNF, a third dose is definitely recommended. That is different from a booster.

There is evidence that protection provided by the Pfizer vaccine (which has 1/3 the amount of mRNA as the Moderna vaccine - which is the one that caused myocarditis mostly) wanes quickly - by 3 months, it's something like 77% effective and at 6 months, efficacy is far lower. The efficacy of the Moderna vaccine is still around 93% even 6 months after the shot.

Hospitalization in teens is rare but still possible, particularly in immunocompromised teens. But even mild COVID can cause "long haul" symptoms or other issues. I have a friend with Rheumatoid Arthritis who got COVID despite two vaccines and developed Lupus as a consequence. She used to run half marathons. Now walking up a flight of stairs is hard. Her 17 year old son with JIA and Crohn's also got COVID and while his symptoms weren't terrible, they led to a major arthritis and Crohn's flare and now his Stelara is no longer working and he has already failed Humira and several other biologics, so his mother is very worried about what they can use to control his diseases. He had COVID 6 months ago and is still flaring, despite increasing the frequency of Stelara from every 6 weeks to every 4.

So even mild COVID can cause major issues. Your son has had COVID but studies seem to indicate hybrid protection is best - antibodies from the vaccine as well as from the infection. Does he have enough protection from the vaccine? That's something only your doctor can answer and I'd encourage you to discuss this with your child's GI.

FWIW, my nephew got COVID in the summer (he is a young adult - 26 years old) and he was told to get a booster (since he's not immunocompromised, it would be a booster and not a third shot) and he was told to wait a couple more months before having a booster. But then the Omicron variant started spreading and his doctor is recommending a booster ASAP.

Please talk to your doctor - your son's GI would be best,
 
Since my son got his 2nd Pfizer vaccine and tested positive for COVID the end of August, he can go ahead and get the 3rd vaccine now then right? Doctor’s office is closed so I can’t call and ask.
Also, what makes him immunocompromised? Is it the fact he has Crohn’s or the Humira he’s on?
 

Maya142

Moderator
Staff member
Since my son got his 2nd Pfizer vaccine and tested positive for COVID the end of August, he can go ahead and get the 3rd vaccine now then right? Doctor’s office is closed so I can’t call and ask.
Also, what makes him immunocompromised? Is it the fact he has Crohn’s or the Humira he’s on?
The Humira, not the Crohn's, makes him immunocompromised.

Honestly, since he had COVID fairly recently, I'd wait till Monday and ask his doc. He can always get the vaccine later in the week. And yes, he may have more side effects but it's much more likely that they will be minor, like a sore arm and fatigue, than something like myocarditis.
 
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