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COVID-19 Vaccines for People who are Moderately or Severely Immunocompromised

COVID-19 Vaccines for People who are Moderately or Severely Immunocompromised
Updated Apr. 29, 2022
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What You Need to Know
  • If you are moderately or severely immunocompromised (have a weakened immune system), you are at increased risk of severe COVID-19 illness and death. Additionally, your immune response to COVID-19 vaccination may not be as strong as in people who are not immunocompromised.
  • As with vaccines for other diseases, you are protected best when you stay up to date with your COVID-19 vaccines as described below.
  • Use CDC’s COVID-19 booster tool to learn if and when you can get boosters to stay up to date with your COVID-19 vaccines.
  • You may also be eligible for Evusheld, a medicine given by your healthcare provider to help prevent you from getting COVID-19.
  • You can self-attest to your moderately or severely immunocompromised status. This means that you do not need any documentation of your status in order to receive COVID-19 vaccine doses wherever they are offered.

Children Ages 5-11 Years Who Are Moderately or Severely Immunocompromised

Children ages 5 through 11 years who are moderately or severely immunocompromised should receive a primary series of 3 doses of Pfizer-BioNTech COVID-19 vaccine on the schedule shown below to stay up to date. A booster is not recommended for this age group at this time.

PRIMARY SERIES COVID-19 VACCINE
Pfizer-BioNTech

Age Group:
5–11 years

Number of Doses to Complete Primary Series and Timing:
3 doses

  • 2nd dose given 3 weeks (21 days) after 1st dose
  • 3rd dose given at least 4 weeks (28 days) after 2nd dose

Booster and Timing:
Not recommended at this time

Pre-teens, Teens and Adults Who Are Moderately or Severely Immunocompromised

People ages 12 years and older who are moderately or severely immunocompromised should receive a total of 4 doses of mRNA COVID-19 vaccine to stay up to date. The 4 doses include a primary series of 3 doses of Pfizer-BioNTech or Moderna COVID-19 vaccine, plus 1 booster of Pfizer-BioNTech or Moderna COVID-19 vaccine (4th dose), given on the schedule shown below. Note only Pfizer-BioNTech COVID-19 vaccine is available for teens ages 12–17 years.

PRIMARY SERIES COVID-19 VACCINE
Pfizer-BioNTech

Age Group:
12+ years

Number of Doses to Complete Primary Series and Timing:
3 doses

  • 2nd dose given 3 weeks (21 days) after 1st dose
  • 3rd dose given at least 4 weeks (28 days) after 2nd dose

Booster and Timing:
1 booster†

  • Given at least 3 months after 3rd dose*

*mRNA vaccine booster is preferred for people ages 18 years and older, but you may consider J&J/Janssen COVID-19 vaccine in some situations.
† People ages 12 years and older who are moderately or severely immunocompromised can choose to receive a 2nd booster (5th dose) of an mRNA vaccine at least 4 months after their first booster. Teens ages 12–17 years may only get a Pfizer-BioNTech COVID-19 vaccine booster.

PRIMARY SERIES COVID-19 VACCINE
Moderna

Age Group:
18+ years

Number of Doses to Complete Primary Series and Timing:
3 doses

  • 2nd dose given 4 weeks (28 days) after 1st dose
  • 3rd dose given at least 4 weeks (28 days) after 2nd dose

Booster and Timing:
1 booster†

  • Given at least 3 months after 3rd dose*

*mRNA vaccine booster is preferred for people ages 18 years and older, but you may consider J&J/Janssen COVID-19 vaccine in some situations.
† Adults ages 18 years and older who are moderately or severely immunocompromised can choose to receive a 2nd booster (5th dose) of an mRNA vaccine at least 4 months after their first booster.

People Who Are Moderately or Severely Immunocompromised and Have Received a Johnson & Johnson/Janssen Vaccine

People ages 18 years and older who are moderately or severely immunocompromised and received the 1-dose Johnson & Johnson’s Janssen COVID-19 vaccine should get a second dose of either mRNA COVID-19 vaccine (Pfizer-BioNTech or Moderna), plus an mRNA COVID-19 vaccine booster to stay up to date—for a total of 3 doses—based on the schedule shown below.

PRIMARY SERIES COVID-19 VACCINE
J&J/Janssen

Age Group:
18+ years

Number of Doses to Complete Primary Series and Timing:
2 doses

  • 1st dose: J&J/Janssen
  • 2nd dose: either Pfizer-BioNTech or Moderna COVID-19 vaccines given at least 4 weeks (28 days) after 1st dose

Booster and Timing:
1 booster†

  • Either Pfizer-BioNTech or Moderna COVID-19 vaccines in most situations*
  • Given at least 2 months after 2nd dose

*mRNA vaccine booster is preferred for people ages 18 years and older, but you may consider J&J/Janssen COVID-19 vaccine in some situations.
† Adults ages 12 years and older who are moderately or severely immunocompromised can choose to receive a 2nd booster (4th dose) of an mRNA vaccine at least 4 months after their first booster.

Find a COVID-19 vaccine or booster: Search vaccines.gov, text your ZIP code to 438829, or call 1-800-232-0233 to find locations near you.

Who Is Moderately or Severely Immunocompromised?

People are considered to be moderately or severely immunocompromised (have a weakened immune system) due to several types of conditions and treatments. Examples include:

  • 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 chimeric antigen receptor (CAR)-T-cell therapy (a treatment to help your immune system attach to and kill cancer cells) or received a stem cell transplant (within the last 2 years)
  • 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 their immune response

Talk to your healthcare provider about COVID-19 vaccination and your medical condition.

If you are moderately or severely immunocompromised or severely allergic to COVID-19 vaccines, you may be eligible for Evusheld, a medicine given by your healthcare provider to help prevent you from getting COVID-19. Talk to your healthcare provider to find out if this option is right for you.

People Who Were Vaccinated Outside of the United States

People who are moderately or severely immunocompromised and who received COVID-19 vaccines not available in the United States should either complete or restart the recommended COVID-19 vaccine series, including a booster, in the United States. For more information, talk to your healthcare provider, or see the COVID-19 Interim Clinical Considerations.

Frequently Asked Questions

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