Important update: Healthcare facilities

CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. Learn more

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UPDATE

Given new evidence on the B.1.617.2 (Delta) variant, CDC has updated the guidance for fully vaccinated people. CDC recommends universal indoor masking for all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status. Children should return to full-time in-person learning in the fall with layered prevention strategies in place.

UPDATE

The White House announced that vaccines will be required for international travelers coming into the United States, with an effective date of November 8, 2021. For purposes of entry into the United States, vaccines accepted will include FDA approved or authorized and WHO Emergency Use Listing vaccines. More information is available here.

UPDATE

Travel requirements to enter the United States are changing, starting November 8, 2021. More information is available here.

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

Updated July 20, 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.

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

AGE GROUP

12 YEARS AND OLDER

1st Dose

PRIMARY SERIES

2nd Dose

PRIMARY SERIES

3 weeks after 1st dose

3rd Dose

PRIMARY SERIES

At least 4 weeks after 2nd dose

4th Dose

BOOSTER

At least 3 months after 3rd dose ^{[ 1 ]}

5th Dose

BOOSTER

At least 4 months after 4th dose ^{[ 1 ]}

Up to Date: Immediately after 5th dose ^{[ 2 ]}

AGE GROUP

18 YEARS AND OLDER

1st Dose

PRIMARY SERIES

2nd Dose

PRIMARY SERIES

4 weeks after 1st dose

3rd Dose

PRIMARY SERIES

At least 4 weeks after 2nd dose

4th Dose

BOOSTER

At least 3 months after 3rd dose ^{[ 1 ]}

5th Dose

BOOSTER

At least 4 months after 4th dose ^{[ 1 ]}

Up to Date: Immediately after 5th dose ^{[ 2 ]}

AGE GROUP

12–17 YEARS

1st Dose

PRIMARY SERIES

2nd Dose

PRIMARY SERIES

4 weeks after 1st dose

3rd Dose

PRIMARY SERIES

At least 4 weeks after 2nd dose

Up to Date: 2 weeks after 3rd dose in primary series, since boosters are not recommended at this time for any pre-teens or teens who have completed the Moderna COVID-19 primary series

AGE GROUP

18 YEARS AND OLDER

1st Dose

PRIMARY SERIES

2nd Dose

ADDITIONAL DOSE

At least 4 weeks after 1st dose and should be Pfizer-BioNTech or Moderna

3rd Dose

BOOSTER

At least 2 months after 2nd dose ^{[ 1 ]}

4th Dose

BOOSTER

At least 4 months after 3rd dose ^{[ 1 ]}

Up to Date: Immediately after 4th dose ^{[ 2 ]}

AGE GROUP

18 YEARS AND OLDER

1st Dose

PRIMARY SERIES

2nd Dose

PRIMARY SERIES

3 weeks after 1st dose

Up to Date: 2 weeks after the 2nd dose in primary series, since boosters are not recommended at this time for anyone who has completed the Novavax COVID-19 primary series

Children Ages 6 Months-11 Years Who Are Moderately or Severely Immunocompromised

AGE GROUP

5–11 YEARS

1st Dose

PRIMARY SERIES

2nd Dose

PRIMARY SERIES

3 weeks after 1st dose

3rd Dose

PRIMARY SERIES

At least 8 weeks after 2nd dose

4th Dose

BOOSTER

At least 3 months after 3rd dose ^{[ 1 ]}

Up to Date: Immediately after 4th dose ^{[ 2 ]}

AGE GROUP

6 MONTHS–4 YEARS

1st Dose

PRIMARY SERIES

2nd Dose

PRIMARY SERIES

3 weeks after 1st dose

3rd Dose

PRIMARY SERIES

At least 8 weeks after 2nd dose

Up to Date: 2 weeks after 3rd dose in primary series, since a booster is not recommended for this age group at this time

AGE GROUP

6 MONTHS–11 YEARS

1st Dose

PRIMARY SERIES

2nd Dose

PRIMARY SERIES

4 weeks after 1st dose

3rd Dose

PRIMARY SERIES

At least 4 weeks after 2nd dose

Up to Date: 2 weeks after 3rd dose in primary series, since boosters are not recommended at this time for any children who have completed the Moderna COVID-19 primary series

¹ For the 1st booster, an mRNA vaccine booster is recommended; however, you may consider J&J/Janssen COVID-19 vaccine in some situations. However, J&J/Janssen COVID-19 vaccine cannot be used as a 2nd booster dose.

² If you have completed your primary series—but are not yet eligible for a booster—you are also considered up to date.

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

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

No, vaccines used for the primary vaccination series should be the same product or brand. However, if the mRNA vaccine product given for the first two doses is not available or is unknown, either Pfizer-BioNTech or Moderna COVID-19 vaccine (mRNA COVID-19 vaccines) may be administered.

A third primary dose may prevent serious and possibly life-threatening COVID-19 in people who may not have responded to their two-dose mRNA COVID-19 vaccine primary series. People who are moderately or severely immunocompromised who have low or no protection after two doses of mRNA vaccines may have an improved immune response after a third primary dose of the same vaccine.

The safety, effectiveness, and benefit of the third primary dose in people who are moderately or severely immunocompromised continues to be evaluated. So far, reactions reported after the third primary dose of an mRNA COVID-19 vaccine are similar to those of the two-dose primary series. Fatigue and pain at the injection site were the most commonly reported side effects—and overall, most symptoms were mild and temporary.

As with the two-dose primary series, serious side effects are rare, but may occur.

For people who are immunocompromised, the third primary dose is the final dose of the primary series of an mRNA COVID-19 vaccine. Boosters are shots that enhance or restore protection against COVID-19, which may have decreased over time.

If you are moderately or severely immunocompromised, being up to date means you have received all doses in the primary series—plus 2 boosters.

You are also considered up to date if

You have completed your primary series but are not yet eligible for a booster
You have received 1 booster but are not yet eligible for a 2nd booster

People can self-attest to their moderately or severely immunocompromised status. This means that they do not need any documentation of their status in order to receive COVID-19 vaccine doses wherever they are offered.

For Healthcare and Public Health

Use of COVID-19 Vaccines Currently Authorized or Approved in the United States