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The CDC has one of the ambiguities in his recent recommendations for COVID-19 booster vaccinations: If you got a third shot one of the mRNA vaccines, because you have a weakened immune system, this third vaccination is not considered your booster. You can still get a booster if you fall into any of the categories that boosters are recommended for, and this is your fourth intake. The clarification was made in an update dated. released clinical considerations for COVID-19 vaccines.

(There is still no specific recommendation for immunocompromised people who have received the Johnson & Johnson vaccine, but anyone who has received this vaccine is advised to receive a booster dose if at least two months have passed since your starting dose.)

Why do immunocompromised people get up to four syringes? Well, there are the first two doses everyone should get (three weeks apart for Pfizer, four weeks apart for Moderna), but it turns out that some people’s immune systems don’t respond well enough to these two doses, and a third is necessary to obtain full protection. This third dose should be given four weeks after the second.

People with cancer and people who have had an organ transplant are most likely to need the third shot, but the option is open to anyone with “moderately to severely” immunocompromised. This includes people who have primary immunodeficiency or who are taking drugs that suppress the immune system. The CDC has more information here on who needs a third dose and why.

Once you have taken your three doses, your “primary series” is complete and any future syringes will be considered a booster. We have an explainer here what exactly defines a booster, although, to be honest, it has probably not been easy for regulators to decide which is which – the third dose for immunocompromised people is referred to as an “extra” dose rather than a booster. However, with regard to the compulsory vaccination of an employer or an organization, you are considered to be “fully vaccinated” like everyone else even after the second dose.

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