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COVID-19 Vaccine Boosters and Additional Doses for People With Pulmonary Hypertension: Current Guidelines

Posted on October 05, 2021
Medically reviewed by
Steven C. Pugliese, M.D.
Article written by
Alison Channon

  • The Centers for Disease Control and Prevention (CDC) have recommended Pfizer COVID-19 vaccine booster shots for adults over 65 and other high-risk individuals — including people with pulmonary hypertension (PH) — at least six months after their second dose.
  • People with PH currently may be eligible for a third dose of the Pfizer or Moderna COVID-19 vaccine at least 28 days after their initial two doses.
  • There is currently no official guidance for additional shots or boosters for those who have received the Johnson & Johnson vaccine.

People with pulmonary hypertension may be eligible to receive a booster shot of the Pfizer COVID-19 vaccine six months after receiving their initial two-dose series. Additionally, they may be eligible for a third dose of Pfizer or Moderna within 28 days of their second dose.

Vaccine Boosters for People Who Are Immunocompromised

On Sept. 24, the Centers for Disease Control and Prevention recommended booster shots of the Pfizer COVID-19 vaccine at least six months after a second dose in the following groups:

  • People 65 and older
  • Residents of long-term care facilities
  • People ages 50 to 64 with underlying medical conditions that place them at high risk for severe COVID-19

The CDC recommendations state that people ages 18 to 49 with underlying medical conditions and people ages 18 to 64 who are at risk of COVID-19 exposure due to their work or living arrangements may receive a booster shot of the Pfizer vaccine, based on their individual benefits and risks.

The CDC’s list of underlying medical conditions includes chronic lung conditions like pulmonary hypertension. Other conditions include heart disease, diabetes, and current or former smoking.

A Pfizer COVID-19 vaccine booster may be administered at least six months after a person has received a second dose of the vaccine. People generally develop adequate immunity to COVID-19 following the two-dose treatment. However, that immunity can decrease over time, which a booster can address.

The CDC and U.S. Food and Drug Administration (FDA) have not released booster recommendations about the Moderna vaccine or the single-dose Johnson & Johnson vaccine. Both companies have submitted data on booster shots to the FDA for review.

Additional Doses for People Who Are Immunocompromised

On Aug. 12, the FDA amended the Pfizer and Moderna vaccines’ emergency-use authorizations to allow a third vaccine dose at least 28 days after the second dose for certain immunocompromised individuals.

Individuals defined as immunocompromised include:

  • People “receiving active cancer treatment for tumors or cancers of the blood”
  • People who received a stem cell transplant in the last two years
  • People who are organ donor recipients and taking immunosuppressive drugs
  • People taking high-dose steroids or other immunosuppressive drugs, as well as those with certain other health conditions

A third dose of the Moderna or Pfizer vaccine may be recommended for those who did not develop an adequate immune response after the two-dose vaccination series.

The FDA and CDC have not released guidance about additional doses for immunocompromised people who received the Johnson & Johnson vaccine.

Are People With Pulmonary Hypertension Immunocompromised?

Some people with PH may be considered immunocompromised, according to the FDA criteria, such as those who have received a lung transplant. People with pulmonary arterial hypertension (PAH) may qualify as immunocompromised if their PAH is associated with a condition that compromises immunity. That may include an HIV infection or an autoimmune disease treated with drugs that are considered immunosuppressive.

Individuals with PH may also be determined to be immunocompromised under the FDA criteria depending on comorbid health conditions such as cancer.

Learn More About COVID-19 Vaccines

The Pulmonary Hypertension Association has voiced support for the CDC’s recommendations for vaccination. Additionally, the International Society for Heart and Lung Transplantation said in a statement that it encourages immunization in patients with advanced heart or lung disease or in those awaiting or after cardiothoracic transplantation.

If you have pulmonary hypertension, talk to your doctor about whether you qualify to receive a Moderna or Pfizer COVID-19 vaccine booster or third dose Pfizer’s vaccine, or about any questions related to COVID-19 vaccination.

All updates must be accompanied by text or a picture.
Steven C. Pugliese, M.D. is affiliated with the Hospital of the University of Pennsylvania in Philadelphia, serving as the director of the pulmonary embolism response team, co-director of the comprehensive pulmonary embolism program, and an assistant professor of clinical medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Alison Channon has nearly a decade of experience writing about chronic health conditions, mental health, and women's health. Learn more about her here.

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