COVID-19 vaccination guide for people with a weakened immune system—3rd dose plus booster
The following leaflets may be relevant to you if you take any of the medications on this page:
Biologic agents, such as:
- Adalimumab (Humira, Hyrimoz, Idacio)
- Etanercept (Enbrel, Benpali)
- Cetrolizumab (Cimzia)
- Ustekinumab (Stelara)
- Secukinumab (Cosentyx)
- Brodalumab (Kyntheum)
- Ixikizumab (Taltz)
- Guselkumab (Tremfya)
- Tildrakizumab (Ilumetri)
- Rituximab
- Infliximab (Remicade, Remsima)
Oral immunosuppressive medication, such as:
- Ciclosporin
- Methotrexate
- Mycophenolate mofetil
- Azathioprine
- Fumaric acid esters
- High dose steroids e.g. prednisolone above 30mg daily
- Thalidomide
- Apremilast
COVID-19
Updated COVID-19 vaccination schedules for immunosuppressed patients
The UK Health Security Agency (UKHSA) recommends that people with a severely weakened immune system receive a third dose of the COVID-19 vaccine. This third dose is intended to enhance the protection you may have received from your first two doses.
Understanding COVID-19
COVID-19 is a highly contagious respiratory disease caused by the SARS-CoV-2 virus. It can be especially serious for people with weakened immune systems. While there is no cure for COVID-19, some treatments can reduce the risk of severe complications.
Why you need a third dose
This third dose is being offered to all those aged 12 years and older who had a weakened immune system when they received their first two doses of the COVID-19 vaccine. It is possible you may not have responded as well as other people. This third dose may help improve your immune response and give you better protection.
Your specialist has advised that this applies to you. By having the third dose, you may reduce your chances of catching COVID-19. If you do, the symptoms may be less severe, and the illness shorter, than if you had not had the third vaccination.
You may need a third dose if you had a severely weakened immune system around the time you received your first two doses. This includes those who had or have:
- blood cancers (such as leukaemia or lymphoma)
- lowered immunity due to treatment (such as steroid medication, biological therapy, chemotherapy or radiotherapy)
- lowered immunity due to inherited disorders of the immune system
- an organ or bone marrow transplant
- diseases that affect the immune system such as poorly controlled HIV
- other diseases or treatments as advised by your specialist
Timing of third dose and booster
You will need one extra dose to improve your protection.
Your extra (third) dose should be given at least 8 weeks after your second dose. After that, you will also need a booster dose to extend your protection—this should be given around 3 months after your extra (third) dose
If you have already had 2 doses and your booster dose, then you will need another booster dose 3 months later.
Side effects
Very common side effects
- Pain, heaviness and tenderness in the arm where you had your injection—this tends to be worst around 1 to 2 days after the vaccine
- Feeling tired
- Headache
- General aches, or mild flu-like symptoms
You can rest and take paracetamol (follow the dosing instructions on the packaging) to help make you feel better. Although feeling feverish is not uncommon for 2 to 3 days, a high temperature is unusual and may indicate you have COVID-19 or another infection. Symptoms following vaccination normally last less than a week. If your symptoms seem to get worse or if you are concerned, you can call NHS 111.
How to get the vaccination
Your GP will be in contact with your specialist, and the NHS will let you know when and where to have the vaccine.
People who shouldn’t have the third vaccination
If you’ve had a very severe reaction to a previous dose of the vaccine, you should discuss this with your doctor.
If you have missed a vaccination
If you have not yet had either of your first two doses of the vaccine, you should have them as soon as possible.
If it is now more than 8 weeks since your second dose, please arrange to have your extra (third) dose as soon as possible.
You will still need a booster dose around 3 months after your extra (third) dose. Your specialist should be able to advise on the best timing.