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The first batch of COVID vaccines touched down in South Africa in February 2021. Health workers were the first to get a jab under the Sisonke study. But even before the country had bought any jabs, our reporters were writing about the logistics and the politics of the project. If you want to know how well the vaccines work, how the different jabs compare or what it takes to create a vaccine from research, to regulation, to rollout, you’re at the right place.

HomeSpecial ReportsCOVID-19 vaccinesPeople with weak immune systems can now walk in for booster jabs...

People with weak immune systems can now walk in for booster jabs on top of previous extra shots

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  • People with certain illnesses or who are on treatments that weaken their immune systems can now get COVID vaccine boosters in addition to the previous extra shot they received because the normal number of doses didn’t work well enough for them.
  • The health department has updated the EVDS so that this vulnerable group can walk in at a vaccination site and get a booster dose. A circular has been sent out to inform vaccination sites they can issue booster from April 11, but the system already started to operate today (April 8th).
  • An immunocompromised person who got vaccinated with Pfizer, therefore qualifies for two Pfizer shots (normal number of doses), an additional immunocompromised dose (28 days after the second shot) and a booster dose (90 days after the immunocompromised shot).
  • An immunocompromised person who got vaccinated with Johnson & Johnson (J&J), qualifies for one J&J shot (normal dose), an additional immunocompromised dose (28 days after the first J&J dose) and two booster shots (the first booster jab 60 days after the immunocompromised dose and the second booster shot 90 days after the second booster).

The system South Africa uses to track COVID-19 vaccines has been updated to allow people with weak immune systems to come in for a booster shot. This will be in addition to the extra dose they received last year, as the jabs offer less protection in people with certain health conditions like cancer or HIV that doesn’t respond well to treatment.

Read the full script:

What is an immunocompromised shot?

People with certain illnesses or who are on treatments that weaken their immune systems can get an extra shot of a COVID vaccine because the normal number of doses don’t work well enough for them.

Those are people with conditions like blood cancer or HIV infection that doesn’t respond well to treatment, or people who have had liver, kidney, heart or lung transplants. 

There’s a list of all the conditions that qualify for an extra shot on the government’s coronavirus website. 

In South Africa everyone who is 18 years and older with any condition on that list can have an extra shot, so a third shot of the Pfizer vaccine or a second shot of the J&J jab.

They can have that shot 28 days after their last shot. 

What is the difference between an extra immunocompromised shot and a booster dose?

The extra shots that people with weak immune systems get are not the same as a booster dose.

Immunocompromised people get their extra shot as part of their primary vaccination schedule, so where a person with a normal immune system will get two Pfizer doses, an immunocompromised person will get three doses.

For Johnson & Johnson (J&J), a person with a weak immune system will get two J&J jabs, instead of one. 

A booster is something that a fully vaccinated person gets in addition to their primary vaccination schedule because the efficacy of vaccines wane over time.

That’s why an immunocompromised person still qualifies for a booster on top of their extra immunocompromised dose.  

How soon after an extra immunocompromised shot can someone get a booster? 

The waiting period for a booster dose for immunocompromised people is exactly the same as for everyone else, the only difference is that they calculate the waiting period from the date on which they had their additional immunocompromised dose and other people start to calculate it from the date they had their second Pfizer or first J&J jab. 

So an immunocompromised person who has had three Pfizer doses can get a booster shot, so a fourth dose, 90 days after their third dose.

And people with weak immune systems who had two J&J jabs, can have a booster dose 60 days after their second shot and another booster dose 90 days after that — and that’s not a special arrangement for immunocompromised people, everyone who had J&J as their first shot now qualifies for two booster doses.

But remember that the health department allows you to mix and match booster doses, so you don’t necessarily need to use the same vaccine that you got in your primary schedule, to get boosted with. You can also mix and match an immunocompromised shot. The only rule is that if you had the J&J vaccine as your original shot, the health department says you can’t get more than three J&J shots, so one one of the four J&J shots that a person with a weak immune system gets needs to be Pfizer. 

What does an immunocompromised person need to do to get a booster dose? 

Just like everyone else, they can simply walk in at a vaccination site and get a booster dose.

Mia Malan is the founder and editor-in-chief of Bhekisisa. She has worked in newsrooms in Johannesburg, Nairobi and Washington, DC, winning more than 30 awards for her radio, print and television work.

Dylan Bush was a health journalist at Bhekisisa from February 2016 to September 2023.

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