COVID-19 vaccination for people with immunocompromise
It is especially important that people with immunocompromise are fully vaccinated against COVID-19, as you are at a higher risk of developing severe disease from COVID-19.
People 5 years and over who are severely immunocompromised should receive a third dose of a COVID-19 vaccine as part of their primary course.
This is to increase your level of immunity to as close as possible to the general population.
You should get your third dose two months after your second dose.
People 12 years and over should receive their first booster dose three months after their third primary course dose.
In addition to the first booster dose, people 16 years and over who are severely immunocompromised should receive a winter dose.
You can get the winter dose four months after your first booster dose and three months after you’ve recovered from COVID-19 if you caught it after your first booster dose.
People with severe immunocompromise will have different vaccination needs based on age. Find more information about vaccinating:
Find out what to expect before, during and after your vaccination appointment.
Where to get vaccinated
General Practitioners (GPs) are able to give you your third dose of a COVID-19 vaccine. If this is not offered at your GP, you can attend a SA Health vaccination clinic site or pharmacy with evidence of eligibility. This can include:
- A referral letter from GP or other treating clinician
- Proof of an alternative medical record that is dated within the last 5 years:
- a printout of the medical history (from clinical records or My Health Record)
- a printout of a chronic disease care plan from treating GP
- a discharge summary from a hospital or other medical facility
- a named script for a medication that has been prescribed to treat one or more of the relevant conditions or procedures outlined in the guideline.
- A condition-specific identifier
- A completed Eligibility Declaration Form (if unable provide any of the above evidence of eligibility).
For more information speak to your GP and read the ATAGI statement.
A third dose is recommended for people with the following immunocompromising conditions:
- Active haematological malignancy
- Non-haematological malignancy with current active treatment including chemotherapy, radiotherapy, and/or hormonal therapy, but excluding immunotherapy with immune checkpoint inhibitors
- Solid organ transplant with immunosuppressive therapy
- Haematopoietic stem cell transplant (HSCT) recipients or chimeric antigen receptor T-cell (CAR-T) therapy within 2 years of transplantation.
- These patients require revaccination with 3 additional doses of COVID-19 vaccine, irrespective of doses given prior to transplantation, commencing generally ≥3-6 months after their transplant after discussion with their treating specialist.
- Those beyond 2 years from transplant should discuss with their treating specialist about the need for a third dose.
- Immunosuppressive therapies including:
- High dose corticosteroid treatment equivalent to >20mg/day of prednisone for ≥14 days in a month, or pulse corticosteroid therapy.
- Multiple immunosuppressants where the cumulative effect is considered to be severely immunosuppressive.
- Selected conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDS):
- including mycophenolate, methotrexate (>0.4 mg/kg/week), leflunomide, azathioprine (>3mg/kg/day), 6-mercaptopurine (>1.5 mg/kg/day), alkylating agents (e.g. cyclophosphamide, chlorambucil), and systemic calcineurin inhibitors (e.g. cyclosporin, tacrolimus)
- excluding hydroxychloroquine or sulfasalazine when used as monotherapy
- Biologic and targeted therapies anticipated to reduce the immune response to COVID-19 vaccine:
- including B cell depleting agents (e.g. anti-CD20 monoclonal antibodies, BTK inhibitors, fingolimod), anti-CD52 monoclonal antibodies (alemtuzumab), anti-complement antibodies (e.g. eculizumab), anti-thymocyte globulin (ATG) and abatacept
- excluding agents with likely minimal effect on vaccine response such as immune checkpoint inhibitors, anti-integrins, anti-TNF-α, anti-IL1, anti-IL6, anti-IL17, anti-IL4 and anti-IL23 antibodies
- Primary immunodeficiency including combined immunodeficiency and syndromes, major antibody deficiency (e.g., common variable immune deficiency (CVID) or agammaglobulinemia), defects of innate immunity (including phagocytic cells), defects of immune regulation, complement deficiencies and phenocopies of primary immunodeficiencies.
- Advanced or untreated HIV with CD4 counts <250/μL or those with a higher CD4 count unable to be established on effective anti-retroviral therapy
- a third primary dose is not required for people living with HIV, receiving ART with CD4 counts ≥250/μL
- Long term haemodialysis or peritoneal dialysis