Early booster vaccination for COVID-19

ÍSLENSKA/ICELANDIC
PÓLSKA/POLISH

A booster vaccination is recommended 5–6 months after the primary vaccination against COVID-19, for all individuals16 years and older within Iceland. For severely immunocompromised individuals, a third dose should be given earlier, as these individuals are less likely to respond adequately to the primary vaccination. To date, the group of immunocompromised patients recommended to receive a third dose three months after the primary vaccination has been relatively small:

1.  Organ recipients.

2.  Those with severe bone marrow suppression due to illness or treatment.

The list of these individuals was registered in the vaccination system in August 2021; the call-in is complete.

In consultation with specialists in immunology and rheumatology, neurology, gastroenterology, oncology and renal medicine, the following groups should also receive the booster three months after the primary vaccination:

3.  Patients being treated with rituximab now or in the last 18 months. If treatment is still ongoing, it is desirable to schedule the vaccination 2–3 weeks before the next dose. Vaccination should be avoided within four months after rituximab administration. However, the patient’s doctor may recommend vaccination even if it has been a shorter time since the last administration.

The list of these individuals was entered into the vaccination system in November 2021; if booster vaccination is requested before starting rituximab treatment, the treatment doctor must send a letter to the individual to be presented at the vaccination site.

4.  Patients being treated with ocrelizumab now or in the last 18 months. If treatment is still ongoing, it is desirable to schedule the vaccination 2–3 weeks before the next dose. Vaccination should be avoided within four months after ocrelizumab administration. However, the patient’s doctor may recommend vaccination even if it has been a shorter time since the last administration.

The list of these individuals was entered into the vaccination system in November 2021; if booster vaccination is requested before starting ocrelizumab treatment, the treatment doctor must send a letter to the individual to be presented at the vaccination site.

5.  Patients who have been prescribed Gilenya (fingolimod) over the last 12 months.

The list of these individuals was entered into the vaccination system in November 2021.

6.  Patients who have received chemotherapy in 2021 (ATC class L01). This also applies to patients who have received such drugs for rheumatic diseases, e.g. Sendoxan.

    • If a booster vaccine is given during chemotherapy or within three months after the end of treatment, a specialist should be consulted regarding the reason and the timing of antibody testing to assess response.

A list of individuals who have received treatment at Landspítali was registered in the vaccination system in November 2021.

7.  Patients receiving long-term steroid therapy at doses equal to 20 mg prednisolone or greater.

These individuals need to demonstrate that early booster vaccination is appropriate when they arrive at the vaccination site, e.g. with a doctor’s letter.

8.  Patients with severe tissue damage due to rheumatic diseases, on significant immunosuppressive therapy not covered by items 1–3 above or who are taking drugs in category L04AA.

These individuals need to demonstrate that early booster vaccination is appropriate when they arrive at the vaccination site, e.g. with a doctor’s letter.

9.  Patients with severe congenital immunodeficiency, including those who need regular antibody administration. Those who receive regular intravenous or subcutaneous antibodies should be vaccinated between administrations.

The list of these individuals will be entered into the vaccination system in advance.

10.  Patients with severe renal failure, especially those on haemodialysis or peritoneal dialysis.

Vaccinations will be given at the dialysis ward, but individuals who are not on dialysis or peritoneal dialysis will be registered in the vaccination system in advance.

The following individuals should not receive the booster vaccine without consulting their treating specialist:

  1. Individuals with autoimmune diseases who have an active disease when a booster vaccination is recommended.
  2. Individuals with autoimmune diseases who experienced the worsening of symptoms or new symptoms within 2 weeks of primary COVID-19 vaccination.
  3. Individuals who experienced life-threatening adverse reactions after primary vaccination.

For these individuals, it is possible to perform an antibody test at the Department of Immunology at LSH to assess whether the need for a booster dose outweighs the risk of exacerbation of the underlying disease. 

Older articles on booster vaccinations:


Fyrst birt 13.01.2022

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