11/08/21 Health Advisory: COVID-19 Vaccine 3rd and Booster Doses

syringe in a vial

Requested Actions

 Be aware of the confusion between the terminology and guidance for 3rd dose versus booster doses.

    • Been receiving active cancer treatment for tumors or cancers of the blood
    • Received an organ transplant and are taking medicine to suppress the immune system
    • Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
    • Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
    • Advanced or untreated HIV infection
    • Active treatment with high-dose corticosteroids or other drugs that may suppress immune response
    • Call and recall patients determined to be immunocompromised who received Pfizer or Moderna vaccineand offer an additional (third) dose of COVID-19 vaccine. Offer the same vaccine product (i.e., Pfizer or Moderna) the person originally received.
  • Booster dose: an additional dose of a vaccine given after the protection provided by the original shot(s) has begun to decrease over time.
    • Booster doses of the Pfizer-BioNTech and Moderna COVID-19 vaccines are now recommended for certain individuals.
      • At least six months after completing the primary Pfizer or Moderna vaccine series, the following individuals should receive a booster dose of the Pfizer vaccine:
      • People 65 years of age and older,
      • People 18 years of age and older living in a long-term care setting, and
      • People 50 – 64 years of age with underlying medical conditions or those at increased risk of social inequities.
      • Additionally, the following individuals who completed a Pfizer or Moderna vaccine series at least six months ago may receive a booster dose:
      • People who are 18 – 49 years of age with underlying medical conditions, and
      • People 18 – 64 years of age who are at higher risk of COVID-19 exposure and transmission due to their occupational or institutional setting.
    • At least two months after administration of the initial Johnson & Johnson/Janssen vaccine, a booster dose is now recommended for all recipients of the Johnson & Johnson/Janssen vaccine.
  • Additionally, on October 20, 2021, the FDA extended the Emergency Use Authorization (EUA)to allow for a heterologous (or “mix and match”) booster dose in eligible individuals following completion of primary vaccination with a different available COVID-19 vaccine.
  • The recent CDC and FDA decisions about booster doses do not change the definition of full vaccination. Booster doses are not required where vaccine mandates are in place.
  • Help patients access their vaccine records and explain the different ways to show vaccination status. There are options for everyone, including those who need language assistance or don’t have access to a computer or smartphone.


Clinician Outreach and Communication Activity (COCA) call on Sept. 28, 2021 covered what clinicians needs to know about administering booster doses.

Become a COVID-19 vaccine provider and vaccinate patients during their visit. Learn how to enroll as a COVID-19 vaccine provider.

COVID-19 Vaccine Resources

 Contacting the Health Department

360-778-6100         Main Call Line – available M-F 8:30am to 4:30pm
360-715-2588         Afterhours Answering Service – available after 4:30pm and weekends
360-778-6150         Communicable Disease Report Line – 24 hours a day 7 days a week
360-778-6103         Confidential Communicable Disease Fax – 24 hours a day 7 days a week

1500 N State Street, Bellingham WA 98225