EHC: Medical situations where a third vaccine dose is recommended

The European Haemophilia Consortium have posted information on the decision of the French authorities to provide a third dose of vaccine to some people who have been recipients of solid organ transplants, on dialysis  or who are on strong immune-suppressive therapies. This is due to the fact that the immune-suppressive therapies may cause them to have a sub optimal antibody response to two doses of the vaccine, necessitating a third dose. The EHC information is below.

The European Haemophilia Consortium (EHC) continues to closely monitor developments with the COVID-19 pandemic and associated roll-out of COVID-19 vaccines. The EHC wishes to inform its community of the following recent Notice by French government authorities.

On May 7th French vaccination authorities, Le Conseil d’Orientation de la Stratégie Vaccinale, issued a recommendation calling for a third vaccine dose to be administered in certain medical situations, such as in patient with severe immune-deficiencies including:

– Organ transplant recipients
– Dialysis patients, and
– People taking strong immune-suppressant therapies

French authorities cited international data that demonstrates a range from absent to insufficient antibody response after administration of two vaccine doses, and therefore issued the following recommendations:

1. Strict maintenance of protective barriers by all immune-deficient people as well as their families and caregivers;
2. Observance of national vaccination schemes with a maximum interval of 28 days in between doses of mRNA-based vaccines;
3. Vaccination of adults who live in the same household with a severely immune-deficient person, whether child or adult (e.g., recipient of a solid organ transplant, recent bone marrow transplant, dialysis, or patient affected by auto-immune disease taking strong immune-suppressant therapies such as anti-CD20 or anti-metabolites, those affected by certain types of lymphomas treated with anti-CD20, and those affected by chronic lymphocytic leukemia);
4. Thorough vaccination of healthcare providers treating/caring for this cohort of patients; and
5. Systematic administration of a third vaccine dose four weeks after the second dose in people who are severely immune-deficient or as soon as possible if more time has already elapsed.

The complete French government Notice together with its supporting scientific references is available here (in French).

The EHC will continue to closely monitor and update on COVID-19 developments relevant to our community, as necessary.