Question:
I have a 14-year-old son with Down Syndrome who has received two doses of the COVID vaccine. Do you recommend a third dose for adolescents with Down Syndrome?
Answer:
The Centers for Disease Control and Prevention (CDC) have recently recommended third (or additional) shots and booster shots for some individuals.
The first thing to note is only the Pfizer-BioNTech vaccine has been approved for people younger than 18 years of age at this time. It is approved for those as young as 12 years of age.
A 14-year-old can receive a third (additional) Pfizer vaccine under certain conditions. A 14-year-old is eligible for an additional (third) shot only if he has certain moderately to severely immunocompromising conditions. Down syndrome is not included in that list. A 14-year-old is not eligible for a booster currently. Booster doses are recommended for certain groups of people who are 18 years of age or older at this time.
What is the difference between a third (additional) shot and a booster shot?
The terms “booster shot” and “third dose” are often used interchangeably. They are technically different. In August, the CDC made recommendations about third doses. In September, the CDC made recommendations about booster shots.
The “third shot” is for those who are moderately to severely immunocompromised who are getting an additional third dose sooner than 6 months after the second dose. This third dose can be given 28 days after the second dose. That includes the people who have conditions in this full list. Down syndrome is not on this list but some people with DS may have some of the conditions listed such as being actively treated for cancer or taking medications that suppress the immune system. See the full list for more details.
The “booster” is that given to others not on the list above and is given at least 6 months after the second. Down syndrome is included as a condition for the booster. The CDC has recommendations for who “should” get the booster at this time and who “can” get the booster. That list is available at this link. A summary of those recommendations is available at this link. The article includes information about how we are recommending the boosters at our Center in Illinois.
At this time, both Pfizer and Moderna are recommended for the third shot. The same vaccine should be used as the one given for the first 2 shots.
At this time, only Pfizer is recommended as a booster. It is only being given to people who had Pfizer as their first 2 doses. The booster is the same dose as the first two shots.
In summary, a 14-year-old is eligible to get a Pfizer vaccine as a third dose if he has certain qualifying immunocompromising conditions but is not eligible for a booster shot. The CDC has not recommended boosters for individuals younger than age 18 at this time. We recommend additional vaccinations as per the CDC guidelines.
More information on COVID booster shots can be found on the:
Centers for Disease Control and Prevention (CDC) Website
American Academy of Pediatrics (AAP) Website
Adult Down Syndrome Center Resource Library