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COVID-19 vaccination guide for people with a weakened immune system 3rd dose PLUS booster

This may be relevant to you if you take any of the following medications:

Biologic agents, such as: 

  • Adalimumab (Humira, Hyrimoz, Idacio)
  • Etanercept (Enbrel, Benpali)
  • Cetrolizumab (Cimzia)
  • Ustekinumab (Stelara)
  • Secukinumab (Cosentyx)
  • Brodalumab (Kyntheum)
  • Ixikizumab (Taltz)
  • Guselkumab (Tremfya)
  • Tildrakizumab (Ilumetri)
  • Rituximab
  • Infliximab (Remicade, Remsima)

 Oral immunosuppressive medication, such as:

  • Ciclosporin
  • Methotrexate
  • Mycophenolate mofetil
  • Azathioprine
  • Fumaric acid esters
  • High dose steroids e.g. prednisolone above 30mg daily
  • Thalidomide
  • Apremilast

Update on COVID-19 vaccination schedules for immunosuppressed patients – timing of third dose 

The UK Health Security Agency (Public Health) have further updated advice for people who have a severely weakened immune system in relation to third dose and booster vaccination, they should now come forward for a third dose of coronavirus (COVID-19) vaccine. This is to help improve any protection you may have built from your first 2 doses.

What is Coronavirus or COVID-19?

COVID-19 is a very infectious respiratory disease caused by the SARS-CoV-2 virus. It can be very serious in people who have a weakened immune system. There is no cure for COVID-19 although some newly tested treatments help to reduce the risk of complications.

Why are you being offered a third dose of the COVID-19 vaccine?

This third dose is being offered to all those aged 12 years and older who had a weakened immune system when they had their first 2 doses of the COVID-19 vaccine. It is possible you may not have responded as well as other people. This third dose may help to improve your immune response and give you better protection.

Your specialist has advised that this applies to you. By having the third dose you may reduce your chance of catching the COVID-19 infection. And, if you do, the symptoms may be less severe and the illness shorter, than if you had not had the third vaccination.

People who need a third dose are those who had a severely weakened immune system around the time they had their first 2 doses. This includes those who had or have:

  • blood cancers (such as leukaemia or lymphoma)
  • lowered immunity due to treatment (such as steroid medication, biological therapy, chemotherapy or radiotherapy)
  • lowered immunity due to inherited disorders of the immune system
  • an organ or bone marrow transplant
  • diseases that affect the immune system such as poorly controlled HIV
  • other diseases or treatments as advised by your specialist

Timing of third dose and booster

You will need 1 extra dose to improve your protection.

Your extra (third) dose should be given at least 8 weeks after your second dose. After that you will also need a booster dose to extend your protection – this should be given around 3 months after your extra (third) dose.

If you have already had 2 doses and your booster dose then you will need another booster dose 3 months later.

Side effects

Very common side effects include:

  • having a painful, heavy feeling and tenderness in the arm where you had your injection. This tends to be worst around 1 to 2 days after the vaccine
  • feeling tired
  • headache
  • general aches, or mild flu like symptoms

You can rest and take paracetamol (follow the dose advice in the packaging) to help make you feel better. Although feeling feverish is not uncommon for 2 to 3 days, a high temperature is unusual and may indicate you have COVID-19 or another infection. Symptoms following vaccination normally last less than a week. If your symptoms seem to get worse or if you are concerned, you can call NHS 111.

How to get the vaccination

Your GP will be in contact with your specialist and the NHS will let you know when and where to have the vaccine.

People who shouldn’t have the third vaccination

If you’ve had a very severe reaction to the previous dose of the vaccine, you should discuss this with your doctor.

If you have missed a vaccination

If you have not yet had either of your first 2 doses of the vaccine you should have them as soon as possible.

If it is now more than 8 weeks from your second dose, please arrange to have your extra (third) dose soon as possible.

You will still need a booster dose, around 3 months after your extra (third) dose. Your specialist should be able to advise on the best timing.

Further information


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