COVID-19 SERIES: Benefits of a Vaccine Booster Shot for Immunocompromised Patients

Jonathan Golob, MD, PhD, joins Michigan Minds as part of a special series that focuses on the COVID-19 pandemic. Golob discusses what being immunocompromised means, the challenges that people with weakened immune systems face, and the benefits of a third vaccine dose for this group. 

As an assistant professor of internal medicine in the division of infectious diseases, Golob studies how microbiomes inside the human body affect the way treatments work, particularly for immunocompromised people. 

Golob explains that when a person is immunocompromised, their immune system — the body’s defense — is not able to work properly, either overreacting to things it shouldn’t be reacting to, or not reacting at all.

“It generally means that someone’s body is not able to defend itself against invaders quite as well as we would expect,” Golob says. “This can be from autoimmune disease, so things like colitis or lupus. It can be from primary, which is more often in kids where a part of the immune system just doesn’t develop quite right. Or it can be from medications or treatments for things.”

COVID-19 is a challenge for even non-immunocompromised systems.  For people whose immune systems are already not working well—particularly people with blood cancers or who have had blood transplants—the virus can be more difficult to deal with..  

​​Golob notes that the three COVID-19 vaccines available in the US were tested on people who were not immunocompromised, so the term “fully vaccinated” really describes those who have not only received the full vaccine regimen, but who are also are not immunocompromised. His research indicates that people with weakened immune systems should receive a third dose of the vaccine.

“Because people who are immunocompromised were excluded for their safety [from the original trials], we kind of just extrapolated that the same doses would be enough. But there is evidence now to believe this isn’t the case and that people who are immunocompromised really do benefit from a third dose of a vaccine—particularly after a little bit more time,” he says. 

Golob adds that many vaccines, for example the Hepatitis B vaccine, are routinely  given in multiple doses.

“The first dose is just that—it’s the first introduction. If you receive additional doses of vaccine, it restimulates that part of the immune system and also allows people whose immune system may just be weak that extra chance to catch up and to really develop it.”

In closing, Golob encourages people to consult their doctor if they have questions or concerns about the vaccine. He says that the vaccines are a nearly miraculous thing that can protect the public and help end the pandemic. 

“The vaccines for COVID-19, any of them that are available in the United States, are excellent, safe, and by far the best way to protect yourself and others against getting terribly ill from a horrible disease. If you’re on the fence, I would just encourage you to talk to someone you trust, including your physician, who is knowledgeable.”

LISTEN TO THE FULL CONVERSATION