COVID-19 vaccine for immunocompromised people

Key points about COVID-19 vaccine for immunocompromised people

  • People with compromised (weakened) immune systems are at higher risk of getting serious infection from COVID-19 and therefore their COVID-19 vaccine requirements are different from that of a person with a healthy immune system.
  • The information on this page is for immunocompromised adults. For information about tamariki, including those with weakened immune systems, read more about Pfizer COVID-19 vaccine in children(external link)
  • For severely immunocompromised people having your booster doses as well as your 3-dose primary course will give you the best protection against COVID-19.
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You can be severely immunocompromised by having a medical condition causing a weakened immune system, or through taking medicines used to treat a range of conditions. Learn more about criteria for severely immunocompromised people.(external link)

Having a weakened immune system means that you may not build the same level of immunity after vaccination and you will require additional vaccine doses to adequately protect you against COVID-19. These doses are additional to your primary vaccination course AND to your booster doses. Learn more about COVID-19 vaccine in severely immunocompromised people(external link).  

Third primary dose for severely immunocompromised people

Some people over the age of 5 years who are severely immunocompromised are eligible to get a third primary dose of the COVID-19 vaccine. 

  • It should be given 8 weeks after the second dose, but may be given 4 weeks after, depending on current or planned immunosuppressive therapies.
  • The eligibility criteria to get a third primary dose is complex. It only applies to people who are severely immunocompromised. Your doctor can tell you whether you are eligible for this third primary dose.
  • If you think you might qualify, ask your doctor or specialist.

How to get a third primary dose

You can only get a third primary dose after seeing your doctor or specialist. They can give you a prescription to take to any vaccination centre. Appointments with your doctor for a third primary dose are free.

Getting a vaccine booster

Protection from the primary course of the vaccine decreases over time. To keep your immunity levels high, stay up-to-date with your vaccinations – including boosters. 

  • Boosters will lower your chances of getting very sick from COVID-19 and ending up in hospital.
  • For boosters, we now use the Pfizer BA.4/5 bivalent vaccine. This is an updated vaccine targeting Omicron.
  • If you are at higher risk of severe illness from COVID-19, you are encouraged to get another booster 6 months after a previous dose, regardless of how many boosters you have had. Read more about COVID-19 vaccine boosters.

Health New Zealand | Te Whatu Ora recommends the third primary dose of the Pfizer COVID-19 vaccine be given more than 8 weeks after the second dose.

Your doctor will also consider whether you are receiving or planning to get immunosuppressive therapies. The third dose can be given from 4 weeks if advised by your healthcare provider – this may be because of current or planned immunosuppressive therapies. 

Yes, you should still get the COVID vaccine if you have had COVID. The vaccine can provide a stronger immunity response than the natural immunity you get from a COVID-19 infection. If you have had COVID-19, you can get the vaccine 6 months after you tested positive.

So far, reactions reported after the third vaccine are similar to that of the second dose – tiredness and pain at the injection site were the most commonly reported side effects and most symptoms were mild to moderate. As with the first and second dose, serious side effects are rare, but may occur. Read more about the Pfizer vaccine.


  1. Vaccine advice if you have a health condition(external link) Health New Zealand | Te Whatu Ora

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Reviewed by: Angela Lambie, Pharmacist, Auckland

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