(HealthDay News) — Adherence to COVID-19 booster dose recommendations is low among immunocompromised adults, according to a study published in JAMA Network Open.

Most of the immunocompromised adults studied did not adhere to the US Centers for Disease Control and Prevention (CDC) recommendations regarding booster doses of the monovalent COVID-19 vaccines.

Researchers examined uptake of the monovalent mRNA COVID-19 vaccines and factors associated with uptake among immunocompromised adults from December 14, 2020, through August 6, 2022, in a cohort study. A total of 42,697 immunocompromised individuals met the eligibility criteria.


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The researchers found that 78.0% of the immunocompromised individuals had received 3 doses of a monovalent mRNA COVID-19 vaccine, and 41.0% had received 4 doses. Four doses corresponds to a primary series and monovalent booster dose in immunocompromised individuals.

After the CDC started recommending that immunocompromised patients receive a second monovalent booster (fifth dose), 0.9% of patients did so.

The likelihood of receiving at least 4 doses was increased for adults aged 65 years or older compared with those aged 18 to 44 or 45 to 64 years (hazard ratios [HRs], 3.95 and 2.52, respectively).

The likelihood of receiving at least 4 doses was lower for Hispanic and non-Hispanic Black adults vs non-Hispanic White adults (HRs, 0.77 and 0.82, respectively), for individuals with prior documented SARS-CoV-2 infection vs no infection (HR, 0.71), and for those receiving vs not receiving high-dose corticosteroids (HR, 0.88).

“Given the vulnerability of this population to develop severe COVID-19, a renewed focus on targeted and tailored efforts to ensure that immunocompromised individuals remain up to date with continuously evolving COVID-19 booster dose recommendations is warranted at this stage of the pandemic,” the study authors wrote.

Several authors disclosed financial ties to biopharmaceutical companies, including Pfizer, which funded the study.

Abstract/Full Text