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Doctor preparing a dose of Covid-19 vaccine for African American patient

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Following the recommendation by the Centers for Disease Control and Prevention, Wake County Public Health will begin administering additional doses of the COVID-19 vaccine today to people with moderately to severely compromised immune systems who already received two doses of either Pfizer or Moderna.

“We need to ensure that everyone, especially those people who are most vulnerable to COVID-19, get as much protection as possible from vaccination,” said Dr. Kim McDonald, Wake County Public Health Medical Director. “With hospitalizations increasing more than 100% over the past two weeks and the Delta variant spreading quickly across Wake County, we’re looking forward to offering third vaccine doses to people with weakened immune systems, because it could help prevent serious illness or possibly death.”

Why are third doses needed?

People who are moderately to severely immunocompromised make up about 3% of the adult population and are especially vulnerable to COVID-19, because they are more at risk of serious, prolonged illness.

Studies indicate some immunocompromised people don’t always build the same level of immunity even after getting both doses of either Pfizer or Moderna. Additional studies show that fully vaccinated, immunocompromised people account for a percentage of hospitalized “breakthrough cases,” and that suggests these people are more likely to transmit the virus to others in their home.

Who can get a third vaccine dose?

You should talk to your healthcare provider about your medical condition to determine whether getting an additional dose is appropriate for you. The CDC recommends third doses to:

  • Cancer patients undergoing active treatment for tumors or cancers of the blood;
  • Organ transplant recipients who are taking medicine to suppress their immune systems;
  • Stem cell transplant recipients who are less than two years out from their transplant and taking medicine to suppress their immune systems;
  • Anyone with moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome);
  • Anyone with advanced or an untreated HIV infection; and
  • Anyone receiving high-dose corticosteroids or other drugs that may suppress their immune response.

The CDC does not recommend additional doses or booster shots for any other population at this time, including those who received the single-dose Johnson & Johnson vaccine. The FDA and CDC continue to analyze data and will provide further guidance on this issue as needed.

How can I get a third dose?

You can walk into any of Wake County Public Health’s vaccine clinics or events, which run six days a week and include evening and Saturday hours. Appointments aren’t needed for third doses. But, if you’d like to make one, you can do so later this week after our system is updated. Walk-ins should not expect to experience long wait times. A third dose needs to be given at least 28 days after a second dose and should be the same brand as the first and second dose.

Will I need to bring medical records or proof of my weakened immune system?

No. When you arrive at a clinic, our registration staff will find your vaccination record in the NC COVID Vaccine Management System, or CVMS, to ensure you received both doses of either Pfizer or Moderna. You can also bring your vaccine card. Then, you’ll simply be asked to attest or declare that you are immunocompromised by signing a digital form.

What do I need to do after my third shot?

Please sign-up for V-Safe, a symptom checker that will send you occasional texts to ask you how you’re feeling and allow you to report any symptoms. It’s critically important, and it only takes two minutes to answer the questions. It’s the best way to help keep vaccines safe. Go to to sign up.

Even after receiving this additional dose, people who are immunocompromised should continue follow the 3Ws – wearing a mask, waiting six feet apart from others they do not live with and washing hands frequently. They should also avoid crowds and poorly ventilated areas.

Wake County encourages everyone to get vaccinated. No-cost COVID-19 vaccines are available to anyone 12 and older at more than 200 providers in Wake County by appointment or walk-in. Wake County Public Health has vaccination clinics in all corners of the county offering weekend and evening hours. No ID is required. Anyone can check out the free clinic schedule at



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