Booster versus Third Primary Dose.: Hi everyone, I... - LUPUS UK


28,761 members25,158 posts

Booster versus Third Primary Dose.

CSLO profile image

Hi everyone, I'm a little confused about this. Are these one and the same?

The JCVI report that was kindly posed here was talking about the need for us immunocompromised to have a Third Primary Dose but the medics and government are only talking about a booster jab.

I'm assuming they are the same but am I being dozy?

Another question if I may? On today's briefing Prof Van Dam suggested that there had to be a six month interval between 2nd vaccinations and a booster shot. Does anyone know whether this will apply to the immunocompromised?

Goodness me, things are as clear as mud sometimes. I wonder whether Paul-Howard may be able to clarify this? Paul you have the ability to simplify beautifully!

Many thanks!

37 Replies

I wondered what the difference was between a booster and 3rd dose too. hope someone can enlighten us

CarolMcl profile image
CarolMcl in reply to suzannah16

Hi, as far as I'm aware the 3rd dose is a full dose whereas the booster isn't. With regards to what you receive depends on what dose immunosuppressants you were on at the time of receiving your vaccines

CSLO profile image
CSLO in reply to CarolMcl

Carol, that's what I'd assumed but on today's briefing they talked about the Pfizer 'booster' being a full dose and the Moderna booster being a half dose.

Hi, I didn't hear that today. I know there was talk regarding side effects, mainly clots with the moderna but as for the dose I only know what I read yesterday. No doubt it'll become clearer very soon.......for all of us 🤞

Barnclown profile image
Barnclown in reply to CarolMcl

👍 seems the side effects thing is relevant - see my PS reply below in which my PID forum biochemist friend mentions 1/2 dose moderna etc

Good question! My immunologist said the main diff between the 3rd Primary Dose & the Booster Vacc is the criteria for each:

Booster COVID Vacc: is more or less for everyone over a certain age

3rd Primary Dose COVID Vacc : is only for those who meet the JCVI criteria…here’s that link again to the JCVI criteria document:

I wonder if there’s a difference between booster & 3rd Primary jabs in their actual vacc dosage, but I didn’t ask my Immunologist about this…but I’m now going to ask my Primary Immunodeficiency Disease forum if they know the diff 🤷🏼‍♀️…will get back to you if I find out🍀❤️

Barnclown profile image
Barnclown in reply to Barnclown

PS this explanation just came in on my UK PID forum…it’s from a guy who has had PID for years & works as a biochemist and always gives reliably great explanations of stuff like this:

There's no difference between them except in name and the eligibility criteria, they're both boosters in the same way. Either a full dose of the Pfizer vaccine or a half dose of the Moderna vaccine are approved (or if there is a documented allergy to both and it was previously given for the other 2 doses a dose of the Astra-Zeneca vaccine can be used) for a third dose.

CarolMcl profile image
CarolMcl in reply to Barnclown

Thanks very much for that explanation Barnclown 👍🏻

Thank you so much for your explanation Barnclown, so I was right in my assumption after all!

I'm seeing my rheumy next week and I'll enquire about the potential of a shorter period between 2nd jabs and booster shot. I was mistakenly left off the priority list by my GP first time round thus there was a delay in getting my jabs. Whether they'll do the booster a little quicker, who knows?!

Many thanks ladies.

Barnclown profile image
Barnclown in reply to CSLO

You’re v welcome…am just feeling my way with A LOT of help from good folk like you in my various 🦓 support groups..thank goodness for the Internet forums our support groups run on our behalf 👏👏👏👏

Hope you’ll let us know how your gp reacts…Yesterday I asked on my GP’s patient portal & got this reply:

Barnclown profile image
Barnclown in reply to CSLO

PS 😯another scientist member of my UK PID forum just replied this way to my post about this question:

For those eligible for a 3rd primary dose you will then get a booster 6 months later 4 in total. For those only getting booster will have 3 in total unless guidelines change in future

CSLO profile image
CSLO in reply to Barnclown

Oh my goodness, I wonder whether most medics are even aware of this. I'll ask the questions next week and let you know how I get on.

Thanks for your help. 🙂

Barnclown profile image
Barnclown in reply to CSLO



Hope this is legible

My understanding (from Scotland where things may be different) is that the third dose is a booster, and it will be different from. the vaccine given already, which here was the Astra Zeneca. It will be the Phizer. And given six months after the second main dose. As I'm on Rituximab things are a wee bit more complicated because there has to be a space between my infusion and any vaccines.

Barnclown profile image
Barnclown in reply to cathie

Very interesting, here’s how my Univ of Cambridge immunologist explained this to my GP & me in the report she sent after our tele review last week:

Barnclown profile image
Barnclown in reply to Barnclown

On the phone last week, my immunologist specified that the 3rd Primary COVID Vacc is not precisely the same as the COVID booster vacc…in England the 3rd Primary Dose is explained in the JVCI document (link posted above)

Hope this is legible
Whippet_lady profile image
Whippet_lady in reply to cathie

I'm in Scotland and was given the Pfizer. According to Paul, who replied on a Lupus UK facebook post, those of us who are immuno-suppressed are to get a 3rd primary dose followed by a booster 6 months later and there is still some debate over when we will get the flu jab as some reports have said booster and flu jab at the same time and some have said there needs to be 4 weeks between a primary covid jab and the flu jab.

🤔Am getting the impression our dear NHS folk are doing a lot of ‘trying to 3rd Primary Vacc & Booster protocols straight’ …just like we are ❣️😅

louise-a profile image
louise-a in reply to Barnclown

Im not sure what is going on. Need to make a call at some point. Thinking when have antibody tests for response re Immuonology they leave a gap, so mmm. Have to go out now. Will update when find out more and or read up. I am sure needing to re read your posts Dear Coco. xx

According to Paul, who replied on a Lupus UK facebook post about this yesterday, those of us who are immuno-suppressed are to get a 3rd primary dose followed by a booster 6 months later and there is still some debate over when we will get the flu jab as some reports have said to get the booster and flu jab at the same time and some have said there needs to be 4 weeks between a primary covid jab and the flu jab.

👍That sounds right!

Re already double COVID vaccinated folk: a Primary Immundeficiency Disease patient on my U.K. PID forum was explaining that he works in a U.K. COVID Vacc centre & they won’t let doubled vacc’d immunocompromised patients have the COVID Vacc unless it’s at least 7 days before/after the flu vacc

My concern is that whatever the advice is, the message isn't getting through to the medics that we deal with. Neither my GP nor my rheumatologist have been up to speed with any of the covid vaccine advice surrounding my problems and my household members. Consequently, my kids ended up getting their jabs a lot later than they should, resulting in one of them getting covid when, had they been jabbed when they should have been, they might not. The stress and anxiety this caused in our house was through the roof because the only thing my rheumy has said all the way through this is that I am at the highest risk (and will likely die). I just wish they would all get their act together.

THAT’S BAD BAD BAD☹️…I feel very very 😳 the way the GOV & NHS are dealing with children & parents during this pandemic

Re wishing they’d get their act together… Me too! I am officially ‘extremely clinically vulnerable’ & was getting all the bumpf from dear Matt & co…but my GP Surgery failed completely to officially offer me even my first jab, so I ignored them & went straight to the GOV U.K. vacc website which let me book no prob.

Melba1 profile image
Melba1 in reply to Whippet_lady

Hello whippet lady, Did your rheumy say you’d likely die? This really worries me that some rheumys are saying that because it is just not true. The most recent research shows we are at increased risk of covid complications but no more than double the normal population. That’s only a very small percent, still obviously a risk and one we need to take seriously and take measures to protect against but the anxiety caused by people thinking they have a high chance of dying is causing so many other problems.

I’m about as high risk as we can be (complex SLE and was on cyclophosphamide, just had rituximab and high dose IV steroids and 30mg of steroids a day) and had covid last March. I had about a week of feeling fluish and my doctors were very careful with me and monitored it daily but I wasn’t as sick as one son and my husband (who were both healthy although son had asthma). Being male, over 50 and overweight (like my husband 😬) have been found to be higher risk factors. Rituximab does make us a little extra at risk as less antibodies to the vaccine are made in some people.

But please don’t believe that you will likely die if you catch Covid. Research is now showing this just is not true. Covid is not going away and if we live in constant fear and don’t have any life at all because of it, then that can be more damaging.

Obviously we still need to be careful and everyone has to make their own risk/ benefit decisions and take medical advice about their own circumstance but if your rheumy told you would likely die I’d be very concerned about that (unless it was in the early days when no one knew the relative death rates for differing diseases/ treatments and we were felt to be at much higher risk than the later research has shown).

But also very rubbish of your GPS not to vaccinate your kids early to help protect you. Although my sons were double jabbed early and one of them had covid a few weeks ago (too many clubs I think!) quite badly considering he was double jabbed xx

Whippet_lady profile image
Whippet_lady in reply to Melba1

My BMI is high on top of everything else. I'm still being told not to go to shops or other public places, have been all the way through. Combined with the UV sensitivity I'm a prisoner. And having a young and inexperienced rheumy who doesn't know about meds that could make things better (or vaccines) and would rather pass the buck than do some research is very depressing. There is concern for my mental health but nobody makes the connection that if they prioritised my physical health instead of just ticking boxes to say that my 6 monthly contact has been done then my mental health would improve infinitely.

Melba1 profile image
Melba1 in reply to Whippet_lady

Oh yes definitely, I think that getting the right support for the lupus makes such a difference to mental health. Knowing there’s someone knowledgeable to call on and who will help and advise. And like you say tick box appointments particularly at the moment when they’ve got the backlogs.

Can you ask for a grown up rheumy? I have a young new consultant and he admits he knows little about lupus and we sort of learn together. He’s made some mistakes with me and I do feel sometimes I’d like the security of a knowledgable grown up! X

CSLO profile image
CSLO in reply to Whippet_lady

Thanks Whippet_lady. Oh my, I wonder whether this info will feed down to the GPs? I've booked my flu jab at Boots for Monday. My GP didn't offer them til Dec last year, I'm certainly not prepared to wait for that.No doubt it'll all sort itself, I fully appreciate what a mammoth task this must be. I certainly wouldn't wish to be the one calling the shots! The tricky thing is feeling confident that I won't be 'overlooked' again, and I certainly don't want to be nagging them.

Whippet_lady profile image
Whippet_lady in reply to CSLO

I know exactly what you mean. There's so much confusion over everything. I haven't heard anything about my flu jab or an extra covid jab or anything yet. My son has had a consent letter home from school for the flu jab but nothing for me or my husband.

If we had an idea when these jabs might be offered, it would be easier to arrange this time gap. I'll have the flu jab Monday as I would be truly amazed if this booster shot/3rd vaccination appointment comes through this next week!

HiJust waiting for a repy to my email to local vaccination centre & GP....

This is my email:

Following my telephone call today to the health board vaccination enquiries, I am writing as I fit the criteria recommended by the JCVI for a third covid-19 vaccination and I wanted to know when 'people with "severe immunosuppression" should be invited for the third COVID-19 vaccine dose ? This third vaccination is in order for patients like myself to achieve similar levels of protection compared to the broader population. 'The British Society for Rheumatology has suggested that nearly all rheumatology patients (aside from those solely on hydroxychloroquine or sulfasalazine), should receive a third dose.'

The JCVI advice about this can be found here:

Joint Committee on Vaccination and Immunisation (JCVI) advice on third primary dose vaccination - GOV.UK (

'People who were severely immunosuppressed (had a very weakened immune system because of a health condition or medical treatment) when they received the first or second dose of COVID-19 vaccine may not have made a good immune response to the vaccine.

The JCVI have recommended that these individuals aged 12 years and over will need a third primary dose of COVID-19 vaccine. This includes those who had or have:

blood cancers (such as leukaemia or lymphoma)

lowered immunity due to treatment (such as high dose steroid medication, biological therapy, chemotherapy, radiotherapy)

lowered immunity due to inherited disorders of the immune system

an organ or bone marrow transplant

disease that affects the immune system (such as poorly controlled HIV)

other disease or treatments (as advised by a specialist)

This third dose is not a booster – it is an additional dose of vaccine which aims to increase levels of protection for these individuals. The specialist involved with an individual should advise on whether the patient needs a third primary dose and will also advise on when this dose should be given. '

Following chemotherapy treatment shortly before my first covid-19 vaccination, being on immune suppressants and being tested for anti-bodies I know that I have a compromised immune system and I would benefit (following studies to date) from a 3rd vaccination as a priority and I wanted to know if a third vaccination is available now?"

Unfortunately, news is using 'booster' vaccination, so doesn't prioritize us to get a 3rd vaccine asap....

We will see....m

Ps thanks Barnclown good to hear from your professionals...

Barnclown profile image
Barnclown in reply to maggielee

😃 i think you’ll chuckle @ this…it’s from a buddy who, like me, has Primary Immunodeficiency Disease…she too is getting her head around these latest twists in the COVID vacc saga😉:

“ Just had a call with my GP who asked me what the difference was between the 3rd Primary dose and Booster dose, she explained they are being sent so much paperwork to read at the moment that she couldn’t keep up with it 😬xx”


louise-a profile image
louise-a in reply to maggielee

Excellent and well done. xxx

Great news! Just got a call from the vaccination centre & I am going to get my 3rd vaccine tomorrow (wasn't ready today) !!!!!

So for me no waiting for a letter!!

This is in the by... ml

CSLO profile image
CSLO in reply to maggielee

Whoa, well done maggielee! I don't have a local vaccination centre here, one was created by a collective of local practices but it's not running now. Perhaps they'll set it up again.

Good luck tomorrow!

Barnclown profile image
Barnclown in reply to maggielee


louise-a profile image
louise-a in reply to Barnclown

Read all now. Got it sorted in my head. xxx

You may also like...