SF offers third dose of Pfizer or Moderna vaccines to immunocompromised people

A third dose of the Pfizer and Moderna series is offered to people with certain medical conditions based on guidance from federal and state health authorities.
August 18, 2021

The San Francisco Department of Public Health (SFDPH) today began offering a third dose of the Pfizer-BioNTech or Moderna COVID-19 mRNA vaccines to individuals who meet specific criteria for immunocompromised health conditions, such as active cancer treatment, organ transplant, advanced HIV infection, and others.

SFDPH’s new health advisory aligns with recent guidance from the U.S. Centers for Disease Control and Prevention (CDC) and the California Department of Public Health (CDPH) and is a response to vaccine trials showing that many people with moderate to severe immunosuppression would benefit from a third dose of the mRNA vaccine series to increase their protection against COVID-19.

Patients should first consult with their health care provider about their medical condition and whether getting an additional dose is appropriate and safe for them. Eligible individuals should first seek out third doses through their health care providers, if they have one. Doses will also be available through SFDPH- affiliated sites and the SF Health Network. When presenting at a SFDPH or affiliated site an individual must self-attest to having one of the following, specific conditions:

  • Receiving active cancer treatment for tumors or cancers of the blood
  • Received an organ transplant and am taking medicine to suppress my immune system
  • Received a stem cell transplant within the last two years or am taking medicine to suppress the immune system 
  • Moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome)
  • Advanced or untreated HIV infection
  • Active treatment with high-dose corticosteroids or other drugs that suppress my immune response

“Our strategy has always been to protect the most vulnerable in our community based on the latest available research and guidance from federal and state partners,” said Director of Health, Dr. Grant Colfax. “With a third dose of an mRNA vaccine our intent is to prevent severe illness among people who may not have had a complete immune response to the initial two-dose series. We will continue to monitor guidance from the CDC for further eligibility expansion. For now, we ask that only individuals who meet the criteria for immune compromise request a third dose.”

People who are immunocompromised have a reduced ability to fight infections and are vulnerable to COVID-19. The U.S. Food and Drug Administration (FDA) has determined that the administration of a third dose may increase protection from the virus for individuals with these health conditions.  Because the vaccine is not 100 percent effective, persons with immune compromise, including those who receive a third dose, should continue to take additional precautions to prevent COVID infection, including wearing a well-fitted facemask, maintaining social distancing, and avoiding crowds and poorly ventilated indoor spaces whenever possible. Their close contacts should be strongly encouraged to be vaccinated against COVID-19.

Based on CDC estimates that approximately 3 percent of the population meets the criteria, SFDPH expects number of individuals eligible for a third dose to be relatively small.

SF’s protocol remains the same in accommodating special requests from individuals who have received the Janssen (Johnson & Johnson; J&J) viral vector COVID-19 vaccine and who have consulted with a healthcare provider and wish to receive a supplemental dose with an mRNA vaccine (Pfizer or Moderna). Supplemental doses are being provided through Zuckerberg San Francisco General Hospital and other SFDPH-operated vaccination sites to SF residents and to people who can prove they were vaccinated with the J&J vaccine in SF.

Immunocompromised individuals can make an appointment or find a nearby vaccination site at To stop the spread of COVID-19 and protect individuals who are immunocompromised, SFDPH is strongly encouraging everyone who is eligible to get vaccinated, to do so now.

SF’s Health Advisory for a third dose of mRNA vaccine for immunocompromised can be found here: