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Low Uptake of Bivalent COVID-19 Booster Vaccinations in Immunocompromised Adults

A new study published in the MMWR Morb Mortal Wkly Rep found that uptake of bivalent COVID-19 booster vaccinations was low in immunocompromised adults.[0] The study examined the reasons why some adults chose to receive or not receive the booster vaccinations. The study found that 78.0% of immunocompromised adults received the third dose of the mRNA COVID-19 vaccine, while only 41.0% had received the fourth dose.[0] This corresponds to a primary series and monovalent booster dose. Following the CDC recommendation to receive a second monovalent booster (fifth dose), only 0.9% had uptake.

The study also found that adults aged 65 years or older were more likely to receive at least four doses of the vaccine, while Hispanic and non-Hispanic Black adults were less likely to receive at least four doses compared to non-Hispanic White adults.[0] Similarly, individuals with prior documented severe acute respiratory syndrome coronavirus 2 infection were also less likely to receive at least four doses.[0]

Of the 714 participants who had not received a booster dose, the most common reasons cited were ignorance of eligibility, belief that they were still adequately protected against infection, anxiety about adverse effects, and uncertainty regarding the booster’s efficacy. The study also found that, among those who did not receive the booster, most had not experienced a SARS-CoV-2 infection or received a COVID-19 vaccine within the preceding 6 months.[1]

The study’s results suggest that those who received the bivalent vaccine last fall were better protected – especially if they were 65 or older – than those who did not. This underscores the importance of getting vaccinated, especially for those who are immunocompromised or in the higher-risk demographic.

0. “Uptake Low for COVID-19 Vaccine Boosters in Immunocompromised Adults” The Daily Collegian Online, 24 Jan. 2023,

1. “What the latest studies show — and what they don’t — about the bivalent boosters’ effectiveness”, 20 Jan. 2023,

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