The Third Dose: What Immunocompromised People Need to Know

As the COVID-19 pandemic rages on, you’ve probably been hearing a lot about the third dose or the “booster shot.” It’s currently available for immunocompromised folks, and while my medical issues certainly don’t feel like a gift, receiving that third dose did.

I’ll preface my story by saying I’ve never had COVID-19 (that I know of). I’m 41 years old, and I have several autoimmune diseases, which, unfortunately, mean I’m dependent on a medication that suppresses my immune system. I’ve been on a biologic (a drug produced from or containing components of living organisms) for the past 17 years, save my two pregnancies. I still live with chronic pain, but I’d likely be unable to walk without the aid of these medications. Biologics help millions of people who have conditions like multiple sclerosis, diabetes, rheumatoid and psoriatic arthritis, Crohn’s disease, ulcerative colitis, and many types of cancers. Some biologics you might know include:

Like many in my position, I was extremely anxious to get an appointment when the FDA initially approved vaccines in late 2020. I received my vaccines in February of 2020. Within 12 hours of my second dose, I was miserable. I had an intense headache, fever, chills, and severe joint and muscle pain. I couldn’t sleep. These side effects went on for about three days, and at the time, felt unbearable. If this was even a glimpse of COVID-19, I knew it was not something I wanted.

And for me, the vaccine has worked. I felt a little freer this past spring and summer. I was less worried about bringing COVID-19 home to my two daughters, who are too young to get vaccinated. We went out to dinner occasionally. We spent time with friends, and we even went on vacation! But, when the Delta variant started to take over, my anxiety began ramping up. I heard of breakthrough case after breakthrough case. My dad got COVID-19, and so did my stepmom. Unfortunately, they live in an area with very low vaccination rates, so their breakthrough cases weren’t that surprising. But when a neighbor my age, with whom I’m close, had a breakthrough case, I started to worry. We are lucky to have a very high vaccination rate in Colorado, but it isn’t perfect. Now we know that breakthrough cases are still relatively rare, but I was concerned.

My daughters were back in elementary school, and even though they were masked, I was terrified that they’d bring it home. Or that my husband or I would get a breakthrough case from the office or the grocery store, even though we still mask too. What happens if I do get COVID? Who knows? I could have a mild case. But I could have a terrible case and end up hospitalized, or worse. What I do know is that my immune system doesn’t work as well as the immune systems of some other people. As someone who deals with anxiety regularly, the idea of dealing with COVID has sent me into countless tailspins.

So, per my doctor’s recommendation, I got my third dose of the Pfizer vaccine a few days ago. I immediately went home and spent 45 minutes exercising, trying to get my heart rate up in the hopes that it would help circulate the vaccine more effectively (solely my idea, no one told me to do it). I ate some protein and then lay on the couch for the rest of the afternoon. I felt fine at first. I watched Netflix. I doomscrolled Facebook and Twitter and let the kids run wild.

I did have side effects, but they weren’t as awful as I had feared. They were similar to the impact I felt after my second dose but not quite as intense. I woke up in the middle of the night again with moderate to severe body pain. My muscles and joints ached, and I couldn’t sleep. My head was pounding. I slept most of the next day, hydrated as best I could, and let my body do the work. Reacting to the vaccine was good news; it meant my immune system was working. By the third day, I was back to working, taking the dog on long walks, cooking dinner my kids didn’t want to eat, and obsessively checking COVID numbers in my state.

If you’re immunocompromised and scared of getting the third dose, I hope my experience will bring you some peace of mind. It wasn’t easy, but it wasn’t the worst thing in the world either. We know the vaccine works. If you need extra protection, it’s OK to go ahead and talk with your doctor about making that appointment. Take care of yourself and the world around you. It’s the best we can do right now.