Eagle County begins offering third vaccine doses to the immunocompromised

Federal guidance on booster shots for the general public is expected in the coming days

Vail Health nurse Kacy Geary draws a vaccine dose into a syringe at a clinic at Homestake Peak Middle School on Friday afternoon. Vail Health and the MIRA Bus began offering third vaccine doses this week.
Kelli Duncan/

Eagle County hit the ground running in its effort to provide third doses of COVID-19 vaccine to immunocompromised residents who wish to receive them, offering the first doses at clinics mere days after a federal advisory committee recommended the booster shots.

On Friday, an advisory committee to the Centers for Disease Control and Prevention approved an additional dose of the two mRNA vaccines — Pfizer and Moderna — for moderately to severely immunocompromised people.

By Monday, the MIRA Bus, an RV that travels the county offering public health services, was offering third doses at a mobile clinic in Avon. Colorado Mountain Medical will offer the third shots to qualifying individuals at its Eagle campus every Thursday from 8 a.m. to 4 p.m.

“We know the third dose booster with this population provides more protection for them and is recommended on a disease severity piece that they’ll have more protection,” said Chris Lindley, Vail Health’s chief population health officer. “So, we don’t want to wait, even though the guidance is not as clear as we would like it.”

The CDC outlined six categories of people that will qualify as “immunocompromised” in this first phase, an eligibility group much smaller than the definition of immunocompromised used in the initial vaccine rollout earlier this year, Eagle County Public Health Director Heath Harmon said.

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In the spring, the immunocompromised priority group contained about 20,000 Eagle County residents, but this new group is likely much smaller, Harmon said.

During the initial vaccine rollout, “everybody was vulnerable to the illness at that time,” he said. “So now, when we’re looking at third doses, we do have access to a lot of data, especially relative to individuals that may have already received two doses of an mRNA vaccine. So, it’s really helpful to be more specific in terms of who can benefit most from that third dose.”

Among the eligible are those receiving active cancer treatment for tumors or cancers of the blood as well as people who have received an organ transplant and are taking medication that suppresses the immune system, according to the CDC.

Anyone who received a stem cell transplant within the past two years, is currently taking immunosuppressant medication or has a “moderate or severe primary immunodeficiency” is also eligible, according to the guidance.

The last two groups included are those with advanced or untreated HIV or who are actively receiving treatment with “high-dose corticosteroids or other drugs that may suppress your immune response.”

The relatively vague language of some of these groups “leaves a little bit to be desired,” Lindley said, and the guidance does not say anything about requiring proof of eligibility from a medical provider, so Vail Health and Colorado Mountain Medical will not do so at this time.

The guidance also does not provide a booster option for immunocompromised people who received the single-shot Johnson and Johnson vaccine. Currently, there is no additional shot available for the Johnson and Johnson vaccine, and it cannot be mixed with Pfizer or Moderna.

To those in that situation, “we hear you,” Harmon said. “We understand that you have some questions, and we just ask for patience. We would expect for guidance to be available from our federal partners in the not-too-distant future.”

The most important thing is that Eagle County now has one more prevention tool in its belt to help protect its most vulnerable residents, Harmon said.

The MIRA Bus hosted a vaccine clinic at Homestake Peak School on Friday afternoon in which Vail Health nurses gave out first and second doses to local students and parents. The bus began offering third doses this week.
Kelli Duncan/

Colorado Mountain Medical’s Thursday clinics will continue to offer first and second doses of the COVID-19 vaccine to anyone who has yet to receive it, in addition to the third doses, said Shannatay Bergeron, director of specialty care services for Colorado Mountain Medical.

The clinics will be walk-in only and demand for third shots may be high, especially at first, so Bergeron cautioned residents to prepare for a wait. The MIRA Bus will be at the Eagle Colorado Mountain Medical location Thursday providing additional vaccination capacity, she said.

Eligible residents should bring a form of identification proving their age along with their vaccination card. More information on the Thursday clinics, as well as other COVID-19 and vaccination updates, can be found at

Eagle County Public Health is also offering third doses at its locations in Eagle and Avon, Harmon said Tuesday.

Though the third shots were made available beginning Monday, Harmon said he did not think anyone had received one yet. More information on the county’s clinics can be found at

Vail Health’s aggressive approach to offering the third shots as soon as possible is on par with how Eagle County has handled the entire pandemic thus far, Lindley said with pride.

“It has always been our objective in dealing with COVID to be as aggressive and quick in the response as we possibly can,” he said. “We did it with testing by standing up the first drive-thru test center in the state. … We were the first hospital to receive the mass vaccination distribution from the state of Colorado.”

“Once we heard whispers that this was likely coming, aligning with that aggressive approach, we started planning, staffing, we ordered more vaccine and supplies so we had it all on hand by last week so we would be ready to go,” Bergeron said.

Part of the reason why Colorado Mountain Medical was able to mobilize so quickly was due to the significant surplus of vaccine doses in Eagle County, but also across the United States, Lindley said.

“The United States has millions and millions, hundreds of millions, of doses of vaccine that are available,” he said. “There’s no shortage of vaccine in the United States of America.”

The third shot has not been recommended for the broader population quite yet but, based upon murmurings about an announcement from the CDC and President Joe Biden’s administration, guidance for the general public is likely to come soon, Lindley said.

Harmon said he cannot be sure whether a subsequent priority group will be announced or if eligibility for the third doses will be opened to all.

“I would imagine that they’ll continue to look at data and still look first and foremost at who’s going to benefit most from receiving third doses,” he said. “We may see an additional tier 2 group for immunocompromised individuals in the future.”

Lindley urged residents to continue following local, state and federal public health guidance and to get a third shot as they are eligible to maintain their immunization against COVID-19 as community spread of the Delta variant continues to rise.

“Just like the annual influenza vaccines, I think we should all prepare to get annual or even more frequent COVID-19 vaccines,” Lindley said. “COVID is here to stay. I do not believe there will be a time in our lives that we will be alive that COVID is not here.”

“There’s six very common circulating COVID viruses that have been around for hundreds of years. It’s our common cold. This is just another dimension of it,” he continued. “It’s going to continue to mutate, … so, we need to learn to deal with it, to protect ourselves and to do that immunization is our best tool. So, stay immunized, stay protected.”

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