Many Americans with compromised immune systems have skirted government guidelines to receive unauthorized fourth or fifth shots of COVID-19 vaccines, The New York Times reported.

Although Israel has begun rolling out fourth shots to its citizens, the Centers for Disease Control and Prevention announced in late October that immunocompromised groups would be eligible for a fourth dose six months after a third.

That meant the earliest eligibility for a fourth shot would be in late February. 

Some patients and their doctors, however, believe the federal agencies have acted too slowly to protect the most vulnerable.

Stacey Ricks, 49, a kidney transplant recipient who takes immune suppressing medication, received a dose of the Johnson & Johnson vaccine in June without disclosing she already had received the Moderna shots, the Times reported Monday.

Ricks, who didn’t develop antibodies after her Moderna shots, convinced a Houston pharmacist to give her two doses of the Pfizer vaccine in July, the Times said.

The pharmacy records listed her previous shots, but Ricks, armed with a doctor’s note explaining that she hadn't developed antibodies, convinced the pharmacist to give her the shots.

"She kept saying, 'There's no clinical data here,'" Ricks told the Times. "And I said, 'Hey, I am the clinical data.'"

It's not illegal to receive extra shots, though recipients could face civil lawsuits if vaccine providers decide to go after them for lying; but that is something extremely unlikely, Govind Persad, an assistant professor at the University of Denver Sturm College of Law, told the Times.

With the omicron variant having created a surge of infections nationally, many people with weak immune systems are getting extra shots without being certain of whether they are safe or effective, the Times said.

Normally, doctors have discretion to use approved medications outside of their recommended uses. However, to receive and administer COVID-19 vaccines, providers must sign a legal agreement with the CDC.

Violating the agency's rules could result in being kicked out of the vaccination program and result in prosecution. The CDC also has said that providers administering unapproved shots might not be protected from patients’ legal claims if something goes wrong.

The Times added that legal experts say the government has done little to enforce compliance with regulations, and seems unlikely to pursue punishments for most providers.

Israeli Prime Minister Naftali Bennett said Sunday that the country would offer additional shots to people age 60 and over, as well as to medical workers, becoming the first country to roll out an additional booster so broadly.

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