Faced with growing concerns about a potential coronavirus outbreak over the winter, health officials in California and other areas are boosting COVID-19 booster shots in hopes of getting more adults on the extra dose as soon as possible.
The move comes amid initially sluggish demand for boosters, which has raised concerns that more people who received their first vaccinations nearly a year ago will see their immunity wane further into the crucial holiday season. In California, only 34% of fully vaccinated seniors 65 and older have received a booster, as have only 14% of fully vaccinated adults.
According to federal guidelines, any adult can receive a booster if they are at increased risk of exposure to COVID-19 because of where they work or live.
State and local health officials are urging the public, as well as pharmacies, medical centers and other vaccine distributors, to take a liberal view of this — meaning all adults are eligible as long as two months have passed since getting a Johnson & Johnson injection, or at least six months have passed since they received a second dose of Pfizer-BioNTech or Moderna.
Traditionally, the criteria for “increased risk,” as set forth by the U.S. Centers for Disease Control and Prevention, have been applied to those who work in places such as hospitals, schools, supermarkets, or factories — or those who live in communal environments, such as prisons or shelters. for homeless people.
But the wording of the recently enacted criteria is broad, and some health officials, including in California, are now increasingly pointing out that it can be interpreted in a much broader way.
dr. Tomás Aragón, state health official and director of the California Department of Public Health, sent a letter Tuesday instructing vaccine providers to “let patients determine their risk of exposure for themselves. Don’t turn down a patient who asks for a booster.”
Adults eligible for a booster may include those who “live in geographic areas hit hard by COVID,” those who “live in high-transmission areas,” “work with the public or live with someone who works with the public.” works,” or “live or work with someone who is at high risk for serious consequences from COVID,” Aragon wrote.
There may also be “other risk conditions as assessed by the individual,” he added.
On Wednesday, the California Department of Public Health summarized its booster guidelines as follows: “In general terms that anyone can understand, we urge Californians to get a booster if anyone in their home has a medical condition or if they work around other people. ”
The list of qualifying medical conditions itself is extensive, including being overweight, pregnant, being a current or former smoker, or having high blood pressure, diabetes, asthma, depression, or an alcohol or drug use disorder.
For all of these reasons, “pretty much anyone qualifies,” says Dr. Sara Cody, the health officer and public health director for Santa Clara County, Northern California’s most populous county. “We really encourage everyone to get out there and get their booster shot.”
Officials have regularly beaten the drum for boosters in recent weeks, saying it’s important for eligible people to take advantage of the extra protections ahead of the Thanksgiving and Christmas holidays, which sparked the worst COVID-19 wave to date last year. fueled up.
Governor Gavin Newsom this week called the potential COVID-19 surge in the winter his “greatest fear.”
“While we were spared the worst in the summer, the prospects of a challenging winter are obvious,” he said Wednesday at a news conference to promote booster shots in Los Angeles. “And that’s why we’re doing everything we can to prepare and protect ourselves.”
While California relies on an interpretation of the CDC booster guidelines to essentially throw open the doors, federal officials, for their part, are already evaluating whether to officially expand eligibility.
This week, Pfizer and BioNTech asked the US Food and Drug Administration to allow boosters of their COVID-19 vaccine for anyone 18 years of age or older. Results of a new study found that a booster dose resulted in 95% relative vaccine effectiveness compared to people who did not receive a booster.
California coverage marks a shift from just a few weeks ago, when officials generally placed more emphasis on urging the elderly and those with weakened immune systems to get the booster.
That was based in part on the CDC’s official recommendations that — for people vaccinated with Pfizer-BioNTech or Moderna — groups who should receive the booster injections are seniors 65 and older, adults 50 and older with certain underlying conditions and adults are living in long-term care settings. The CDC also recommended that all adult J&J receivers receive a booster.
The CDC also made the boosters available to other specified groups, but stopped officially recommending them to take advantage of the additional inclusion. This included younger adults with an underlying condition, as well as 18- to 64-year-olds who live or work in environments where they are at increased risk.
However, as the CDC guidelines point out, that risk “may vary from environment and be influenced by the extent to which COVID-19 spreads in a community.”
In Colorado, for example, officials have taken the position that given the widespread transmission of coronavirus statewide, all adults are eligible for a booster.
“As COVID-19 is spreading rapidly across the state, Colorado is a high-risk place to live and work. Anyone 18 or older who would like a booster and needs to get one should make a plan to get one,” the Colorado Department of Public Health and Environment says on its website.
The message from California is similar. Without a booster, health officials warn, vaccinated people will be at greater risk of breakthrough infections, which could lead to hospitalizations and death in the most vulnerable.
“If you think you’ll benefit from getting a booster shot, I encourage you to go out there and get it,” said Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, at a briefing Wednesday.
He added: “It’s not too late to get it this week. Get that extra protection for the Thanksgiving gatherings you may be attending. Certainly, going into the other winter holidays is important.”
More than 3.7 million Californians have received a booster to date, according to the State Department of Public Health. By comparison, about 25 million people statewide are fully vaccinated.
The group of boosted Californians includes Daniel Loyd, 60, who said he got his booster as soon as possible.
Outside of a CVS in Agoura Hills on Thursday, Loyd said he was not only concerned about his own risk factors, he has diabetes, but also tried to protect those around him — including his wife, who has asthma, and their neighbors at the retirement community where they live.
Woodland Hills’ Greg Mead, on the other hand, said he won’t be getting a booster. He said he was fully vaccinated with J&J and felt unwell for three days afterwards.
“I’m done with the shots,” he said.
It’s not uncommon for people on a booster to experience a low-grade fever, or perhaps some chills or fatigue; it usually takes 24 hours.
“But that’s all going away. And it’s much more important for people to just tolerate that one day of side effects because they can enjoy the protection for a long time to come,” says Dr. Marty Fenstersheib, vaccine officer for Santa Clara County.
Unvaccinated Californians are still about seven times more likely to have a coronavirus infection than those who have already been vaccinated. But Ghaly said the state is seeing more cases of coronavirus among those who received their injections before.
“We are concerned about what it means for hospital admissions and the strain on our healthcare system, but ultimately for your safety and protection,” he said. “So now is the best time to consider taking that photo.”
That’s especially important, health officials say, as California’s rise from the latest Delta wave appears to have stalled. The number of newly confirmed coronavirus cases has stabilized in recent weeks — and the number of COVID-19 hospitalizations across the state has remained relatively flat since mid-October.
Nationwide, new daily cases of coronavirus are beginning to rise – a 5% increase over the past week.
Studies have shown that all three COVID-19 vaccines have lost some of their protective power, and data from Israel indicate that booster injections reduce the risk of serious illness and death.
Recently, Dr. Anthony Fauci, the US government’s foremost infectious disease expert, published a study in the journal Lancet that found that, compared with people in Israel who received two doses of the Pfizer-BioNTech vaccine, people who received a third dose a 93% lower risk of COVID-related hospitalization, a 92% lower risk of serious illness and an 81% lower risk of COVID-related death.
A report published by the CDC in September showed that the vaccine’s effectiveness against hospitalizations fell from 91% to 77% for the Pfizer-BioNTech vaccine four months after receiving the second dose. Available data for the J&J vaccine showed that the vaccine efficacy against hospitalization more than 28 days after receiving the single dose was 68%.
But while boosters are an increasingly important part of the fight against the pandemic, health officials say it is even more important to get more people vaccinated.
Nearly 70% of Californians have already received at least one dose, and about 63% have been fully vaccinated, according to data collected by The Times. However, those numbers remain well below what health officials believe is necessary to bring the pandemic to its knees.
“We are concerned about the winter. We are concerned about the rising number of cases, the pressure on our hospitals from a number of other issues on top of COVID,” Ghaly said. “So do what you can today to get your vaccine. Protect yourself in the winter.”