California urges COVID booster shots for all adults

State officials are urging COVID-19 vaccine providers to give booster shots to pretty much any adult who wants one, in a messaging shift toward loosely interpreting their own guidance that recommends the shots only for those 65 and older, in poor health or who live or work in a high-risk setting.

“Do not turn a patient away who is requesting a booster” who’s at least 18 years old and last had the Pfizer or Moderna shot 6 months ago or the Johnson & Johnson shot 2 months ago, California Public Health Director Dr. Tomás J. Aragón said in a Nov. 9 memo to local health jurisdictions and providers.

The memo with the subject line “Booster Messaging,” Aragón said, “clarifies the state’s expectations for administering COVID-19 vaccine boosters and patient eligibility,” and says providers should “allow patients to self-determine their risk of exposure.”

Santa Clara County health officials made that same recommendation Wednesday. But other local health jurisdictions — including health officials in Alameda, Contra Costa, San Mateo and Marin — indicated they were adhering to the eligibility guidance from the U.S. Centers for Disease Control and Prevention and the state’s posted recommendations that largely mirror them.

Pharmacies like Walgreens and CVS said Thursday they too are following the CDC’s eligibility guidance for boosters. The pharmacies’ online vaccine appointment schedulers ask those seeking boosters to attest that they meet the CDC’s guidelines, but leave it up to the applicant to determine their eligibility — those below the recommended ages aren’t asked to submit verification of high risk employment or health conditions.

Likewise, San Mateo County health department spokesman Preston Merchant said “we’re saying to follow CDC guidance for eligibility, which includes self attestation and perception of risk,” suggesting those who consider themselves eligible won’t have trouble getting boosters.

Officially, the state recommends boosters for those who received their second Pfizer or Moderna dose at least six months ago and are 65 or older, or 18 or older and live in long-term care settings, have underlying medical conditions, are at increased risk due to social inequity, or work or live in high-risk settings.

California Health and Human Services Secretary Mark Ghaly on Wednesday hinted at the new “Booster Messaging” during a news conference in Los Angeles, stressing there is vaccine supply available and the state is concerned about rising hospitalizations heading into the holiday season

“If you think you will benefit from getting a booster shot, I encourage you to go out and get it,” Ghaly said Wednesday.

The state defines high-risk jobs to include healthcare workers, firefighters, police, congregate care staff, teachers, school support staff, daycare workers, food and agriculture workers, manufacturing workers, correctional officers, public transit workers, postal workers and grocery workers. That guidance remained unchanged on the agency’s website Thursday.

It’s not clear that anyone who wanted a booster has been turned away.

But Santa Clara County Health Officer Dr. Sara Cody said Wednesday that the guidance is “quite complicated” and likely discouraging people from getting booster shots. Only 20% of Santa Clara County residents who are 6 months past their last Pfizer or Moderna shots or 2 months past their last Johnson & Johnson shots have gotten boosters, she said.

CDC data show only about one in three Californians 65 or older have gotten a booster vaccine, similar to figures in Texas, Florida, and many other states. Among all adults 18 and older, the figures drop to 14%.

Cody and state health officials cited concerns the state may be heading into another rise in COVID-19 cases this winter, with numbers once again trending upward.

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