Los Angeles Times (Sunday)

All adults are urged to get a booster shot

Los Angeles County and San Francisco health officials say everyone, not just the high-risk, is eligible.

- By Rong-Gong Lin II and Luke Money

Los Angeles County and San Francisco health officials are encouragin­g all fully vaccinated adults to get a COVID-19 booster shot.

L.A. County Public Health Director Barbara Ferrer and San Francisco Public Health Director Grant Colfax have added their endorsemen­ts to those of a growing number of health officials in California who are suggesting that virtually all adults are already eligible for boosters under the guidelines issued by the U.S. Centers for Disease Control and Prevention.

Ferrer said she recommends that any vaccinated adult get a booster as long as at least six months have passed since the second dose of the Pfizer-BioNTech or Moderna vaccinatio­n series, or at least two months have passed following a Johnson & Johnson vaccinatio­n.

“The only exception would be a person who lives in a bubble: You’re in your house, you telework, you never leave, you don’t live with anybody, you don’t really have a lot of risks, nor are you creating a lot of risk. But I don’t know anybody living in that world,” Ferrer said during a news briefing Friday.

Some young adults have returned to workplaces or are “certainly out and about enjoying all that L.A. County has to offer, and we’d like them to continue to do that,” Ferrer said.

However, she warned, “they do have waning protection. And unfortunat­ely, if they get infected, they can infect others who really could end up with very serious illness.”

“So, yes, I do recommend that, if it’s your time — because you’re six months out from that second dose of Pfizer or Moderna, two months out from receiving Johnson & Johnson, you’re 18 or older and you’re not living in that bubble — please come in and get your booster,” Ferrer said.

Some who look at the eligibilit­y criteria on the state’s scheduling website, myturn.ca.gov, might think they don’t qualify for a booster.

But Ferrer and other health officials have pointed out that one of the criteria, being “at high risk for COVID-19 exposure due to occupation or institutio­nal setting,” applies to virtually every adult.

That criterion, Ferrer said, can apply to:

Going to work and being around other people.

Living with people who cannot get vaccinated, such as babies or young children, or who are at high risk of serious illness should they get infected, such as the elderly

or those who are overweight or pregnant, are a current or former smoker or have high blood pressure, diabetes, asthma, depression or an alcoholor drug-use disorder.

Being in a community that has been hit hard by COVID-19 or is seeing high numbers of coronaviru­s cases — “which, at this point, is all over L.A. County,” Ferrer said.

She said she thinks this interpreta­tion is in alignment with the guidance outlined by the CDC.

Her counterpar­t in San Francisco echoed her approach.

“We are taking an expansive approach to COVID-19 boosters, realizing that people are at risk of getting COVID or spreading it as we enter the busy holiday season,” Colfax said in a statement.

“We are already seeing an uptick in cases, and that could mean hospitaliz­ation for some vulnerable people, even if they are fully vaccinated,” Colfax added. “We have been stressing that boosters are essential for higher-risk individual­s, but now it’s become apparent that we need many more people to receive a booster dose so that we can protect ourselves, our families and friends, and our community.”

Additional­ly, Ferrer pointed out, there’s ample supply of booster shots, and officials are concerned that those who were vaccinated more than six months ago may start to experience weakened immunity to COVID-19.

Increasing the uptake of booster shots, getting unvaccinat­ed people to begin the regimen and wearing masks in indoor public spaces and crowded outdoor spots are essential strategies to stave off a winter COVID-19 surge, Ferrer said.

“Certainly around the country and across parts of the world, the colder weather has already brought significan­t increases in cases and, unfortunat­ely, in hospitaliz­ations. It would be foolish to not heed the warning inherent in

these increases,” Ferrer said. “Our ample supply of vaccinatio­ns allows us to offer the initial series to everyone 5 and older and boosters for those with waning protection, putting us in a better position to prevent the tragic heartbreak we experience­d last winter.”

In a letter this week to local health agencies and vaccine clinics, California State Health Officer and Director of Public Health Dr. Tomás Aragón wrote that adults can determine they are at high risk of exposure simply by living “in geographic areas that have been heavily impacted by COVID.”

To vaccine providers, Aragón directed: “Do not turn a patient away who is

requesting a booster,” as long as enough time has passed since the initial vaccinatio­n.

Health officials in Santa Clara County, Northern California’s most populous, offered the same interpreta­tion at a recent news conference and have since seen increased demand for boosters.

“Pretty much everybody is eligible,” said Dr. Sara Cody, the county’s health officer and public health director. “We really encourage everyone to get out and get their booster shot.”

The San Francisco Department of Public Health said some people seeking booster shots may still see a narrower set of eligibilit­y criteria while trying to book appointmen­ts.

“As the systems are updated, people should choose the least restrictiv­e of the criteria that applies to them. Many work and residentia­l settings pose the risk of exposure to COVID,” the agency said in a statement.

California’s messaging marks a shift from just a few weeks ago, when officials placed greater emphasis on urging elderly individual­s and those with weakened immune systems to get boosters. That was partly based on the CDC’s official recommenda­tions that among people vaccinated with Pfizer-BioNTech or Moderna, groups who should get boosters include anyone 65 and older, those 50 and over with certain underlying conditions and adults who live in long-term care settings. The CDC also recommende­d that all adult J&J recipients get a booster.

The CDC made the boosters available to other specified groups but stopped short of officially recommendi­ng them.

Among these groups are younger adults with an underlying condition and those age 18 to 64 who live or work in settings that put them at increased risk. As the CDC guidance notes, that risk “can vary across settings and be affected by how much COVID-19 is spreading in a community.”

While California is relying on an interpreta­tion of the CDC guidelines to essentiall­y throw the doors open, federal officials, for their part, are evaluating whether to officially expand eligibilit­y.

Pfizer and BioNTech recently asked the U.S. Food and Drug Administra­tion to allow boosters of their COVID-19 vaccine for anyone 18 or older. Results from a new study found that a booster dose resulted in a relative vaccine efficacy of 95% when compared with people who did not receive a booster.

Demand for booster shots in L.A. County has climbed significan­tly in recent weeks, Ferrer said. However, administra­tion of first doses has remained relatively low.

During the first week of November, L.A. County administer­ed 182,000 booster shots or additional doses to immune-compromise­d people and slightly more than 43,000 first doses of vaccine and 42,000 second doses.

At this pace, L.A. County won’t achieve its goal of fully vaccinatin­g at least 80% of residents age 12 and up until next year. Hitting that goal is one of the county’s criteria to lift its mask mandate for indoor public areas.

About 73% of Angelenos in that age range have completed their initial inoculatio­n series, county data show.

Progress in getting unvaccinat­ed people their shots, Ferrer acknowledg­ed, is “plodding ahead much more slowly than we would wish.”

“The single most important thing that we can do as a community to reduce our risk for another winter surge is to decrease our numbers of unvaccinat­ed people,” she said, adding that this includes getting newly eligible children vaccinated.

 ?? Gary Coronado Los Angeles Times ?? NICOLE FAHEY of Altadena, who is six months pregnant, receives a Pfizer vaccinatio­n booster shot from nurse Veronique Vida in Los Angeles on Nov. 3.
Gary Coronado Los Angeles Times NICOLE FAHEY of Altadena, who is six months pregnant, receives a Pfizer vaccinatio­n booster shot from nurse Veronique Vida in Los Angeles on Nov. 3.

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