Who’s eligible for COVID boosters, and how do you prove it?

Hospitals and pharmacies across Connecticut are now offering booster shots or third doses of COVID-19 vaccines to those who qualify.

Gov. Ned Lamont has promised the process of getting an additional shot of vaccine will be easier than in the spring, when high demand led appointments to fill up within minutes.

He reiterated that point on Wednesday.

“You can go to any of our pharmacies virtually no questions asked, you can get that booster if it’s been more than six months and you think you’re eligible,” the governor said, speaking to reporters after an event in Bethel.

Booster versus additional dose

Federal regulators announced last month that a limited number of Americans would be eligible to receive booster shots of the Pfizer-BioNTech vaccine. The announcement was narrower than the Biden administration’s stated goal of allowing anyone who had received the vaccine to get a booster six months after their initial series of shots.

Moderna and Johnson & Johnson have also submitted data to the Food and Drug Administration to allow boosters of the two other federally authorized COVID-19 vaccines, but neither has been approved by the agency yet.

Vaccine providers also make a distinction between booster shots and additional doses. In August, the FDA authorized third doses of the Pfizer-BioNTech and Moderna vaccines for people with compromised immune systems.

The difference comes down to immunity. A booster is meant to address waning immunity, while a third shot is intended for those with compromised immune systems who need more than two doses to achieve maximum effect.

Eligibility

People eligible for a booster shot of the Pfizer BioNTech fall into three basic categories, according to the Centers for Disease Control and Prevention. They include people 65 and older, adults over the age of 18 with underlying medical conditions, and adults over the age of 18 who are at increased risk of exposure due to their job or living conditions.

The list of underlying medical conditions includes cancer, chronic kidney disease, chronic lung disease, dementia, down syndrome, heart conditions, HIV infection, obesity, liver disease, pregnancy, sickle cell disease or thalassemia, smoking, being a solid organ or blood stem cell recipient, stroke, substance use disorders and patients who are immunocompromised.

Jobs that might put someone at increased risk of exposure to the virus include first responders like health care workers, firefighters, police and staff of congregate facilities; educators, including teachers, school staff and day care workers; food and agricultural workers; people who work in manufacturing; prison guards and staff; postal workers; grocery workers and people who work in public transit. However, the CDC said people should “talk with their health care provider about their personal risks” to determine if their job puts them at increased risk.

Dr. James Cardon, Hartford HealthCare's chief clinical integration officer, admitted those categories are a little vague, and said the hospital system’s inclination is to administer the booster if someone feels they qualify, rather than policing who is eligible.

“We tend to take a liberal view of people who say ‘gee I think I qualify and I feel safer with a vaccine,’” Cardon said. “As long as it’s Pfizer and they have it in the right time interval.”

Scheduling a shot

Cardon said the hospital system is handling around 3,000 booster shots every week, and people can either walk up or schedule an appointment for their shot. During the sign-in process, people must attest that they qualify for a booster. People should bring documentation from their previous shots.

“We are adhering to just Pfizer and not cross-matching the different (mRNA) vaccines,” Cardon said.

Large pharmacy chains, including CVS, Walgreens and Walmart, are accepting appointments for booster shots. During the online scheduling process, people must to attest that they qualify for a booster under one of the categories outlined by the CDC. The systems also require users to enter the date of their last vaccine dose, and will not let them proceed if they received their last dose within the past six months.

CVS, Walgreens and Walmart locations around the state all showed readily available appointments for Pfizer booster shots within the next week.

Flu shots

People can also now safely get a flu shot at the same time as their booster. When COVID vaccines first became available, many recipients were told to wait to get other vaccines. The CDC has since clarified the two can be taken together.

“You can get them at the exact same time,” Cardon said. With the flu shot, timing is important because getting it too early can cause immunity to wane before flu season ends, he pointed out, “but from this point on, you’re pretty much in good shape to get both if that’s what you need.”

That’s important, because the colder weather headed into the fall could see COVID-19 infections rise, but also cases of other respiratory illnesses as well.

“We are also seeing some increases in respiratory illnesses and flurelated illnesses right now,” said Dr. Ajay Kumar, Hartford HealthCare’s chief clinical officer. “So we might actually have a different type of problem in terms of different types of respiratory infections in late winter.”

Those could impact hospital capacity later in the winter, he said.