Some States Are Making Booster Shots Available to All Adults

Federal health agencies currently only recommend COVID-19 booster shots for certain individuals. However, in the past week California, Colorado, New Mexico, and New York have all expanded eligibility for booster shots to all adults.

This move skirts the Food and Drug Administration (FDA) authorization and the Centers for Disease Control and Prevention (CDC) recommendation currently in place.

The CDC recommends people who are 65 and older, adults with a high risk of severe illness, or those with frequent institutional or occupational exposure to the virus to get a booster, provided it has been at least six months since the second dose of Pfizer-BioNTech or Moderna vaccine or at least two months since the Johnson & Johnson shot.

Are States Allowed to Expand Booster Shot Eligibility?

“The states have really been adapting and designing their own guidelines throughout the pandemic,” Nicholas Kman, MD, an emergency medicine physician at The Ohio State University Wexner Medical Center, told Verywell. “We saw this when some states reopened last year with mask guidance and many did not. We also saw states craft their own plans when it came to the vaccine rollout.”

States are able to skirt federal guidance by emphasizing the criteria stating that adults with frequent exposure to COVID-19 are eligible to get a booster shot.

“California’s guidance is a little easier to understand as they allow any of their residents to decide if they are high-risk, either by risk of contracting the virus or due to underlying health conditions,” Kman said. “Colorado recommended the booster as they believe all of their residents are at risk due to increasing rates traced to the Delta variant.”

California and New York residents are permitted to determine their own risk of exposure, and the entire state of Colorado was declared as high risk for exposure or transmission of COVID-19, which essentially allows all adults to get their booster shots.

Meanwhile, New Mexico Governor Michelle Lujan Grisham signed an executive order specifically expanding the eligibility of booster shots to all adults.

Why Aren’t Booster Shots Available For Everybody Yet?

Health authorities are carefully reviewing data to determine whether expanding booster eligibility to all adults is necessary. Although there is no apparent concern about vaccine supply, the CDC is still prioritizing shots for those who need them first.

In the case of Pfizer-BioNTech and Johnson & Johnson vaccines where the booster shot is the same as the primary shot/s, the vaccine doses can be used for unvaccinated Americans instead, who have yet to receive their primary vaccination series.

“It is important to note that the vaccines, prior to boosters, still seem to be very effective at preventing hospitalizations and deaths in most Americans,” Kman said. “In these cases, the extra vaccines can be used to get others the all-important first vaccination."

For groups whose risk of contracting COVID-19 or getting severe illness from infection is low, booster shots might not be needed.

“Ultimately, boosters may not be needed for all adults,” Scott C. Roberts, MD, Yale Medicine infectious diseases specialist and assistant professor at Yale School of Medicine, told Verywell. “In fact, some individuals may still have very robust immunity. Getting a booster dose would be both unnecessary and take away a dose from someone who does need it, such as those over the age of 65 or those with medical conditions that place them at a high risk for severe COVID-19.”

Currently, Pfizer Inc. and BioNTech are requesting the FDA authorize their COVID-19 booster dose for everyone 18 and older, demonstrating its safety and efficacy based on the results of clinical trials. Should the FDA approve their request, the CDC will update their Pfizer-BioNTech booster shot recommendations.

What Should You Do If You’re Not Currently Eligible?

If you’re worried about your vaccine’s waning effectiveness against infection, talk to a healthcare provider about your COVID-19 risk and booster shot eligibility, experts say.

“If you are at high risk—either by age 65 and older, occupation or exposure, or underlying conditions—get your booster,” Kman said. “There may be high case rates in your county or state that put you at increased risk. Further, if you are two months past the Johnson & Johnson shot, you should get a booster. Consider an mRNA vaccine. Finally, if your doctor thinks you are at a higher risk or you are exposed to others at high risk, it is probably wise to get the booster if you are more than 6 months out from your second vaccine.”

Many are especially concerned about their protection against COVID-19 during the holiday season, but gatherings are likely safe as long as everyone who is eligible is fully vaccinated and has received their booster.

“The most important tool is ensuring everyone in the family—or whoever is gathering at the Thanksgiving table this year—is vaccinated,” Roberts said. “Other ways to maximize safety include masking during travel, avoiding large indoor congregate events, and taking rapid at-home COVID-19 tests if these are available.”

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.