The definition of “fully vaccinated” could soon be updated to require three shots.
The CDC and other organizations are considering changing the definition of the term “fully vaccinated” in light of the surging omicron variant. The current COVID-19 vaccines are less effective against omicron than delta or other COVID variants, and protection from the vaccines also decreases over time, particularly after 6 months.
Recent evidence demonstrates that booster shots are needed to protect against infection from the new omicron variant. On Monday, the FDA expanded the authorization of boosters of Pfizer’s COVID-19 vaccine to include children aged 12 to 15.
“Breakthrough cases” of COVID in people who’ve completed two shots of the Moderna or Pfizer vaccines or one shot of the Johnson & Johnson vaccine have become increasingly common. On Monday, NBC New York reported that the rate of breakthrough infections in the state was five times higher for the last week of December than it was during the first. On ABC’s This Week on Sunday, New York City Mayor Eric Abrams said that he is considering implementing a booster mandate for teachers, police and other city workers.
Public health officials are also discussing whether the term “fully vaccinated” should be modified to include boosters. In December, on CNN, Dr. Anthony Fauci, chief medical adviser to President Joe Biden, said that it was a matter of “when, not if” the definition of “fully vaccinated” would be updated to include boosters.
However, the CDC hasn’t changed its definition yet. Its COVID-19 booster page states, “Everyone is still considered fully vaccinated two weeks after their second dose in a two-shot series, such as the Pfizer-BioNTech or Moderna vaccines, or two weeks after a single-dose vaccine, such as the J&J/Janssen vaccine.” Similarly, Chicago’s vaccine requirements that went into effect Monday also define fully vaccinated as two shots of Modern or Pfizer or one shot of J&J.
At the White House COVID-19 press briefing last Wednesday, CNN’s Jeremy Diamond queried CDC Director Dr. Rochelle Walensky: “Should those people who are more than six months from their second mRNA dose or two months from J&J no longer consider themselves to be fully vaccinated?”
Walensky sidestepped the question, saying, “our CDC guidance has been very clear that people should get their boost when they are eligible.” In regard to fully vaccinated people who haven’t been boosted, Walensky continued, “We do know that they do have some protection against severe disease and death, but that they do have quite a bit of waning with regard to protection against infection. And since these are guidelines for quarantine, we really wanted to have those measures in place since they have had quite a bit of waning protection against infection.”
US government agencies haven’t made the official change, but many colleges, businesses and the NFL are already requiring boosters. The NFL announced that all media covering the NFL playoffs or the Super Bowl will need to have received a booster shot for COVID-19 starting Jan. 14. The NFL also mandated booster shots for coaches and staff (but not players) last month.
Colleges and universities aren’t waiting either. In November, Wesleyan University in Connecticut became the first college to make boosters mandatory for students, starting in 2022. Several other northeastern colleges quickly followed suit, including Syracuse University, Harvard University and all of the Ivy League schools. California and Oregon universities on the West Coast soon followed suit.
On New Year’s Eve, New York Governor Kathy Hochul announced that all students of SUNY and CUNY colleges in New York State must be boosted to return to campus, starting Jan. 15.
Here’s what we know today about why the definition of fully vaccinated may change to include booster shots. For more, here’s the latest on the Moderna booster shots, what you need to know about the Pfizer antiviral pill, and how to pick between the vaccine boosters.
While two doses of the Moderna or Pfizer vaccine combined with a booster shot doesn’t provide complete protection from a COVID-19 infection, the vaccines offer a sturdy defense against catching the virus and suffering serious illness. Walensky on Wednesday said an unvaccinated person has a 10 times higher risk of testing positive for COVID-19 and a 20 times greater risk of dying when compared with those who are vaccinated and boosted.
According to the CDC, you’re fully vaccinated two weeks after you receive the second dose of the Moderna or Pfizer vaccine, or two weeks after a single dose of Johnson & Johnson’s vaccine.
The CDC also considers you fully vaccinated if you received any single-dose vaccine listed for emergency use by the World Health Organization or any combination of the two-dose vaccines approved by the FDA or listed by the WHO for emergency use.
However, that might change soon. “We’re looking into the definition right now,” CDC Director Walensky said during a White House briefing about changing how the agency defines “fully vaccinated.”
“That evaluation is currently underway,” she said. “But to be very clear, our recommendations are to get boosted.”
Dr. Anthony Fauci, chief medical adviser to President Joe Biden, was asked on MSNBC if the definition of fully vaccinated would be updated to include boosters shots. His answer? “You know, it very well might.”
This month, as preliminary studies showed omicron’s ability to infect those who are considered fully vaccinated, the definition began shifting, if not formally, then practically, from two doses of the Pfizer and Moderna COVID vaccine to three.
“As far as I’m concerned — I make it very clear — if you want to be optimally protected, get boosted,” Fauci said on CNN’s State of the Union, when asked if three shots will become the standard.
Robert Wachter, chair of the University of California at San Francisco’s department of medicine, said he thinks the definition change is coming soon.
“It’s increasingly clear that if you have three shots, you’re in pretty good shape,” Wachter said during an online discussion about COVID-19 hosted by the San Francisco Chronicle on Dec. 10.
“I think we will stop calling people with two shots fully vaccinated within a week or two,” he said. “Omicron is going to make that case quite vividly.”
How many shots to be protected from omicron?
If two doses of the Moderna or Pfizer COVID-19 vaccine are not enough to guard against omicron, would we need a variant-specific booster to restore protection? According to Fauci, no. “At this point, there is no need for a variant-specific booster.”
But getting from the two-dose definition to three will take work. The CDC says almost 206 million people right now are “fully vaccinated” with the Moderna, Pfizer or Johnson & Johnson vaccines. That’s 62% percent of the total US population. However, only 68 million in the US have received a booster — 33% percent of the “fully vaccinated” or a little more than 20% of the total population.
“That’s why getting more Americans vaccinated and boosted is central to the president’s plan to fight COVID and confront omicron this winter,” Jeff Zients, the White House coronavirus response coordinator, said during Wednesday’s White House briefing.
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On Dec. 16, the CDC recommended the mRNA vaccines
from Moderna or Pfizer instead of Johnson & Johnson’s viral vector vaccine. The recommendation came a few days after a preliminary study out of South Africa suggested the Johnson & Johnson COVID vaccine may produce “virtually no antibody protection” against omicron, Bloomberg News reported. The CDC’s preference for mRNA vaccines also applies to booster shots.
CNET reached out to Johnson & Johnson for a comment but didn’t get a response.
Vaccine makers are already pushing for three doses as the new standard. “Although two doses of the vaccine may still offer protection against severe disease caused by the omicron strain, it’s clear from these preliminary data that protection is improved with a third dose of our vaccine,” Pfizer Chairman Albert Bourla said in a statement on early results about the Pfizer vaccine’s continued effectiveness.
The next step would be for the CDC to change its definition of what it means to be fully vaccinated. The CDC has continued to define “fully vaccinated” as two shots of the mRNA vaccines or one dose of Johnson & Johnson’s.
And will there be a fourth shot? Israel has already started rolling out a fourth vaccine shot for people over 60, medical workers, and people who are immunocompromised. On Monday, the country began a world-first study on the effectiveness of a second booster shot, testing 150 health care workers at the Sheba Medical Center. According to Reuters, a spokesman says the study “will zero in on efficacy of the vaccine in producing antibodies, and safety, in order to ascertain if a fourth vaccine is needed in general.”
In the White House press briefing Wednesday, Fauci stressed the importance of first collecting and analyzing data from the third shot before considering a fourth shot. Fauci said, “It is conceivable that in the future we might need an additional shot, but, right now, we are hoping that we will get a greater degree of durability of protection from that booster shot.
For more, here’s what we know about the omicron variant and how the new mutation compares with delta. And here’s how to store your vaccine card on your phone.
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
