Governors Defy Federal Guidance, Expand Booster Eligibility to All Adults

Strategic Insights -

As the COVID-19 pandemic surges nationwide, a growing number of governors from both parties are opting out of federal guidance on coronavirus booster shots, paving the way for anyone over 18 to receive the vaccine. This dramatic shift in policy comes as federal officials continue to limit booster eligibility to specific age groups and high-risk individuals. California, Colorado, New Mexico, Arkansas, West Virginia, and New York City have all endorsed boosters for all adults, with more states expected to follow suit.

Key Takeaways:

  • California was the first to expand access to boosters, instructing local health jurisdictions and vaccine providers to trust patients to decide whether a booster is appropriate.
  • Colorado, New Mexico, Arkansas, West Virginia, and New York City have all endorsed boosters for all adults, citing increasing case numbers, waning hospital capacity, and overextended healthcare workers.
  • Several more states, including Kansas, Maine, Rhode Island, and Louisiana, have expanded booster eligibility to all fully vaccinated adults.
  • The Centers for Disease Control and Prevention (CDC) recommends booster shots for individuals 65 years and older, as well as adults 18 and older who are at a heightened risk of serious infection due to underlying conditions.
  • Local health officials, clinicians, and consumers are self-attesting to booster eligibility, often getting shots despite not meeting the federal guidelines.
  • States are leading the charge on booster expansion, with several state officials arguing that they are better positioned to make decisions about booster eligibility based on local case rates and hospital bed availability.
  • Federal officials are weighing the implications of state-level expansion, with some worrying that it could undermine the credibility of the FDA and CDC.

Statistics:

  • Over 18% of the US population has received a booster shot, with many more expected to follow as state-level expansion continues.
  • The number of COVID-19 cases surpassed 45 million in the US as of November, with hospitalizations near 100,000.
  • The CDC recommends a booster shot six months after receiving the second dose of Pfizer-BioNTech or Moderna vaccines.
  • Adults over 18 who received a single-dose Johnson & Johnson vaccine more than two months ago are eligible for a booster under the CDC recommendations.

Sources:

  • Katie Shepherd, "While federal officials continue to limit who can receive a coronavirus booster shot, a growing number of governors from both political parties and other officials are circumventing that guidance to offer boosters to anyone over 18 in hopes of staving off a spike in cases over the holidays."
  • Carolyn Y. Johnson, Laurie McGinley, and Lena H. Sun, "California, Colorado, and New Mexico are expanding access to COVID-19 boosters to all adults, despite federal guidance limiting eligibility."
  • Joe Goode, CVS Health spokesman, "We understand that some states may expand the criteria for COVID-19 boosters, but our participation in the Federal Pharmacy Program requires us to follow recommendations from the CDC."
  • Eric France, chief medical officer for the Colorado Department of Public Health and Environment, "We decided the state, as an institution, has a higher exposure for people in that institution."
  • David R. Scrase, Department of Health Acting Secretary for New Mexico, "Case counts are significant, spread rates are far too high, and the Delta variant is far more transmissible than previous variants."