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Being ‘up to date’ on COVID vaccine now includes a booster, CDC says


The Centers for Disease Control and Prevention on Wednesday said it was not changing its definition of full vaccination against the coronavirus. But the agency changed its emphasis on the appropriate regimen, tweaking how it referred to the shots.

By Noah Weiland and Emily Anthes


The Centers for Disease Control and Prevention last week said it was not changing its definition of “full vaccination” against the coronavirus. But the agency changed its emphasis on the appropriate regimen, tweaking how it referred to the shots.


The agency said that three doses of Pfizer’s or Moderna’s vaccines should be considered “up-to-date” inoculations, and that Johnson & Johnson recipients should receive a second dose, preferably of Moderna or Pfizer, to also be considered up to date.


The move indicated a shift in how federal health officials think Americans should talk about vaccination schedules. Later on Wednesday, the CDC expanded its recommendation for booster shots to include all Americans 12 and older.


“Consistent with how public health has historically viewed or even talked about how we recommend vaccines, we are now recommending that individuals stay up to date with additional doses that they are eligible for,” Dr. Rochelle Walensky, the CDC director, said at a White House news briefing Wednesday.


The CDC did not change the definition of what qualifies as full vaccination — a subject of intense interest to corporations, schools, state health departments and professional sports leagues, which have been reconsidering what it means to be fully vaccinated.


“The technical definition of ‘fully vaccinated’ — two doses of an mRNA vaccine or one dose of the J&J vaccine — has not changed,” Kristen Nordlund, a CDC spokesperson, said in a statement. “Individuals are considered fully vaccinated once they have received their primary series.”


She added that the agency recommend that people “stay ‘up to date’ by receiving any additional doses they are eligible for, according to CDC’s recommendations, to ensure they have optimal protection.”


Federal officials have typically referred to people as fully vaccinated two weeks after a first dose of Johnson & Johnson or a second dose of the Moderna and Pfizer vaccines. While studies have showed that protection against infection has waned in fully vaccinated people and can be strengthened by a booster, two doses still offer strong protection against severe COVID-19 — the true goal of vaccination, some vaccine experts have argued.


It is still unclear what practical effect or influence the change will have on institutions. Many schools, businesses and governments have relied on the CDC’s definition of “fully vaccinated” to establish mandates, requiring people to complete a two- or one-dose series in order to go to school, eat at a restaurant or stay employed.


The move Wednesday, Nordlund said, was intended to make COVID-19 vaccines “align with standard language CDC uses about other vaccinations.” It also accounted for differences in eligibility for booster shots, since younger adolescents and children are not yet recommended by the CDC for booster doses. Some people are also still not five months out from receiving a second dose of the Pfizer vaccine, six months from a second dose of Moderna or two months from a first dose of Johnson & Johnson, the authorized intervals for boosters.


Top federal health officials, including Dr. Anthony Fauci, had pushed the administration to change in any way it could how it discussed vaccine schedules, arguing that the Pfizer and Moderna shots in particular should be considered three-dose vaccines. But some officials wanted to avoid altering what is formally considered a full vaccination schedule.


That change could have carried significant legal implications, potentially intensifying challenges to vaccination requirements, as the Biden administration’s attempt to mandate that large employers require employees to be vaccinated is already bogged down in the courts.


“If you think about the different requirements,” Jeffrey Zients, the White House COVID-19 response coordinator, said at the Wednesday news briefing, “that has not changed, and we do not have any plans to change that.”

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