What does it mean to be “fully vaccinated” against Covid-19?
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As the evidence grows that the Delta and Omicron variants of the coronavirus are causing groundbreaking infections in people who were once thought to be “fully vaccinated,” momentum seems to be building to change the definition of that term in order to ” include booster injections.
Some workplaces and college campuses now require immunizations to include boosters. The New York governor has said state officials plan to change the definition of “fully vaccinated” to include receiving a booster dose, and the UK government will not be far behind. The NFL last week issued a recall mandate for team staff members who work closely with players.
And speculation is growing that we may need to source boosters regularly in the years to come as new variants emerge.
A few months ago, confirming full immunization status was as easy as showing a card or QR code with proof that the required number of vaccines had been completed within six months. But in a world of multiple vaccines with varying efficacy and a variety of mixing and pairing strategies, it will soon be more difficult to tell who is “fully vaccinated”.
A consensus will eventually emerge. But here’s what some health experts had to say as another year of life with the pandemic drew to a close.
What is the official definition of “fully vaccinated”?
For now, US health officials say you are fully vaccinated two weeks after your second injection of a two-dose vaccine like that from Pfizer or Moderna or after a single-dose vaccine like that from Johnson & Johnson. They have not (yet) expanded this definition to include a booster injection.
During a White House press briefing on Wednesday, Dr Rochelle Walensky, director of the Centers for Disease Control and Prevention, said the agency “continues to monitor” the science around Omicron before deciding to expand the definition. However, the agency recommends that people receive booster shots.
The same goes for Dr Anthony S. Fauci, the country’s leading infectious disease expert, who said at the same press briefing: “If you are not vaccinated, get vaccinated. And especially in the Omicron arena, if you are fully vaccinated, get vaccinated.
Other countries, such as Britain and South Africa, also do not require boosters for a person to be considered “fully immunized”.
It was always going to change.
When it became clear that the immunity conferred by the first rounds of vaccines was waning, Israel announced in October that it would make a booster dose a requirement for its vaccination passport. We thought it was the first country to do so, but it would not be the last.
In late November, just ahead of Omicron’s accelerated recall programs around the world, the European Union began discussing adding a nine-month expiration date to its digital certificates, a move it has made. officially adopted this week.
Some of the EU member countries, like Austria, had already adopted an expiration date for their residents. In France, where certificates expire seven months after a second dose, all adults have until January 15 to receive a reminder, or their passes will no longer allow them access to places like restaurants and museums.
Do I need a reminder to fend off Omicron?
Early research indicates that the Omicron variant is somewhat less vulnerable to the body’s immune defenses. Booster shots help boost your antibody response, said Michel Nussenzweig, an immunologist at Rockefeller University in New York.
So, yes, you should get that extra jab, said Dr. Jesse L. Goodman, former chief scientist with the Food and Drug Administration.
“This booster dose has really better protected people against Delta,” he said. “Even without Omicron, there are good reasons to get the booster dose.”
You can still get infected even after a booster, but the vaccine will likely protect you against serious illness or death, he said.
The coronavirus pandemic: what you need to know
How effective is being “fully vaccinated” at this stage?
“It depends on what you’re trying to prevent,” said Dr Celine Gounder, an infectious disease specialist at Bellevue Hospital Center who previously advised the Biden administration.
A booster is more effective than the first two injections in preventing hospitalization or death, she said.
Many US public health experts continue to say that the two-dose regimen of Pfizer-BioNTech or Moderna will protect most people from serious illness or death, like vaccines are supposed to. A preliminary study in South Africa showed that two doses of the Pfizer vaccine were 70 percent effective against hospitalization, which is part of the first evidence cited by those supporting the boosters.
The first two doses were effective against the Delta variant infection, but it is not yet known how well they work against Omicron, said Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia. and Advisor to the Food and Drug Administration.
“If the goal is protection against any form of disease, then two doses of the current mRNA vaccine will not protect you as well against mild disease,” he said.
If the definition changes, how does it work?
Like so many since the start of the pandemic, expect a time of confusion as a patchwork of local, national and international governments evolve at different speeds. Any place that has so far required proof of vaccination – offices, schools, airlines, concerts, sporting events, entire countries – will likely soon be faced with questions about how and when to change admission rules.
Businesses already face uncertainty amid challenges with existing immunization mandates, and the addition of boosters along with the rapidly increasing number of cases has further complicated matters.
At BlackRock, an investment management firm, the vaccination requirement at its New York City offices has not evolved to include booster injections, Brian Beades, a spokesperson for the company, said on Monday. But, as with immunization policies around the world, he said, “people are thinking of new considerations all the time.”
Elian Peltier contributed reports.
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