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CDC and FDA Approve Second COVID-19 Boosters

On April 1st, the Department of Health (DOH) issued updated guidance for vaccination providers recognizing Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) approval of second COVID-19 boosters. The guidance includes the following additions:

  • People ages 12 and older who are moderately or severely immunocompromised may choose to receive a second booster dose using an mRNA COVID-19 vaccine at least four months after the first booster dose.
  • All adults ages 50 and older, regardless of health status, may choose to receive a second booster dose using an mRNA COVID-19 vaccine (Moderna and Pfizer-BioNTech) at least four months after the first booster dose.
  • People ages 18 to 49, regardless of health status, who received Janssen/Johnson & Johnson’s (J&J) COVID-19 vaccine as both their primary series dose and booster dose may receive a second booster dose using an mRNA COVID-19 vaccine at least four months after the first Janssen booster dose.
  • Clarification of safety issues, including those related to multisystem inflammatory syndrome in children (MIS-C) and adults (MIS-A) and myocarditis.
  • Update on the availability of Moderna COVID-19 vaccine supplied in a vial with a blue cap (0.5 mL dosage volume) for administration of a 50 µg booster dose. The red cap vial is still available (0.25 mL dosage volume).

The vaccination regulations for nursing homes and adult care facilities (ACFs) require facilities to offer all consenting, unvaccinated existing personnel and residents an opportunity to receive the first or any recommended next or booster dose of the COVID-19 vaccine. The Department has not issued specific guidance regarding second boosters, but it appears that the regulations require the offering of any additional doses or boosters to staff and residents. Staff and residents are not required to receive the second booster. 

With regard to routine testing of staff and the second boosters, the Centers for Medicare and Medicaid Services' (CMS) “up-to-date” term means that an individual has completed a primary series of COVID-19 vaccination and received one booster dose when eligible. As such, nursing homes are not required to include in routine staff testing those staff who have not received their second booster, regardless of eligibility. More on what it means to be up-to-date with COVID-19 vaccination is available from the CDC here, and a LeadingAge National article on the issue is available here.

Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871