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Booster Guidance

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New York State COVID-19 Vaccination Program Guidance Appendix A Individuals Eligible to be Vaccinated

Eligibility for Booster Doses of Pfizer-BioNTech COVID-19 Vaccine effective September 24, 2021:

The following individuals are eligible for a single booster dose of the Pfizer-BioNTech COVID-19 Vaccine six months after completion of the primary series:

  • individuals 65 years of age and older, and residents in long-term care settings
  • individuals 50-64 years of age with underlying medical conditions
  • individuals 18-49 years of age with underlying medical conditions, based on individual benefit and risks. (This can be based on shared clinical decision-making and encourages, but does not require, prior consultation with a provider before administration of a booster dose.)
  • individuals 18-64 years of age who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting, based on their individual benefits and risks.

For the purposes of booster dose eligibility, long-term care facilities include settings such as:

  • Nursing homes
  • Assisted living facilities
  • Residential care communities
  • Group homes
  • Senior housing

For the purposes of booster dose eligibility, underlying conditions include:

  • Cancer (current or in remission, including 9/11-related cancers)
  • Chronic kidney disease
  • Pulmonary Disease, including but not limited to, COPD (chronic obstructive pulmonary disease), asthma (moderate-to-severe), pulmonary fibrosis, cystic fibrosis, and 9/11 related pulmonary diseases
  • Intellectual and Developmental Disabilities including Down Syndrome
  • Heart conditions, including but not limited to heart failure, coronary artery disease, cardiomyopathies, or hypertension (high blood pressure)
  • Immunocompromised state (weakened immune system) including but not limited to solid organ transplant or from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, use of other immune weakening medicines, or other causes

Does not apply to those moderately to severely immunocompromised who are already covered under the eligibility for additional doses of the Pfizer-BioNTech or Moderna COVID-19 Vaccines 28 days after their second dose, as authorized by the FDA on August 12, 2021

  • Severe Obesity (BMI 40 kg/m2), Obesity (body mass index [BMI] of 30 kg/m2 or higher but < 40 kg/m2)
  • Pregnancy
  • Sickle cell disease or Thalassemia
  • Type 1 or 2 diabetes mellitus
  • Cerebrovascular disease (affects blood vessels and blood supply to the brain).
  • Neurologic conditions including but not limited to Alzheimer’s Disease or dementia
  • Liver disease

For the purposes of booster dose eligibility, ACIP gave the following examples as occupational and institutional settings

Eligibility for Additional Doses of Pfizer-BioNTech or Moderna COVID-19 Vaccines effective August 16, 2021:

For public health purposes, immunocompromised people who have completed a primary vaccine series (i.e., 2-dose mRNA vaccine series [Pfizer-BioNTech and Moderna] or single dose of the Janssen vaccine) are considered fully vaccinated ≥2 weeks aftercompletionoftheseries. However, anadditionaldoseof an mRNA COVID-19 vaccine after an initial 2-dose primary mRNA COVID-19 vaccine series, at least 28 days following the last dose of the primary COVID-19 vaccine series, should be considered for people with moderate to severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments. These conditions and treatments include but are not limited

to:

  • Active treatment for solid tumor and hematologic malignancies
  • Receipt of solid-organ transplant and taking immunosuppressive therapy
  • Receipt of CAR-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)
  • Moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome)
  • Advanced or untreated HIV infection
  • Active treatment with high-dose corticosteroids (i.e., ≥20mg prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory.

Factors to consider in assessing the general level of immune competence in a patient include disease severity, duration, clinical stability, complications, comorbidities, and any potentially immune- suppressing treatment.

The EUA amendment for additional doses is not intended for persons with chronic conditions such as diabetes or heart disease, for which there might be mild associated immunosuppression, nor for residents of long-term care facilities who do not otherwise meet the moderate to severe immunocompromised criteria.

Additional information about the level of immune suppression associated with a range of medical conditions and treatments can be found in general best practices for vaccination of people with altered immunocompetence, the CDC Yellow Book, and the Infectious Diseases Society of America policy statement, 2013 IDSA Clinical Practice Guideline for Vaccination of the Immunocompromised Host.

A patient’s clinical team is best positioned to determine the degree of immune compromise and appropriate timing of vaccination, provided at least 28 days have passed following the last dose of the primary COVID-19 vaccine series.

New York State COVID-19 Vaccination Program Guidance Appendix B

All individuals 12 years of age and older are eligible to be vaccinated. However, minors 12 through 17 are NOT authorized to receive the Janssen/Johnson & Johnson or Moderna COVID-19 vaccines. They may ONLY receive Pfizer-BioNTech at this time pursuant to the FDA EUA. Children under 12 years of age are not yet authorized to receive ANY COVID-19 vaccine.

It is important to verify the age of individuals who appear to be a minor to confirm eligibility and ensure the administration of the proper COVID-19 vaccine.

Proof of age should be requested but is not required where the parent or guardian is available to attest to the minor’s age. Documentary proof may include (but is not limited to):

  • Driver’s license or non-driver ID;
  • Birth certificate issued by a state or local government
  • Consulate ID
  • Current U.S passport or valid foreign passport
  • Permanent resident card
  • Certificate of Naturalization or Citizenship
  • Life insurance policy with birthdate
  • Parent/Guardian attestation

Minor Consent:

16 and 17-year olds:

For all minors, a parent or legal guardian must provide consent for vaccination. For minors 16 or 17 years of age, such consent should be provided either in person or by phone, at the time of vaccine appointment. Providers may elect whether to accept a written statement of consent from the parent or guardian, where the parent or guardian is not available by phone to provide consent to vaccinate an unaccompanied minor. The NYS COVID-19 Immunization Screening and Consent Form may be considered for this purpose.

12 through 15-year olds:

For minors who are 12 through 15 years of age, additionally, an adult caregiver should accompany the minor. If the adult caregiver is not the parent/guardian, the adult caregiver should be designated by the parent/guardian. The parent/guardian must still provide consent to the vaccination.

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Getting your COVID-19 Booster Dose:

Richmond University Medical Center is providing COVID-19 booster vaccine doses in accordance with all New York State Department of Health (NYS DOH) guidelines. To determine if you meet the most current eligibility requirements, please refer to the New York State website.

There are two ways to make an appointment:

·         Walk-ins will be accommodated based on vaccine availability. Appointments are highly recommended and will be given preference for vaccination.

·         To make an appointment, download the RUMC CARES App by clicking here.