September 27, 2021

Booster Shots: Workers in High-Risk Jobs Are Now Eligible

Stephen Massey
Managing Director, Health Action Alliance

CDC says boosters are not required to be "fully vaccinated."

Late last week, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) recommended certain populations receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least six months after receiving their second dose. On Friday, the CDC Director endorsed that decision and also recommended a booster dose for people whose jobs put them at high risk of COVID-19 exposure.

The Food and Drug Administration (FDA) had previously listed healthcare workers, teachers and daycare staff, and grocery workers as among those frontline workers whose occupational exposure puts them at high risk of COVID-19 exposure. However, the CDC said the data does not support that everyone who falls into this group should get a booster shot. Instead, booster shots are available to people in this category if they would like to get one. People should make that determination based on their individual benefits and risks.

That’s a lesser degree of recommendation than the CDC made for other groups. For example, it said people 65 years and older and residents in long-term care settings should receive a booster shot, as should people aged 50 to 64 with certain underlying medical conditions. People ages 18 to 49 with underlying medical conditions, and people ages 18 to 64 whose jobs put them at high risk of exposure and transmission may receive a booster shot. 

CDC’s recommendations do not change the definition of “fully vaccinated.” People are still considered fully vaccinated two weeks after their second dose of a 2-shot series, such as the Pfizer-BioNTech or Moderna vaccines, or two weeks after a single-dose vaccine, such as the Johnson & Johnson vaccine. This definition applies even to immunocompromised people who receive an additional dose.

Further, people will not have to show a doctor’s note or proof of any kind that they are eligible to receive a booster shot. Individuals can self-report that they are eligible and receive a booster shot wherever vaccines are offered. The White House COVID-19 Response Team estimates that up to 20 million Americans are eligible today to receive the booster shot.

What it means for employers

  • Even while making recommendations for boosters, the CDC reiterated that the top priority is getting unvaccinated people fully vaccinated. Employers should continue to encourage vaccination and facilitate access to the vaccines.
  • As employers continue to share facts about COVID-19 vaccines, it is important to note that they are still working well to prevent severe illness, hospitalization and death, even against the Delta variant. A booster shot provides continued protection for people who are at high risk of exposure.
  • Employers who have a workplace vaccination requirement should not need to update their policies to require booster shots at this time. The CDC’s definition of “fully vaccinated” has not changed. 
  • Employers should consider providing paid time off for a booster shot appointment and recovery to workers who are eligible to receive the booster.

Additional questions employees may be asking

Q: If the vaccines work, why should anyone need a booster?

A: For adults ages 65 and older, vaccines remain effective in preventing hospitalization and severe disease, but recent evidence suggests they are less effective in preventing infection or milder illness. And while vaccine effectiveness against severe disease remains high for healthcare personnel and other frontline workers, those with even mild illness often cannot do their essential work.

Q: If I received the Moderna or Johnson & Johnson vaccine, can I get a booster? Am I at risk without one?

A: The CDC is bound by what the FDA has authorized. So far, the FDA’s booster authorization only applies to the people who received the Pfizer-BioNTech vaccine. More data on the effectiveness and safety of Moderna and Johnson & Johnson booster shots is expected in the coming weeks. But all the vaccines remain safe and effective. And nearly all the cases of severe disease, hospitalization, and death from COVID-19 occur among those not yet vaccinated.

Q: What are the risks of getting a booster?

A: Reactions to the third shot of the Pfizer-BioNTech vaccine have been reported to be similar to those felt after the first two shots. Fatigue and pain at the injection site were the most commonly reported side effects, and overall, most side effects were mild to moderate.

Q: Do I need to show proof that I am eligible for a booster shot?

A: No. Individuals can self-report that they are eligible for a booster and receive one wherever vaccines are offered. No doctor’s note or proof of employment as a frontline worker is required.