Health officials in California want everyone 18 and older to get COVID-19 booster shots ahead of the holiday season. But there is still widespread confusion about who can book an appointment and how.
That’s because most online vaccination scheduling systems — including the state’s MyTurn appointment site — still show the specific eligibility categories to receive a booster dose that were in place before state and county officials last week began encouraging booster shots for all.
Those categories follow federal guidelines from the Centers for Disease Control and Prevention. The standard says shots are available to those who are 65 and older; people who got the Johnson & Johnson vaccine; and any adult 18 and over with underlying health conditions or who works or lives in a high-risk setting.
People who do not tick one of those boxes are unable to book appointments.
The California Department of Public Health website says booster eligibility is now open to anyone 18 and older, six months after full vaccination with the Pfizer or Moderna vaccines, or two months after the J&J vaccine.
San Francisco made it official locally, saying that no one who feels at risk of exposure to the coronavirus would be turned away if they request a booster dose; other Bay Area counties have similarly lined up on the issue.
State officials said the MyTurn scheduling site will be updated Wednesday to reflect the new recommendations. Until then, officials suggest that people speak to their provider or find a walk-in clinic to get a booster dose.
“If you think you will benefit from getting a booster shot, I encourage you to go out and get it,” Dr. Mark Ghaly, the state’s health secretary, said last week. “Supply is available.”
Until the change that’s promised on Wednesday, people using the MyTurn.ca.gov site or clinic attestation forms who do not qualify under the older criteria will have to lie and say they fall into one of the eligible categories to secure an appointment slot.
The state is also directing pharmacies and other providers to “not turn away a patient” who says they are at high risk.
The health department on Monday said its messaging “is simplified to help empower more Californians to get a booster.” State officials said the guidance was based on the CDC’s provision that people ages 18 and older may get a booster based on individual risk and benefits, though the state appears to use a more permissive reading of the agency’s actual criteria.
The muddiness carries over into counties where public health officials typically try to follow state guidelines. While some Bay Area counties have announced they will open the booster doors to everyone over age 18, others are holding off.
Health care providers similarly have taken differing approaches to the state’s new verbal directive.
More than 80% of the state’s vaccinated residents received their shots more than six months ago, and fewer people have received booster shots than anticipated. Public health experts fear that waning immunity will lead to a winter surge, putting a strain on the state’s hospital system.
“Booster uptake has been abysmal,” said Peter Chin-Hong, an infectious disease specialist with UCSF.
While vaccines are still effective in preventing most severe COVID-19 outcomes, waning immunity may contribute to virus spread and an increase in breakthrough cases.
Nationwide, about 15% of fully vaccinated individuals have received a booster shot since they were approved in August, the CDC says. Two other states — Colorado and New Mexico — and New York City have also expanded access to booster doses for all adults.
California health officials wrote Tuesday to providers and local health departments, instructing them to “proactively” reach out to eligible groups to encourage boosters.
In a follow-up roundtable with health care professionals, state epidemiologist Dr. Erica Pan emphasized they should not turn away any people who want a booster as long as they meet the simplified, broadened criteria.
But there is still no uniform approach, with county officials acknowledging providers may not yet have shifted procedures to the new booster open door.
Kaiser says it is following CDC and California guidance. It appears to be taking the new broad approach suggested by California’s top health officials:
“Members who indicate that they meet the booster criteria are welcome and encouraged to book an appointment online or by calling our appointment and advice call centers,” Kaiser said in a statement on Monday.
San Francisco and Sonoma County announced Friday they would open up booster eligibility to anyone 18 and older who completed their COVID-19 vaccination series at least six months ago. San Francisco has not updated its website, but officials say that will happen this week. It currently lists eligibility for only high-risk groups.
Recently rising cases could mean hospitalization for the vulnerable, even some who are vaccinated, noted Dr. Grant Colfax, the city’s health officer.
“We have been stressing that boosters are essential for higher-risk individuals, but now it’s become apparent that we need many more people to receive a booster dose so that we can protect ourselves, our families and friends, and our community,” he said.
Alameda County officials also said no one should be turned away “if they have made a determination for themselves that they are eligible for a booster.” But they cautioned that some providers might need more time to adjust to the new guidance.
Santa Clara County officials last week expressed a similar urgency for all to get boosters.
“Our top-line message is we really encourage everyone to get out and get their booster shot,” said Dr. Sara Cody, the county’s health officer. “Pretty much everybody in our population is eligible.”
Contra Costa County, in tune with the state’s new language, says it will “provide boosters to anyone ages 18+ who feels they are at increased risk from COVID-19 and wants one,” wrote county spokesperson Karl Fischer in an email.
San Mateo County health department spokesman Preston Merchant also acknowledged the state’s shift, saying county residents now can self-determine their risk, and thus their eligibility for a booster.
Sonoma County directs people to make appointments with their primary care physicians and pharmacies, noting that county clinics have limited supplies. The county reiterated that guidance, and also pointed to the MyTurn website as an avenue for appointments, when asked how people can bypass booster eligibility requirements that remain on some vaccine portals.
Solano County updated its vaccine website to include the expanded eligibility for all over 18 and said booster shots are available at the Solano County Fairgrounds mass vaccination site Wednesdays through Saturdays.
Marin County also is broadening eligibility so that no one 18 or older will be turned away for a booster provided they meet the appropriate time lag since their initial shots, and noting some providers may not yet be reflecting the change.
Napa County did not respond Tuesday to questions about whether its policy had updated.