Norris Cunningham

Remember the confusion over who was eligible for the COVID-19 vaccine and when? Remember the confusion over the COVID-19 vaccine mandates? Remember the confusion over the approval for the COVID-19 booster shots?  Well, the confusion does not stop there.  

Up to date vs. fully vaccinated

What is considered “fully vaccinated”?  According to the Centers for Disease Control and Prevention, you are considered “fully vaccinated” two weeks after you get a second dose of an mRNA COVID-19 vaccine (Pfizer or Moderna) or two weeks after you get a single dose of the Johnson & Johnson COVID-19 vaccine.

What is meant by “up to date”?  It depends.  According to the CDC, you are up to date with your COVID-19 vaccines when you have received all doses in the primary series (i.e., you are “fully vaccinated”) and all boosters recommended for you, when eligible.  In other words, you are considered “up to date” if:

  • You have completed your primary series but are not yet eligible for a booster;
  • You have received one booster but are not recommended to get a 2nd booster;
  • You have received one booster but are not yet eligible for a 2nd booster; or
  • You have completed your primary series and 2nd booster

Currently, the CDC recommends everyone ages five years and older get one booster after completing their COVID-19 vaccine primary series.  The CDC also recommends that adults ages 50 years and older, or people ages 12 years and older who are moderately or severely immunocompromised, receive two boosters.  Notably, healthcare workers who are not 50 years and older or immunocompromised are not eligible to receive a second booster.

How does this affect facility staff?
Angela Rinehart

As LTC facilities now know, the Centers for Medicare and Medicaid Services promulgated a rule that requires long-term care and other healthcare facilities to require their staff to be vaccinated against COVID-19 as a requirement for participating in the Medicare and Medicaid programs.  But does this require facility staff to be “fully vaccinated” or “up to date”?  

Per the language of the rule, compliance requires 100% of staff to have received the necessary doses to complete the vaccine series (i.e., one dose of a single-dose vaccine or all doses of a multiple-dose vaccine series) or have been granted a qualifying exemption.  This does not require boosters. 

With boosters not required per the CMS rule, and many nurses not yet eligible for a second booster, that begs the question: why is this time any different?  As you will recall, healthcare personnel were the very first group initially eligible for the COVID-19 vaccine.  Healthcare workers were also the first to be eligible for the first booster when it was approved.   

Now, healthcare workers who are under 50 years of age and who have worked on the frontlines of the pandemic are several months out from their initial booster dose.  Recently, National Nurses United called upon the CDC to approve a second COVID-19 booster for healthcare workers for that very reason.  For healthcare workers who wish to be “up to date” on their COVID-19 vaccines, this appears to make sense.

For now, just as with initial vaccination before the mandate, administrators and facility leadership should encourage staff to be “up to date” on their COVID-19 vaccines as opposed to “fully vaccinated” to prioritize not only their health and safety but the health and safety of the residents they are caring for daily.

Norris Cunningham is a founding shareholder and leads the Health Care Practice Group at Katz Korin Cunningham PC (KKC) in Indianapolis. Contact him at [email protected]

Angela Rinehart is an associate attorney in the Health Care Practice Group at KKC and focuses her practice on the defense of long-term care providers. Contact her at [email protected].

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.