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Colorado’s COVID-19 incidence rate prompts expansion of booster shot eligibility

The change means anyone far enough from initial vaccination over age 18 is eligible for a COVID-19 booster shot

Every county in Colorado except Lincoln County on the Eastern Plains is considered high risk for transmission of COVID-19 by the Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention/Courtesy

Colorado health officials are asking vaccine providers to offer booster shots to anyone above age 18 — a much broader group than previously approved for the boosters — because of the state’s high incidence of COVID-19.

With just 7% of the state’s intensive care beds available, the Colorado Department of Public Health and Environment sent a letter to vaccine providers Wednesday asking to give a booster dose to anyone far enough out from their initial vaccine regimen to be eligible for the shot.

“With the high risk of exposure in Colorado, it is our hope that everyone receives a booster six months after Moderna or Pfizer and two months after (Johnson & Johnson),” Scott Bookman, the state health agency’s COVID-19 incident commander, said in a letter to vaccine providers.



“Consultation by the state’s chief medical officer with the (Centers for Disease Control and Prevention) confirms that offering the vaccine to anyone in the state who is over 18 and is due for their booster is allowed given the high rate of disease transmission in Colorado,” the letter continues.

Colorado’s incidence rate per 100,000 people was third highest in the U.S. on Wednesday, according to The New York Times COVID-19 tracker. The only states with higher incidence rates were Alaska and North Dakota.



The broad expansion of booster eligibility is an attempt to curb surging case rates across the state that have hospital capacity strained. While 79% of people in Colorado hospital beds are unvaccinated, boosters hope to slow an increase in hospitalizations that state officials predict might not peak until the end of the year.

Across the United States, about 69% of counties are considered high risk by the Centers for Disease Control and Prevention, which means they are averaging 100 or more cases of COVID-19 per 100,000 people in a week.
Centers for Disease Control and Prevention/Courtesy image

On Oct. 21, the CDC gave emergency-use authorization for booster shots made by Moderna and Johnson & Johnson. Pfizer-made boosters had previously earned the authorization.

These approvals were for just a limited group of people, specifically those over age 65, and people who are older than 18 and either at high risk for a severe case of the virus because of underlying health conditions or whose job frequently exposes them to the virus.

But Bookman’s letter says the CDC’s authorization allows for much broader administration of the vaccine that would “essentially include everyone in a state with high risk of exposure like ours.”

Out of the 3,209 counties in the U.S. reporting data to the CDC, 2,222 of them, or 69%, are currently considered high risk for community transmission of the virus. The CDC’s standard for high risk is 100 or more cases per 100,000 people over the past seven days. Lincoln County, on the state’s east side, is the only Colorado county not considered high risk for transmission per the CDC.

“Nobody should be turned away from receiving a booster dose,” Bookman wrote.

The letter also explains changes to the state’s public health order on vaccine access and reporting structures to require providers administer booster doses of the vaccine to people regardless of where they got prior doses and allows people to self-attest to being eligible.

Routt County Public Health Director Roberta Smith said the booster expansion was brought up on a meeting with state health officials last week with the state’s chief medical officer, Eric France, signaling the change.

The state health agency issued a COVID-19 public health advisory Friday that also said booster eligibility would be expanded.


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