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What on Earth Does ‘Fully Vaccinated’ Mean?

Do not get me wrong: I know what the CDC describes as the definition for fully vaccinated. However, this phrase has been utilized to encourage those who received the required number of vaccine doses to travel and see loved ones over the Thanksgiving holiday, even to congregate maskless indoors with relatives and friends who are also “fully vaccinated.”

And wow, did they travel! Airlines logged their busiest days since early 2020, with the TSA (Transportation Security Administration) screening about 2.5 million people on the Sunday after Thanksgiving alone.

From November 22 through November 28, some 14.4 million people passed through TSA, more than double the amount from a year ago, pre-vaccines.

The statistics concern me. These travel records occurred prior to the announcement that the world is dealing with a new and potentially frightening variant, Omicron.

But thinking back for a moment, how many Thanksgiving passengers were past full efficacy of their vaccines? How many of them, believing themselves to be “fully vaccinated,” might have had diminished immunity? Could they have been capable of serving as new vectors for coronavirus disease? If what has transpired in Israel, the UK, and European nations is a prelude to what will constitute our fifth COVID surge, then surely the definition of “fully vaccinated” should be examined and clarified by experts.

According to statistics, vaccine efficacy wanes over a period of months, which is the reasoning behind the need for booster injections. Data points vary, but according to one CDC study, Moderna’s antibody threshold wanes little in regard to protection against severe illness and hospitalization, whereas Pfizer vaccine recipients’ immunity fell from 91% to 77% during the same period.

Israel, once considered the most vaccinated country in the world, began authorizing boosters sooner than the United States, as the country experienced breakthrough infections among their vaccinated population. Since that time, world scientists have studied Israel for both infection rates as well as the national response.

Unfortunately, the United States did not follow the path forged by Israel. The FDA initially authorized boosters only for the immunosuppressed, and later for those over the age of 65 or people with comorbid conditions. At the time, I was concerned that we did not authorize booster shots for all adults, although the FDA eventually approved them by November 19.

As of this writing, CDC guidelines instruct anyone “18 and older to receive a booster shot as soon as six months has elapsed since their initial vaccination series.” Disease experts emphasize the importance of boosters even more by the fact that they encourage any type of booster shot, regardless of the original vaccine manufacturer.

Are we too late? Have we confused people with what the idea of “fully vaccinated” means? Time will tell, but the fact that cases have been rising dramatically in 39 states prior to Thanksgiving might give us a clue.

Are you fully vaccinated?

What does the phrase mean, 11 months after vaccines initially gained EUA? Is it one injection of J&J, two shots of Moderna or Pfizer, three shots for the immunosuppressed, or all the above plus a booster? It is time for epidemiologists around the world to specifically define what the phrase means. Not only for people wishing to fly and/or travel but for those who are too young, unwilling, or too hesitant to be vaccinated at all, so that everyone is clear regarding their choices for socializing and celebrations. As healthcare providers, let us provide clarity while diminishing confusion.

Another variant is knocking at our door, and there are millions of Americans who may be a potential host for the disease. According to recently published statistics, only 1 in 10 adults have received a booster injection, leaving millions with partial or diminished immunity.

We may be behind the eight ball, although we have the science to be better prepared. In the interim, let us be more accurate for the remainder of 2021. What does the phrase “fully vaccinated” mean?

It should mean to check the dates carefully on your vaccination card and receive a booster (if needed) before planning the next trip to see loved ones. Only then will you feel comfortable socializing maskless with those who have done exactly the same.

Be safe, be healthy, and enjoy the holidays!

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About Diane M. Goodman
Diane M. Goodman, BSN, MSN-C, APRN, is a semi-retired nurse practitioner who works from home contributing to COVID-19 task force teams and dismantling vaccine disinformation, as well as publishing in various nursing venues. During decades at the bedside, Diane worked in both private practice and critical care, carrying up to five nursing certifications simultaneously. Yet she is not all about nursing. She is equally passionate about her dogs and watching movies, enjoying both during time away from professional activities. Her tiny chihuahuas are contest winners, proving that both Momma and the dogs are busy, productive girls!

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