SAN FRANCISCO (CBS SF/BCN) — A number of Bay Area public health departments on Friday expanded eligibility requirements for the COVID-19 booster to all adults over the age of 18.

The decision comes after the state directed that anyone requesting a booster should not be turned away.

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California Public Health Officer Dr. Tomas Aragon sent a letter to local health care providers saying they should allow patients to “self-determine their risk of exposure” if seeking a booster dose. He also highlighted that adults who received their second vaccine dose with Pfizer-BioNTech or Moderna more than six months ago, or their single Johnson & Johnson vaccine dose more than two months ago are eligible.

“The patient’s assessment of risk exposure may include, but is not limited to, those who work with the public or live with someone who works with the public, live or work with someone at high risk of severe impact of COVID, live in geographic areas that have been heavily impacted by COVID, reside in high transmission areas, live in a congregate setting, experience social inequity or other risk conditions as assessed by the individual,” Aragon said in the letter.

In addition, health care providers are to still encourage those who are 65 and older, have underlying medical conditions and those who received the J&J vaccine to seek boosters.

California’s decision to expand eligibility to all adults goes beyond the recommendations from U.S. Centers for Disease Control and Prevention. Originally, boosters were suggested only for people age 65 and older and adults who live in long-term care settings, have underlying medical conditions or who live or work in a “high-risk setting.”

In the Bay Area, public health officials consider the federal definition of a “high-risk setting” vague. Residents are encouraged to talk to their health care provider should they have any questions on what qualifies.

“If you look at the CDC guidelines, and you drill down to the various groups, what you end up with is the recognition that pretty much everybody is eligible,” Santa Clara County Public Health Officer Dr. Sara Cody said in a briefing Wednesday. “There were two main groups for whom the (booster) vaccine was really urged – the 65-and-ups, (people) living in a long-term care facility, et cetera, et cetera – but I think what the public heard was ‘I have to be 65 otherwise I shouldn’t get a booster,’ and that’s not correct.”

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Officials in multiple counties have also said it’s unclear whether residents have even been turned away when seeking a booster dose.

When the county updated the booster eligibility on Friday, a spokesman for Contra Costa Health Services said that data was unavailable for people seeking boosters who were turned away. The vaccination clinic staff have only asked recipients to self-attest their risk.

Public health officials have also noted that booster vaccine uptake has not been as widespread as that of the initial vaccine series.

Cody said only about 20 percent of the roughly 1 million Santa Clara County residents eligible for a booster dose have received one.

“I think there’s been quite a bit of complexity,” in the booster rollout, she said. “And that’s why we want to boil it down now and make it quite simple and let the public know that pretty much everybody is eligible for a booster, and there’s lots of benefit from a booster.”

Below are links to county and state websites with information on how to sign up for vaccinations. However, many counties have yet to update their websites.

There are also direct links to some pharmacies and hospitals offering boosters for adults vaccinations for children. Doctors and pediatricians have also been approved to administer booster shots and the Pfizer child vaccine for children age 5-11.

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