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Aug 20 2021

Back-to-School Update: Vaccine Eligibility, Boosters, and Mitigation

School bells are ringing across the nation, and this year's back-to-school preparations are likely to include supplies that go beyond traditional things like notebooks, pens, and lunchboxes. For the second year in a row, parents, students, teachers, and staff members will need to include precautions related to the COVID-19 virus. As school districts across the country, along with colleges and universities, finalize protocols and practices, pharmacists will continue to serve as leading sources of information, vaccines, prescriptions, and approved treatments.

Late-August guidance from the Centers for Disease Control (CDC) included critical information on key COVID-related topics including:

  • Vaccine eligibility and availability. Everyone 12 years of age and older is eligible to receive a COVID-19 vaccination. According to the CDC, "children 12 years and older are able to get the Pfizer-BioNTech Covid-19 vaccine." Children between the ages of 2 and 12, who are not eligible to receive a COVID-19 vaccine, "should wear a mask in public spaces and around people they don't live with." Individuals interested in getting a vaccine at their local pharmacy should check the pharmacy's website or visit Vaccines.gov to locate a nearby pharmacy that is administering vaccines. In addition, the CDC notes, most pharmacy locations now offer walk-in vaccination appointments, contingent on supply levels.
  • Booster shots for individuals with compromised immune systems. On August 16, the CDC issued guidance that people with "moderately to severely" compromised immune systems receive an additional dose of a mRNA COVID-19 vaccine. This recommendation applies to individuals who previously received two doses of a mRNA vaccine, specifically the vaccines developed by Moderna and Pfizer. According to the CDC this group includes about three percent of the overall U.S. adult population, and includes people who have:
    • Been receiving active cancer treatment for tumors or cancers of the blood.
    • Received an organ transplant and are taking medicine to suppress the immune system.
    • Received a stem cell transplant within the last two years or are taking medicine to suppress the immune system.
    • Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome).
    • Advanced or untreated HIV infection
    • Active treatment with high-dose corticosteroids or other drugs that may suppress immune response.
  • Booster shots for additional individuals. On August 18, the CDC expanded its guidance for booster shots to include all Americans. According to a statement issued by the U.S. Department of Health and Human Services (HHS), federal health officials "have developed a plan to begin offering booster shots this fall subject to FDA conducting an independent evaluation and determination of the safety and effectiveness of a third dose of the Pfizer and Moderna mRNA vaccines, and CDC's Advisory Committee on Immunization Practices (ACIP) issuing booster dose recommendations based on a thorough review of the evidence." Booster shots are likely to become available beginning the week of September 20 and starting eight months after an individual's second dose. "At that time." the statement noted, "individuals who were fully vaccinated earliest in the vaccination rollout, including many health care providers, nursing home residents, and other seniors, will likely be eligible for a booster."
  • Mask Recommendations for K-12 Schools. In guidance issued on August 5, the CDC called for "universal indoor masking" by all students (age two and older), staff, teachers, and visitors to K-12 schools, regardless of vaccination status. Additional elements of the August 5 guidance include:
    • Recommendations that schools maintain at least three feet of physical distance between students within classrooms.
    • Recommendation that fully vaccinated people, who have been exposed to someone with suspected or COVID-19, be tested 3-5 days after exposure, regardless of whether that have symptoms.
    • Prioritization that students return to "in-person learning" for the 2021-2022 school year.


As students and teachers head back to school, uncertainty continues to be the only certainty about the COVID-19 virus. And as federal, state and local health officials develop strategies to protect school communities, interested parties should expect evolving guidance as situations change and conditions warrant.