To: Governors of California, Nevada, Oregon, and Washington State

• Governor Gavin Newsom, California
• Governor Steve Sisolak, Nevada
• Governor Kate Brown, Oregon
• Governor Jay Inslee, Washington

From:  Arthur Reingold, MD, Chair

Western States Scientific Safety Review Workgroup

The Western States Scientific Safety Review Workgroup learned on March 29, 2022 of the Emergency Use Authorization by the US Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention's (CDC) expanded eligibility of second booster doses of the Moderna and Pfizer-BioNTech mRNA COVID-19 vaccines for individuals 50 years of age and older, as well as booster doses of the Pfizer-BioNTech COVID-19 vaccine for individuals 12 years of age and older or the Moderna vaccine for individuals 18 years and older with moderate and severe immunosuppression.

The minimum interval between the first and second boosters is four months.

Individuals with moderate and severe immunosuppression may wish to consult with their healthcare providers as they make their decision concerning the receipt of a second booster dose of these vaccines.

Separately and in addition, based on newly published data, adults who received a primary vaccine and booster dose of Johnson & Johnson's Janssen COVID-19 vaccine four months previously may now receive a second booster dose using an mRNA COVID-19 vaccine.

Workgroup members were canvassed via email the same day and were unanimous in their support of this decision, which is expected to lead to enhanced protection against COVID-19 in individuals who opt to receive a second booster dose.

Respectfully submitted:

• Members of the Western States Scientific Safety Review Workgroup: Arthur Reingold, MD, Chair, UC Berkeley School of Public Health

California Members:

• Tomás J. Aragón, MD, DrPH, California Department of Public Health and State Health Officer
• Oliver Brooks, MD, Watts Healthcare
• Eric Goosby, MD, UCSF School of Medicine
• Rodney Hood, MD, UC San Diego Alumnus and National Medical Association
• Nicola Klein, MD, Ph.D., Kaiser Permanente Northern California
• Grace M. Lee, MD, MPH, Stanford Children's Health and Stanford University School of Medicine
• Bonnie Maldonado, MD, Stanford University School of Medicine and Stanford Children's Health
• Mark H. Sawyer, MD, UC San Diego School of Medicine and Rady Children's Hospital
• Robert Schechter, MD, California Department of Public Health
• Peter G. Szilagyi, MD, MPH, UCLA Health and David Geffen School of Medicine
• Matt Zahn, MD, Orange County Health Care Agency

Nevada Members:

• Ihsan Azzam, MD, Ph.D., Chief Medical Officer, State of Nevada
• Kyle Devine, Bureau of Child, Family and Community Wellness
• Kristy Zigenis, COVID-19 Vaccine Manager

Oregon Members:

• Laura Byerly, MD, Virginia Garcia Memorial Health Center
• Louis J. Picker, MD, OHSU Vaccine and Gene Therapy Institute

Washington Members:

• John Dunn, MD, MPH, Kaiser Permanente Washington
• Edgar K. Marcuse, MD, MPH, University of Washington School of Medicine