These vaccines were shown to be safe and effective in clinical trials. Currently, CDC recommends one updated COVID-19 booster dose: For everyone aged 5 years and older. Vaccines are one of the safest medicines a person can put into their body and are a key tool in preventing deaths from COVID-19, a Mercer University College of Pharmacy vaccine researcher says. Employers should provide face coverings to workers who request them at no cost. See 29 CFR 1904.39(a)(2), (b)(7)-(b)(8).]. If you believe that your health and safety are in danger, you (or your representative) have the right to file a confidential safety and health complaint with OSHA. Fox News correspondent David Lee Miller reports on the growing resistance to OSHA coronavirus vaccine mandate. Vaccines authorized by the U.S. Food and Drug Administration in the United States are highly effective at protecting most fully vaccinated people against symptomatic and severe COVID-19. Eliminate or revise policies that encourage workers to come to work sick or when unvaccinated workers have been exposed to COVID-19. Employers must report fatalities for work-related confirmed cases of COVID-19 if the fatality occurred within thirty (30) days of an exposure to COVID-19 at work. Your employer can take actions that will keep others in your workplace healthy and may be able to offer you leave flexibilities while you are away from work. OSHA Data. Similarly, employers must continue to follow requirements in other OSHA standards, including those that require respiratory protection to protect workers from exposures to certain chemicals and other hazardous substances. "N95" refers to a class of respirator filter that removes at least 95% of very small (0.3 micron) particles from the air. SARS-CoV-2, the virus that causes COVID-19, spreads mainly among unvaccinated people who are in close contact with one another - particularly indoors and especially in poorly ventilated spaces. This guidance is not a standard or regulation, and it creates no new legal obligations. This is misleading; the company says it does not manufacture the compound in the shot -- and the document pertains to research-grade chemicals, which health experts say do not undergo the same strict regulatory approval process. The training that is necessary can vary depending on a worker's job tasks, exposure risks, and the type of controls implemented to protect workers. Individuals who are under the age of 2 or are actively consuming food or beverages on site need not wear face coverings. Employers could also limit the number of unvaccinated or otherwise at-risk workers in one place at any given time, for example by implementing flexible worksites (e.g., telework); implementing flexible work hours (e.g., rotate or stagger shifts to limit the number of such workers in the workplace at the same time); delivering services remotely (e.g., phone, video, or web); or implementing flexible meeting and travel options, for such workers. See CDCs Guide to Masks. Additional fundamental controls that protect unvaccinated and other at-risk workers include maintaining ventilation systems, implementing physical distancing, and properly using face coverings (or other Personal Protective Equipment (PPE) and respiratory protection such as N95 respirators when appropriate), and proper cleaning. However, employers must take appropriate steps to protect other workers from exposure to SARS-CoV-2, the virus that causes COVID-19, in the workplace. If you are working outdoors, you may opt not to wear face coverings in many circumstances; however, your employer should support you in safely continuing to wear a face covering if you choose, especially if you work closely with other people. However, CDC recognizes that even some fully vaccinated people who are largely protected against severe illness and death may still be capable of transmitting the virus to others. Find a COVID-19 Vaccine The rule establishes federal requirements for vaccination and testing for employees of large . This guidance may not be applicable in State Plans. No particular form is required and complaints may be submitted in any language. No particular form is required and complaints may be submitted in any language. Drug Safety Update volume 16, issue 7: February 2023: 1. 87, No. The short-term side effects of the authorized COVID-19 vaccines are similar. In addition, ensure that workers understand their rights to a safe and healthful work environment, whom to contact with questions or concerns about workplace safety and health, and their right to raise workplace safety and health concerns free from retaliation. The Biden administration is withdrawing its Covid-19 vaccination and testing regulation aimed at large businesses, following the Supreme Court's decision to block the rule earlier this month. Consider ways to promote physical distancing between unvaccinated or otherwise at-risk people and/or limiting occupancy to allow for physical distancing consistent with CDC guidance. Millions of people in the United States have received COVID-19 vaccines under the most intense safety monitoring in US history. Learn about and take advantage of opportunities that your employer may provide to take time off to get vaccinated. Respirators, when required, must be used as part of a comprehensive, written respiratory protection program that meets the requirements of 29 CFR 1910.134 including requirements for medical evaluations, training, and fit testing. Getting a COVID-19 vaccine after you have recovered from COVID-19 infection provides added protection. What are the key differences between cloth face coverings, surgical masks, and respirators? The training that is necessary can vary depending on a worker's job tasks, exposure risks, and the type of controls in place to protect workers. Equal Employment Opportunity Commission's COVID-19 webpage and frequently asked questions to learn more about reasonable accommodations. Occupational Safety and Health Administration (Federal OSHA) Federal OSHA COVID-19 Page. Your employer must provide a safe and healthful workplace. healthcare settings, offices, retail settings, construction). However, some government emergency orders may affect which businesses can remain open during the pandemic. ABSTRACT. Ask your employer about possible telework and flexible schedule options at your workplace, and take advantage of such policies if possible. This is called mechanical filtration. For children aged 6 months-4 years who completed the Moderna primary series. Encourage and support voluntary use of PPE in these circumstances and ensure the equipment is adequate to protect the worker. OSHA does not wish to have any appearance of discouraging workers from receiving COVID-19 vaccination, and also does not wish to disincentivize employers' vaccination efforts. As recommended by the CDC, fully vaccinated people who have a known exposure to someone with suspected or confirmed COVID-19 should get tested 3-5 days after exposure and should wear a mask in public indoor settings for 14 days or until they receive a negative test result. Must be certified by the National Institute for Occupational Safety and Health (NIOSH). Vaccine recommendations are based on age, the first vaccine received, and time since last dose. The Mini Respiratory Protection Program applies to specific circumstances specified under the ETS, generally when workers are not exposed to suspected or confirmed sources of COVID-19 but where respirator use could offer enhanced worker protection. Where not prohibited by weather conditions, open vehicle windows. OSHA strongly encourages employers to provide paid time off to workers for the time it takes for them to get vaccinated and recover from any side effects. The recommendations are advisory in nature and informational in content and are intended to assist employers in recognizing and abating hazards likely to cause death or serious physical harm as part of their obligation to provide a safe and healthful workplace. Companies providing specialized remediation or clean-up services need to have expertise in industrial hygiene (e.g., Certified Industrial Hygienist (CIH)) and environmental remediation (e.g., Environmental Safety and Health Professional (ESH)). Ensure adequate ventilation in the facility, or if feasible, move work outdoors. The purpose of this provision is to improve the completeness and accuracy of injury and illness data by allowing OSHA to issue citations to employers who retaliate against their employees for reporting an injury or illness and thereby discourage or deter accurate reporting of work-related injuries or illnesses. All OSHA requirements for respiratory protection in construction that were in place before the COVID-19 pandemic remain in place. Find a COVID-19 vaccine or booster: Search vaccines.gov, text your ZIP code to 438829, or call 1-800-232-0233 to find locations near you. While this guidance addresses most workplaces, many healthcare workplace settings will be covered by the mandatory OSHA COVID-19 Emergency Temporary Standard. Employers who are not covered by the OSH Act (like public sector employers in some states) will also find useful control measures in this guidance to help reduce the risk of COVID-19 in their workplaces. Regardless, all workers should be supported in continuing to wear a face covering if they choose, especially in order to safely work closely with other people. Provide workers with face coverings or surgical masks,4 as appropriate, unless their work task requires a respirator or other PPE. For information about reporting requirements under the Emergency Temporary Standard for Healthcare, please see Reporting COVID-19 Fatalities and In-Patient Hospitalizations. However, it is important for employers and workers to remember that the respirator only provides the expected protection when used correctly. If you are not yet fully vaccinated or are otherwise at risk, optimum protection is provided by using multiple layers of interventions that prevent exposure and infection. The General Duty Clause, Section 5(a)(1) of the Occupational Safety and Health Act, requires each employer to furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm. These FAQs have been updated to include information related to the ETS revisions that were adopted on April 21, 2022 and became effective and enforceable on May 6, 2022. On November 5, 2021, the U.S. Department of Labor's (DOL) Occupational Safety and Health Administration (OSHA) issued an Emergency Temporary Standard (ETS) rule that mandated employers with 100 or more employees to develop, implement and enforce a COVID-19 vaccine and testing plan. Instruct any workers who are infected, unvaccinated workers who have had close contact with someone who tested positive for SARS-CoV-2, and all workers with COVID-19 symptoms to stay home from work to prevent or reduce the risk of transmission of the virus that causes COVID-19. 17) its announcement that effective the same day it was withdrawing the November 5, 2021 emergency temporary standard (ETS) regarding the COVID-19 vaccine mandate, which applied to employers with 100 or more employees. Make sure all unvaccinated and otherwise at-risk workers sharing a vehicle are wearing appropriate face coverings. Occupational Safety and Health Administration OSHA published its COVID-19 Vaccination and Testing; Emergency Temporary Standard in the Federal Register. Follow requirements in mandatory OSHA standards 29 CFR 1910.1200 and 1910.132, 133, and 138 for hazard communication and PPE appropriate for exposure to cleaning chemicals. Despite widely available safety information for the COVID-19 vaccines, vaccine hesitancy remains a challenge. Employers may also need to implement a hazard communication program that provides safety data sheets, container labels, and training on the hazards of the chemicals in the workplace, in compliance with OSHA's Hazard Communication standard at 29 CFR 1910.1200 (29 CFR 1926.59 for construction). See 29 CFR 1904.39(b)(6). Are employers not covered by the Healthcare ETS required to provide cloth face coverings to workers? The situation is so urgent that the worker does not have time to eliminate the hazard through regulatory channels, such as calling OSHA. Under the OSH Act, employers are responsible for providing a safe and healthy workplace free from recognized hazards likely to cause death or serious physical harm. The Centers for Disease Control and Prevention provides updated information about cleaning and disinfecting. Under OSHA's PPE standard at. Where can I learn more about COVID-19 testing? Workers who test positive for COVID-19 will be notified of their results by their healthcare providers or public health department and will likely be advised to self-isolate or seek medical care. Will an N95 respirator protect the wearer from the virus that causes COVID-19? The vaccination campaign helped tackle the pandemic and saved millions of lives. These standards do not apply to the wearing of medical masks or cloth face coverings in work settings with normal ambient air. English . As a result, OSHA will not enforce 29 CFR part 1904s recording requirements to require any employers to record worker side effects from COVID-19 vaccination at least through May 2022. Employers must report in-patient hospitalizations for work-related confirmed cases of COVID-19 if the hospitalization occurred within twenty-four (24) hours of an exposure to COVID-19 at work. Ensure supervisors are familiar with workplace flexibilities and other human resources policies and procedures. In areas with substantial or high transmission, employers should provide face coverings for all workers, as appropriate, regardless of vaccination status. CDC Coronavirus (COVID-19) Page. This could include posting a notice or otherwise suggesting or requiring that people wear face coverings, even if no longer required by your jurisdiction. In workplaces with employees who are deaf or have hearing deficits, employers should consider acquiring masks with clear coverings over the mouth to facilitate lip-reading. The worker continues to have the right to file a safety or health complaint under section 8(f) and/or a retaliation complaint under section 11(c), regardless of any language contained in the waiver. COVID-19 continues to disproportionately affect patients with cancer because of their underlying immunocompromised state. When necessary to protect workers, require a respiratory protection program that is compliant with OSHA's Respiratory Protection standard at, Filtering Facepiece Respirators (FFRs) may be used voluntarily, if permitted by the employer. On Friday, January 7, 2022, the justices heard arguments on the vaccine-or-test ETS for large companies and a vaccine mandate for health care workers. Employers should also report outbreaks to local health departments as required and support their contact tracing efforts. Report work-related deaths due to COVID-19 to OSHA within 8 hours, and work-related . cloth face coverings, surgical masks), unless their work task requires a respirator. Some measures to improve ventilation are discussed in CDCs Ventilation in Buildings and in the OSHA Alert: COVID-19 Guidance on Ventilation in the Workplace. Employers should engage with workers and their representatives to determine how to implement multi-layered interventions to protect unvaccinated or otherwise at-risk workers and mitigate the spread of COVID-19. This page includes frequently asked questions (FAQs) and answers related to the coronavirus disease 2019 (COVID-19) pandemic. Surgical masks are typically cleared by the U.S. Food and Drug Administration as medical devices and are used to protect workers against splashes and sprays (i.e., droplets) containing potentially infectious materials; in this capacity, surgical masks are considered PPE. OSHA anticipates that the emergency temporary standard will be in effect for six months, but there is a possibility it could be extended or made more permanent. We aimed to provide information and context about reports of death to VAERS . Vaccines authorized by the U.S. Food and Drug Administration are highly effective at protecting vaccinated people against symptomatic and severe COVID-19 illness and death. Barriers should block face-to-face pathways between individuals in order to prevent direct transmission of respiratory droplets, and any openings should be placed at the bottom and made as small as possible. The benefits of all COVID-19 vaccines continue to outweigh the risks of the disease. An employee can file a complaint with OSHA by visiting or calling his or her local OSHA office; sending a written complaint via fax, mail, or email to the closest OSHA office; or filing a complaint online. Practice good personal hygiene and wash your hands often. A common practice at some workplaces of sharing employer-provided transportation such as ride-share vans or shuttle vehicles; Frequent contact with other individuals in community settings, especially in areas where there is substantial or high community transmission; and. Finally, OSHA suggests that employers consider adopting policies that require workers to get vaccinated or to undergo regular COVID-19 testing in addition to mask wearing and physical distancing if they remain unvaccinated. It is not an official legal edition of the Federal Register, and does not replace the official print version or the official electronic version on GPO's govinfo.gov. Where can employers and workers find information about requirements for protecting workers during the COVID-19 pandemic? Employers and workers can visit the U.S. For more information, see the Equal Employment Opportunity Commission's (EEOC's) What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws. Which OSHA standards apply to employer protection of workers during the COVID-19 pandemic? Job Accommodation Network (COVID-19) OSHA Newsroom. CDC provides information about face coverings as one type of mask among other types of masks. If you have suffered retaliation because you voiced concerns about a health or safety hazard, you have the right to file a whistleblower protection complaint. SARS-CoV-2, the virus that causes COVID-19, is highly infectious and spreads from person to person, including through aerosol transmission of particles produced when an infected person exhales, talks, vocalizes, sneezes, or coughs. No. The U.S. Department of Justice also provides information about COVID-19 and the Americans with Disabilities Act. The vaccines can't give you COVID-19 because they don't contain the virus that causes it. Type of contact where unvaccinated and otherwise at-risk workers may be exposed to the infectious virus through respiratory particles in the airfor example, when infected workers in a manufacturing or factory setting cough or sneeze, especially in poorly ventilated spaces. These standards would only apply to work settings where there are known or suspected sources of chemicals (e.g., manufacturing facilities) or workers are required to enter a potentially dangerous location (e.g., a large tank or vessel). If the Emergency Temporary Standard for Healthcare does not apply, do I need to report this in-patient hospitalization to OSHA? In workplaces with employees who are deaf or have hearing deficits, employers should consider acquiring masks with clear coverings over the mouth to facilitate lip-reading. What are the requirements for posting the OSHA 300-A Summary of Work-related Injuries and Illnesses? Should workers in settings not covered by the Healthcare ETS wear cloth face coverings while at work? Schools should continue to follow applicable CDC guidance, which recommends universal indoor masking for all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status. Are not considered personal protective equipment (PPE). This vaccine is authorized for use in the US. Some conditions, such as a prior transplant, as well as prolonged use of corticosteroids or other immune-weakening medications, may affect workers' ability to have a full immune response to vaccination. You can wait up to 90 days after you recover from COVID-19 before getting your updated booster if you want. Employers should consider taking steps to protect these at-risk workers as they would unvaccinated workers, regardless of their vaccination status. Require proper training, fit testing, appropriate medical evaluations and monitoring, cleaning, and oversight by a knowledgeable staff member. Employers may need to provide reasonable accommodation for any workers who are unable to wear or have difficulty wearing certain types of face coverings due to a disability or who need a religious accommodation. You have the right to file a complaint if you are required to work and believe you are being exposed to a serious health or safety hazard. OSHA differentiates face coverings from the term mask and from respirators that meet OSHA's Respiratory Protection Standard. The COVAX No-Fault Compensation Program for Advance Market Commitment (AMC) Eligible Economies is the world's first and only international vaccine injury compensation mechanism. Some people have mistakenly claimed that OSHA standards (e.g., the Respiratory Protection standard, 29 CFR 1910.134; the Permit-Required Confined Space standard 29 CFR 1910.146; and the Air Contaminants standard, 29 CFR 1910.1000) apply to the issue of oxygen or carbon dioxide levels resulting from the use of medical masks or cloth face coverings in work settings with normal ambient air (e.g. Guidance posted January 29, 2021; UpdatedJune 10, 2021. The study was conducted in Israel, an early global leader in . This guidance contains recommendations as well as descriptions of the Occupational Safety and Health Administration's (OSHA's) mandatory safety and health standards, the latter of which are clearly labeled throughout as "mandatory OSHA standards." If you believe you are being exposed to SARS-CoV-2, the virus that causes COVID-19, or that your employer is not taking appropriate steps to protect you from exposure to the virus at work, talk to your supervisor or employer about your concerns. ", Are used to protect workers against splashes and sprays (i.e., droplets) containing potentially infectious materials. Stagger workers' arrival and departure times to avoid congregations of unvaccinated or otherwise at-risk workers in parking areas, locker rooms, and near time clocks. Wednesday, April 21, 2021 On April 20, 2021, the Occupational Safety and Health Administration (OSHA) released three new FAQs for employers who recommend or require employees to receive. If you are required to keep OSHA injury and illness records, you must post the OSHA 300-A Summary of Work-related Injuries and Illnesses from February 1 through April 30 at your establishment in a conspicuous place or places where notices to employees are customarily posted. On 15 February 2023, the Florida Department of Health published a "Health Alert on mRNA COVID-19 Vaccine Safety", stating that "In Florida alone, there was a 1,700% increase in VAERS reports after the release of the COVID-19 vaccine, compared to an increase of 400% in overall vaccine administration for the same time period" and also an . [The employer must report the fatality within eight hours of knowing both that the employee has died, and that the cause of death was a work-related case of COVID-19. The requirements for employees who test positive for COVID-19 have been updated to reflect the most recent June 9, 2022 CDPH Isolation and Quarantine Guidance. Such workers may also be near one another at other times, such as when clocking in or out, during breaks, or in locker/changing rooms. Face shields may be provided for use with face coverings to protect them from getting wet and soiled, but they do not provide adequate protection by themselves. Employers are encouraged to proactively inform employees who have a legal right to PPE as a reasonable accommodation for their disability about how to make such a request. Thus, if an employer learns that an employee died within 30 days of a work-related incident, and determines afterward that the cause of the death was a work-related case of COVID-19, the case must be reported within eight hours of that determination.]. Even if your employer does not have a COVID-19 prevention program, if you are unvaccinated or otherwise at risk, you can help protect yourself by following the steps listed below: COVID-19 vaccines are highly effective at keeping you from getting COVID-19. See CDC's Guidance for Fully Vaccinated People; and Science Brief. Employers should also consider working with local public health authorities to provide vaccinations in the workplace for unvaccinated workers. What COVID-19 training resources are available for employers? Where the Emergency Temporary Standard for Healthcare does not apply, OSHA does not require employers to notify other employees if one of their coworkers gets COVID-19. These recommendations are based on American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) Guidance for Building Operations and Industrial Settings during the COVID-19 Pandemic. Such workers should maintain at least 6 feet of distance from others at all times, including on breaks. Workers who clean the workplace must be protected from exposure to hazardous chemicals used in these tasks. U.S. President Joe Biden speaks about the authorization of the Covid-19 vaccine for children ages 5-11, in the South Court Auditorium on the White House campus on November 03, 2021 in Washington, DC. The original guidance, in a nutshell, states that if an employer requires its employees to be vaccinated as a condition of employment, the adverse reaction is . The COVID-19 Prevention non-emergency regulations are in effect until February 3, 2025. Fox News host Tucker Carlson said that authorities are lying about the safety of the COVID-19 vaccine because of their efforts to stop disinformation about the vaccine from spreading on social . Respirators (e.g., filtering facepieces): 1If surgical masks are being used in workplaces not covered by the ETS only as source controlnot to protect workers against splashes and sprays (i.e., droplets) containing potentially infectious materialsOSHA's PPE standards do not require employers to provide them to workers. United States: Employer Liability For COVID-19 Vaccine Side Effects. DOL and OSHA, as well as other federal agencies, are working diligently to encourage COVID-19 vaccinations. In addition to unvaccinated and otherwise at-risk workers, CDC recommends that even fully vaccinated people wear masks in public indoor settings in areas of substantial or high transmission and notes that fully vaccinated people may appropriately choose to wear masks in public indoor settings regardless of community level of transmission, particularly if they are at risk or have someone in their household who is at risk or not fully vaccinated. Respirators, if necessary, must be provided and used in compliance with 29 CFR 1910.134 (e.g., medical determination, fit testing, training on its correct use), including certain provisions for voluntary use when workers supply their own respirators, and other PPE must be provided and used in accordance with the applicable standards in 29 CFR part 1910, Subpart I (e.g., 1910.132 and 133). Equal Employment Opportunity Commission's COVID-19 webpage and frequently asked questions to learn more about this topic. During the COVID-19 pandemic, employers should train workers in a language and literacy level they understand about: Some OSHA standards require employers to provide specific training to workers. he U.S. Occupational Safety and Health Administration (OSHA) has answered a question that has been troubling employers since the pace of vaccinations started to accelerate: when must an. On May 21, 2021, the Occupational Safety and Health Administration (OSHA) revoked recent enforcement guidance issued to clarify the recordability of situations where employees suffered adverse. Yes, an N95 respirator is effective in protecting workers from the virus that causes COVID-19. Move the electronic payment terminal/credit card reader farther away from unvaccinated and otherwise at-risk workers in order to increase the distance between customers and such workers, if possible. You should follow recommended precautions and policies at your workplace. What can I do if I believe my employer is not protecting me from exposure to SARS-CoV-2, the virus that causes COVID-19, on the job? 2 People who are not fully vaccinated should be tested immediately after being identified (with known exposure to someone with suspect or confirmed COVID-19), and, if negative, tested again in 57 days after last exposure or immediately if symptoms develop during quarantine. The Program helps COVAX deliver safe and effective COVID-19 vaccines to the high-risk and vulnerable populations in 92 low- and middle-income countries and economies. Employers must conduct a hazard assessment and, based on the results, provide the appropriate protective equipment for using disinfectants and other chemicals. COVID-19 vaccines are safe and effective. In settings covered by the Emergency Temporary Standard for Healthcare, employers should consult the standard for specific requirements. See 29 CFR 1904.39(b)(6). The recommendations are advisory in nature, informational in content, and are intended to assist employers in providing a safe and healthful workplace. Occupational Safety & Health Administration, Occupational Safety and Health Administration, Outreach Training Program (10- and 30-hour Cards), OSHA Training Institute Education Centers, July 27, 2021 Centers for Disease Control and Prevention (CDC) mask and testing recommendations for fully vaccinated people, What Workers Need To Know about COVID-19 Protections in the Workplace, The Roles of Employers and Workers in Responding to COVID-19, Appendix: Measures Appropriate for Higher-Risk Workplaces with Mixed-Vaccination Status Workers, areas of substantial or high community transmission, Interim Public Health Recommendations for Fully Vaccinated People, update recommendations for fully vaccinated people, Vaccines for People with Underlying Medical Conditions, What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws, Centers for Disease Control and Prevention, safe and healthy workplace free from recognized, tax credits under the American Rescue Plan, Implementing Protections from Retaliation, OSHA Alert: COVID-19 Guidance on Ventilation in the Workplace, Minimum Efficiency Reporting Value (MERV) 13, suspected of having or confirmed to have COVID-19, CDC cleaning and disinfection recommendations, reporting COVID-19 fatalities and hospitalizations to OSHA, educating and training workers about COVID-19 policies and procedures, Guidance for COVID-19 Prevention in K-12 Schools, Severe Storm and Flood Recovery Assistance, Protecting Workers: Guidance on Mitigating and Preventing the Spread of COVID-19 in the Workplace, Reorganize Appendix recommendations for Manufacturing, Meat and Poultry Processing, Seafood Processing, and Agricultural Processing Industries, Add links to guidance with the most up-to-date content, choosing to wear a mask regardless of level of transmission, particularly if individuals are at risk or have someone in their household who is at increased risk of severe disease or not fully vaccinated; and.
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