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You can still have a healthy pregnancy and baby if your pregnancy is high-risk. Learn what steps you can take to give your baby the best start possible. A “high-risk” pregnancy is one that threatens the health or life of the mother or her fetus. Women with high-risk pregnancies should receive care health care specialists to ensure the best possible outcomes. Some examples of a high-risk pregnancy include: Maternal age, women 35 and higher or 17 and younger Lifestyle choices, including smoking, drinking alcohol and illegal controlled substances Existing medical history, chronic hypertension, diabetes and breathing issues Multiple gestation, pregnancy with twins or triplets Overweight and underweight  Remember: You can still have a healthy pregnancy and baby if your pregnancy is high-risk. Some ways to promote a healthy pregnancy: Schedule an appointment with your OBGYN Eat a balanced diet Avoid substances Prenatal care Healthy weight gain Reduce stress Exercise  Pregnancy & Childbirth at Renown | 775-982-KIDS (5437) When you are expecting a new baby, you can depend on Renown Children’s Hospital for all your mom and baby healthcare needs. We can help you find the right doctor and tell you what to expect during your stay. We offer childbirth education classes and tours to help you prepare. Be sure to check out our virtual tours of our Labor Assessment Area.

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Deciding you’re ready to start a family is a big decision for any couple. So once you’ve decided – what are the next steps for both moms and dads-to-be? And what should you know if you’re struggling to conceive? Dr. Myron Bethel, OB/GYN with Renown Women’s Health, offers key insights about fertility. What’s the first thing couples should do when they decide to start a family? For the mom-to-be, it’s important to meet with your obstetrician before you get pregnant. This appointment gives you an opportunity to discuss your family medical history, any past or current health problems, immunization history, medications you’re taking and any issues with previous pregnancies. Your doctor can also provide helpful tips to ensure your body is ready for a healthy pregnancy and help guide you on how to monitor your period, basal resting body temperature and other important factors to help you get pregnant more quickly. How can couples who are trying to get pregnant make sure they’re healthy to conceive? Of course it’s important to maintain a healthy lifestyle all the time, but it’s especially important if you’re trying to get pregnant. There’s no magic pill or single food, but women should start focusing on nutrients they’ll need during pregnancy. Before trying to conceive, start taking folate and folic acid to help prevent birth defects. You can get good sources of these nutrients from cereal, spinach, beans, asparagus, oranges and peanuts. Lifestyle changes can also help improve fertility. For both men and women, extra weight can reduce fertility. Both sexes can increase their chances of conception by not smoking, not drinking alcohol and exercising regularly. And for men specifically, take a daily vitamin containing zinc and selenium to support healthy sperm. What is the average timeline for conception, and what do you suggest for couples who may be struggling to conceive and start a family? First, remember getting pregnant can take longer than you expect. Do not to get stressed out about it or place blame. Seventy percent of couples conceive within six months and 85 percent within one year of trying to get pregnant. To help improve your chances of pregnancy, monitor your ovulation closely. You can do this by tracking your period, watching your body closely and logging symptoms, logging your basal body temperature or using ovulation kits. If you still aren’t sure when you’re ovulating, try to have sex every other day to improve your chances of conception. If you’ve been trying for nine months to a year, you can talk to your OB about options and discuss meeting with a fertility specialist.

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Watch as two dads look back on their newborn adoption process. They reminisce about discovering their newborn was on his way — and how Renown Health subsequently helped them navigate the process.  During Memorial Day weekend, Chris Mulhern and his husband, Jeffrey Bodimer, learned a set of birth parents chose them to parent their unborn baby boy. After writing a letter to the birth parents, they were chosen over other applicants in a private adoption. The adoption agency took care of many details, like connecting Mulhern and Bodimer to the birth mother and dad. In fact, they could participate in nearly all the phases of the pregnancy. The mother's prenatal care and delivery took place at Renown Health, where Mulhern and Bodimer attended her appointments and took childbirth classes. "Our experience was wonderful at Renown," says Mulhern. "We thought it was absolutely incredible how nice and accepting everyone was." The Nuances of Newborn Adoption Their son, Bradley, was born via cesarean section. And the adoptive parents got to see him an hour after he came into the world. The labor and delivery nurses even helped coordinate everything between them and the birth mom. Mulhern and Bodimer stayed in a room at The Inn at Renown. The closeness of the facility on the Renown campus made it possible to feed Bradley every two hours. Incredible Nurses "They were great, the nursing staff. If we weren't sure about doing something right, about burping him right they would say 'It's okay. He's not going to blow up. He will eventually do it'," says Mulhern. The nurses also made arrangements for the two dads to participate in skin-to-skin contact with their newborn baby. Experts agree parents and babies should be in direct contact for at least the first 1–2 hours after the birth. Taking Baby Home Chris and Jeffery took Bradley home after three days at Renown. “It was the most joyful thing to be chosen as his parents, even before we met him,” says Chris.

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We asked, you answered: Moms and dads who have been there, done that offer up 10 pregnancy surprises. These are the things they wish they knew before, during and after their pregnancy. Check out these real examples of insights that would have proved helpful and enlightening to these parents and parents-to-be. When you’re pregnant or considering becoming pregnant, it seems the unsolicited advice runs rampant. You’ll hear people tell you what kind of Boppy Pillow to buy. You’ll have people tell you that you should “definitely” have a natural birth or a pool birth or a doula or a therapy dog present. And you’ll definitely hear about what kinds of foods to induce labor, what kind of tea to drink to reduce nausea during your pregnancy and what kind of underwear for less “chafing.” But something you might not hear as often: Some of the symptoms and side effects, both before and after giving birth, that were totally unexpected. These are the ultimate pregnancy surprises. So we asked the question of moms and dads who have been there, done that: What do you wish you had known would happen during your pregnancy — you know, during the time you were supposed to be all sweet and beautiful and glowing? Here is Part 1, featuring 10 real-life, crowdsourced pregnancy surprises from parents. And yes, there are multiple parts to this post, because people are passionate about sharing their wisdom! We’ll publish the second part later this month. Pregnancy surprises: What do you wish you had known about pregnancy? “The only symptom I never heard anyone talk about is extra blood flow making me feel all sorts of weird feelings in my head. I feel like I’m in a dream half the time. I looked it up online when it started happening, and tons of women have the same symptom.” — Anna K. “For me it was an after-birth surprise. I had no clue your tummy doesn’t just spring back to where it was pre-pregnancy. It was a rude awakening in the hospital when I had to have my husband go home and get a pair of maternity sweatpants to get dressed to go home in. I’d hoped to dress in my old cute jeans…. nope!” — Suzanne M. “I didn’t know that while you’re pregnant, friends and strangers would tell you their nightmare delivery stories. Oh — and that complete strangers will, uninvited, touch your baby bump. I didn’t know that you’re in the safety zone while pregnant and that men and women openly adore you. I didn’t know that besides the mother, the nurses do most of the work. I didn’t know that even though they’ve obviously seen hundreds of deliveries, nurses and doctors cry too once your baby is out. I didn’t know even though I thought they must be crazy to send a tiny human home with me, that you instinctively know how to parent. I didn’t know what it meant to love something more than myself and how that changes everything.” — Cathy B. “I had no idea the weird things that it does to hair. My bangs stuck straight out for months, and I just had to go with it. There wasn’t enough product that would make them lie down.” — Heidi P. “That you may not go home with your child if there are any complications. That was a sad day. But 22 years later, we are blessed, because everything turned out fine.” — Kristine F. “I didn’t know people would opine out loud to you, that you must not have purposely gotten pregnant with Baby #2 or 3, etc., implying you failed basic high school biology and that you should have known better than to have more than one kid.” — Jessica L. “I didn’t know that near the pregnancy’s end, as the hips widen, that those bones could begin to separate. I was sore and achy. And I wish I’d slowed down and rested more in the last few weeks.” — April C. “I had heard about food cravings, but no one told me food aversions were also a thing. I bought a whole load of groceries for the week, and by the time I got home, I suddenly couldn’t even look at the ground turkey (that’s not an exaggeration), let alone cook it and eat it. I didn’t throw up necessarily, but my body told me to avoid most meats and vegetables. I pretty much lived on plain bagels and cereal for half my pregnancy.” — Danielle S. “Morning sickness is SO not just in the morning! All-the-time sickness is what I experienced. And why didn’t anyone warn me about butthole pain during and after birth?” — Stephanie C. “The juiciness. Every possible secretion was in hyper drive.” — Jane F. Giving Birth at Renown At Renown Regional Medical Center we have the skill, expertise and technology — along with a friendly environment — to make your experience a memorable one. Pre-register for childbirth, take virtual tours of our rooms and facilities, and learn more about our labor and delivery offerings at the link below. Explore Our Services

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Clinical research provides agency for our patients navigating a scary diagnosis, and the field has never been stronger in northern Nevada. This strength is thanks in part to the Affiliate Clinical Research Office (ACRO) formed by the 2021 affiliation between Renown Health and the University of Nevada, Reno School of Medicine. Since its creation, the ACRO team has been busy ensuring that community members have access to the latest care options and exceptional experiences as participants in both research and their healthcare. Here are just a few things that set this office apart from the rest. 1. A focus on engagement In 2022, the ARCO team focused on promoting a research culture with patients, clinicians, residents and students by intentionally engaging with healthcare providers, department administrators, internal research team members and leadership. They educated the community with learning materials that emphasized the importance of doing research. This team also worked with front-line staff to raise awareness and excitement about the clinical research options available for Renown Health patients. 2. Meaningful partnerships The most impactful partnership to date is between Renown Health and UNR Med. By identifying opportunities and leveraging resources across institutions, we have maximized our impact and built a solid and sustainable foundation. This gives the people of northern Nevada greater access to new interventions or novel treatments. This team is also investing in the community and national partnerships to provide training opportunities for our research staff and learning opportunities for our medical students. 3. Novel treatments across many disease areas Our research study offerings must reflect the healthcare needs of our community and the expertise of practicing clinicians. The department has over 80 active studies in neurology, pulmonology, oncology, cardiology, pediatrics and disease prevention. The ARCRO team strives to expand care opportunities to allow our community members to stay close to home when seeking care. This year, they will continue exploring our community's unmet healthcare needs by bringing new treatment options to the greater Reno area.

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By taking our pregnancy and birth class, you will gain the tools necessary to have a safe and empowering birth experience for both you and your baby. Chris Marlo, Childbirth Educator at Renown Health explains why birth classes are important. For questions regarding classes or tours, contact Chris Marlo: chris.marlo@renown.org 775-982-4352 What is a Certified Childbirth Educator/Doula? If you are expecting a baby, Renown has a wide variety of classes to help prepare you for birth. Classes are taught by certified childbirth educators and doulas. A certified childbirth educator is a trusted resource who has a passion for educating expecting parents about childbirth, and will provide you with non-biased, evidence-based information. A doula is a professional labor assistant who provides physical and emotional support during pregnancy, childbirth and postpartum. As you prepare for birth, our certified educators will guide you each step of the way and ensure you receive the quality care you deserve. Why Should I Take Pregnancy and Birth Classes? For expecting parents, taking a childbirth education course is an important step in preparing for their new arrival. We cover topics such as labor and delivery, postpartum care, breastfeeding, nutrition, pain management techniques, and more. Our experienced instructors will provide you with the information you need to make informed decisions during your pregnancy and childbirth. With our classes, you can be sure that you have all the knowledge necessary to have a positive experience before, during, and after your baby’s arrival. Our classes will help ease your fears as we practice breathing, relaxation and the many tools you can utilize for birth. At Renown we understand that there is no right way to give birth, and our educators will offer a supportive environment where questions are encouraged, and everyone is respected. Childbirth Class Options: Baby and Family Suites Tour & Virtual Tour Breastfeeding Basics and Beyond Class Breathing & Relaxation Techniques for Birth Pregnancy and Birth – 5 & 7 Week Series Pregnancy and Birth Class Additional Resources: Baby Safe Class Babysitter Class Grandparents Virtual Class Infant CPR & Choking Class Newborn Care Nurturing Your Newborn Preparing for Postpartum Virtual Class

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In February, we think about hearts not just in honor of Valentine’s Day but because it is American Heart Association Month. This is a great reminder to focus on our personal cardiovascular health. Renown Health helps patients think about their heart health with our world-class providers and cutting-edge treatments through our Cardiovascular Clinical Trials. “Research serves a vital role in the future care of cardiovascular diseases. Being involved in research will help our medical community to further discover new treatment plans in our quest for life preservation and extension,” Dr. Thomas To, Cardiologist and Researcher at Renown Health. For example, let’s talk about atherosclerosis. When our hearts are healthy, they are a strong muscle that pumps our oxygen-rich blood through our coronary arteries. Over time, cholesterol and fats can build up in our arteries. This is a condition known as atherosclerosis. This type of plaque buildup in the arteries can lead to a heart attack or stroke if not properly managed. If you are experiencing chest pain or discomfort, shortness of breath or pain in areas of the upper body, these can be the warning signs of a heart attack, and you should call 911. One contributing factor to atherosclerosis is elevated lipoprotein(a) levels and the accumulation of cholesterol in the arteries, which increases the likelihood of a heart attack or stroke. Lipoprotein(a) is tested separately from the standard panel that is completed for cholesterol management, and while your total cholesterol levels may be in a healthy range, lipoprotein(a) levels can still be elevated. "Increasingly we are realizing that lipoprotein(a) levels can be used as an important assessment in more carefully delineating an individual's risk of future cardiovascular events and treatment targets" said Dr. Michael Bloch, Lipid Specialist and Researcher at Renown Institute for Heart and Vascular Health. While it is clear that elevated lipoprotein(a) contributes to atherosclerosis, there are currently no approved medications for reducing cardiovascular disease risk through reducing lipoprotein(a) levels. This is why Renown Health’s Research Office is proud to offer a phase III clinical trial, called the OCEAN(a) study, to our patients with elevated lipoprotein(a) levels as a care option for management of their heart disease risk. Our teams of expert providers and researchers are here to support you on your healthcare journey. “I am thrilled to be able to be part of this study and bring opportunities like this to our patients. The highlight of my day is getting to hear life stories from my patients during our study visits,” Lisa Preciado, Primary Clinical Research Coordinator for the OCEAN(a) study said. Join us in raising awareness around American Heart Month by talking to your provider about lipoprotein(a) at your next appointment. At Renown Health, our goal is to make it easy for patients to access clinical research as a care opportunity where patients can access a variety of standard care treatment options for their health condition or choose to participate in a clinical trial. For more information about clinical trial opportunities available to you or to ask any questions, contact the Renown Research Office at Renown-CRD@renown.org or 775-982-3646.

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Medical emergencies like strokes and heart attacks still happen, even in a pandemic. That’s why Renown Health is always ready to provide emergency care to patients in need, and being admitted at Renown does not put patients at risk of getting COVID-19. When to Get Emergency Care Resources like Renown Virtual Visits have allowed us to stay home while making routine visits with our primary care physician. But, if you are feeling any of the following symptoms, please call 911 or have someone you know take you to the emergency room. Symptoms that may require emergency care: Heart attack Stroke symptoms Difficulty breathing Chest pain Seizure Sudden loss of consciousness Severe abdominal pain Serious allergic reaction Fighting the Good Fight for Our Patients Renown Health provides a clean and safe environment 365 days of the year, 24 hours a day. Alongside regular sanitation practices, Renown is dedicated to protecting patients from infectious disease while providing emergency care. Staff, Care Providers and Visitors Wear Masks Every staff member, care provider and visitor is wearing a mask. Additionally, providers are following guidelines from the Centers for Disease Control (CDC) on wearing protective equipment, such as masks and gloves. Respiratory Illness Screenings for Everyone Care providers and staff members are participating in respiratory illness screenings. Therefore, any care provider or staff member with a fever, cough, difficulty breathing or severe respiratory illness is not on a Renown campus. Visitor Restrictions are in Place Visitor restrictions are in place to prevent the spread of infectious disease by practicing physical distance. Because of these restrictions, Renown is only allowing one visitor per patient for with extenuating circumstances. Staying healthy and safe means caring for yourself in emergency situations, too. Please do not hesitate to call 911 when you or a loved one are in need of emergency medical care. Virtually Visit a Renown Urgent Care Login to MyChart to “get in line” for a virtual urgent care visit between 8:30 a.m. to 10:30 p.m. Monday-Friday and 9:30 a.m. to 4:30 p.m. Saturday and Sunday. Login to MyChart

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There are many lenses through which to view health. As you would expect, medical providers typically focus on the health of individual patients. For example, doctors consider a person’s symptoms, their current lifestyle, their past medical history, and their family’s history to diagnose medical conditions and recommend treatments. The Public Health Perspective Public health professionals look beyond the health of an individual and instead focus on the health of an entire community or population of people. They strive to achieve “the greatest good for the greatest number.” As the CEO of a health system, I feel fortunate to have education and training in both medicine and public health. As Renown Health’s leader, it is my responsibility to care for the people and communities we serve. That involves bringing world-class staff and innovative medical care to northern Nevada. We also focus on prevention by looking for ways to improve health outside of our facilities. That means partnering with local organizations to address the social, economic, and environmental factors that shape our health. Or working with local government to create policies that help to prevent disease and injury. In order to make a genuine and long-lasting impact on health, we must foster a community that helps our neighbors live well. Public health is especially important during times of crisis, such as the COVID-19 pandemic that we’re experiencing now. During these times, health systems must be able to swiftly shift focus from prioritizing the needs of individual patients to considering what is best for our local population. For example, we may need to temporarily limit hospital visitors or educate the public about how to socially distance in order to stop the spread of disease. Being prepared to make this shift and having strong relationships with our local health department and community organizations help us better serve the public. In both good times and bad, I am thankful that my public health background provides me with the perspective to look beyond our health system and embrace the health our community.

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We get it – the entire world has been overwhelmed with COVID-19 vaccine information, questions and celebrations around vaccines developed to combat COVID-19 induring the past several months. It’s hard to know where to start in digesting all this news and information. But one thing is clear: healthcare experts agree that the authorized COVID-19 vaccines are safe, effective and recommended to help end this pandemic. If you are passionate about stepping up in your community to encourage the vaccination efforts, we’re offering a few ideas on how you can be an ambassador. Find the Facts Content on the vaccine is abundant, but and there’s a few resources that we can all rely on to help digest the information: The Centers for Disease Control (CDC) updates its website content around the vaccine regularly, and also offerings information in Spanish. Health departments across the U.S. are leading the way in distribution logistics planning, and partnering with other providers, like such as hospitals and pharmacies, to distribute give people doses. Their websites are great resources to understand options where you live. Locally, check out washoecounty.gov/health/programs-and-services/environmental-health/covid-19-guidance for vaccine updates in Washoe County. Many providers like Renown Health and other providers are sharing content around their recommendations for the vaccine. Get answers about the vaccine types from one of our pharmacists, read common concerns addressed by experts and view videos from many doctors and other specialists on our YouTube Channel.

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While there used to be three basic treatment options for cancer -- surgery, radiation and chemotherapy, or a combination of the three -- there's a fourth option: clinical trials. Here, a Renown patient shares her successful battle with ovarian cancer, aided by a clinical trial. Shari Flamm's battle with ovarian cancer began in 2011. She was experiencing prolonged bleeding, irregular thyroid levels and anemia and was scheduled to undergo a hysterectomy. Before the surgery, her gynecologist ran routine tests to check for cancer as a precautionary measure. All tests were negative for cancer, expect her CA 125 test. A CA 125 test measures the amount of the protein CA 125 (cancer antigen 125) in the blood. In some cases, a CA 125 test may be used to look for early signs of ovarian cancer in women with a very high risk of the disease. In most laboratories, the normal level is 0 to 35 units/ml. Flamm's CA 125 level was 121. As Flamm can attest, early diagnosis played a key role in her battle with ovarian cancer. September is Gynecologic Cancer and Ovarian Cancer Awareness Month – an important time to learn the signs, symptoms and risk factors of this type of cancer so your doctor can diagnosis the disease as early as possible. Ovarian Cancer: Round One Despite the elevated CA 125 results, her doctor recommended they move forward with the hysterectomy. But when surgery began, doctors discovered a mass. She had stage 4 cancer. The procedure was halted, the mass was biopsied and she was immediately seen by Dr. Peter Lim of the The Center of Hope. Following diagnosis, Flamm underwent surgery with Dr. Lim to remove the cancer, which had spread to part of diaphragm, spleen, colon and other organs. Three months after surgery, Flamm had recovered enough to start six rounds of chemotherapy in her hometown of Carson City. She continued working at a doctor's office during her treatment, and was grateful for Dr. Lim’s ability to co-manage her care so she could stay close to work and family. “To me, chemo was the scariest part because I didn’t like feeling sick,” Flamm says. Thankfully, her body responded well to the treatments and she was back to the things she loved. “I stated working out at the gym, even if it was only for 10 minutes,” she says. She also stayed positive by spending time with her grandchildren, attending a San Jose Sharks hockey game, going for walks and enjoying concerts. Ovarian Cancer: Round Two In November 2014, Flamm had a cancer check-up. That’s when doctors discovered three cancerous tumors. For this round, Flamm choose another treatment option -- clinical trials at Renown Institute for Cancer. Clinical trials are the studies that test whether drugs work, and inform doctors' decisions about how to treat their patients. Flamm participated in a clinical trial that featured oral-targeted therapy stronger than IV chemotherapy. The hope was for the drug to shrink her tumors, however the result was stabilization -- meaning the lumps weren’t growing or spreading. The best part of the clinical trial, Flamm says, was the constant monitoring. Between the CT scans every six weeks, a heart scan every three months and monthly doctor visits, she was confident that if the cancer started growing or spreading, her healthcare team would catch it right away. For Flamm, the benefits of the clinical trial included less hair loss, less fatigue and more time to focus on what’s important in her life -- her family. “I decided I wasn’t going to be that sick grandma on the couch with cancer,” Flamm says. After taking the oral medication for one year, Flamm developed a rash and discontinued treatment due to discomfort. Clinical Trials, Setbacks and Survival In June 2016, two of the three tumors began to grow and had to be surgically removed. Despite the setback, Flamm was determined to maintain a positive outlook. "You have to stay positive because cancer feeds off anger, depression and stress," Flamm says. Flamm was released to go home with clear margins, meaning the tumors were removed and are surrounded by a rim of normal tissue that does not have cancerous cells. Flamm says her outlook on life has changed drastically since her first cancer diagnosis. “Your whole mentality changes when cancer disturbs your life," Flann says. "The things that weren’t important, are now ever so important. I’m a lot calmer now,” Flamm says.

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Getting the COVID-19 booster is the best way to protect yourself from severe illness or death due to COVID-19, and both the CDC and the FDA have approved booster shots for people ages 18 and older. So, with the holidays right around the corner and infection rates on the rise both in Nevada and nationally, the best thing you can do to prevent the continued spread of this deadly virus is to get boosted today. The Basics: Who: It is recommended that everyone 18 years or older get a COVID-19 booster shot. When: At least 6 months after completing your primary COVID-19 vaccination series. What: Any of the COVID-19 vaccines authorized in the United States. The CDC allows for mix and match dosing for booster shots. How: To make an appointment for your COVID-19 vaccine booster, please visit vaccines.gov today. Appointment Reminders: Don’t forget to bring your CDC vaccination record card to your appointment. Refresh yourself on the potential side effects and remember that these are normal signs your body is building up protection. Commonly Asked Questions: Q: Does anything change if I received the Johnson & Johnson as my first COVID-19 vaccine? A: If you received the Johnson & Johnson COVID-19 vaccine, you are elidable for a booster two months after completing your primary vaccine. Q: Is the formula the same for the boosters as it was for the primary vaccine? A: COVID-19 booster shots are the same formulation as the current COVID-19 vaccines. However, in the case of the Moderna COVID-19 vaccine booster shot, it is half the dose of the vaccine people get for their primary series. Q: Am I still considered “fully vaccinated” if I don’t receive a COVID-19 booster shot. A: Yes, everyone is still considered fully vaccinated two weeks after their second dose in a two-shot series, such as the Pfizer-BioNTech or Moderna vaccines, or two weeks after a single-dose vaccine, such as the J&J/Janssen vaccine. All information courtesy of the Center for Disease Control and Prevention. All information courtesy of the Center for Disease Control and Prevention

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