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As the highly contagious omicron variant fuels a surge in coronavirus case counts, public officials are reconsidering what it means to be “fully vaccinated.”

Starting Jan. 8, Maui County will require booster shots for those eligible to get them in order to be considered fully vaccinated, making it the first county in the state to do so.

That means those who decline a booster won’t be allowed in the county’s indoor restaurants, bars and gyms, unless they can show proof of a negative Covid test within 48 hours.

Patrons will continue to be able to dine outdoors without a vaccination card or proof of a recent negative Covid test, or they can get take-out.

“Science says that after the second shot of Pfizer and Moderna vaccinations or the single Johnson & Johnson shot, vaccinations weaken after about six months,” Maui Mayor Michael Victorino announced Thursday. “This rule change recognizes that.”

The policy change was applauded by the state’s top public health officials.

“Hooray for Maui,” Hawaii Department of Health spokesman Brooks Baehr said in a text message Thursday, adding that the agency “wholeheartedly” supports the county’s move to include a third shot in the definition of fully vaccinated.

In November, the DOH announced that CDC data show the two-dose regimen of the Pfizer and Moderna vaccines offer significant protection against hospitalization and death, but that protection diminishes over time. Booster vaccinations provide additional protection by re-energizing the body’s natural defense systems.

While nearly 75% of Hawaii’s eligible population have received a double dose of the Pfizer or Moderna vaccine shots or a single dose of the Johnson & Johnson vaccine, the state has administered booster shots to less than a quarter of residents ages five and up.

The CDC has said that people who are eligible for a booster shot should get boosted. But the agency so far has not revised its definition of what it means to be fully vaccinated.

Boosters will not be required for people who rolled up a sleeve for the second shot of the Pfizer or Moderna vaccines less than six months ago and people who got the Johnson & Johnson vaccine less than two months ago.

Beyond Hawaii, companies and colleges are beginning to require booster shots, including Goldman Sachs, the Metropolitan Opera, New York University and Georgetown.

New York State has said it also plans to stop considering residents fully vaccinated without a booster shot, The New York Times reported.

Civil Beat’s coverage of Maui County is supported in part by a grant from the Nuestro Futuro Foundation.