The elderly are one of the priority groups for vaccination. After health professionals and nursing home residents are vaccinated, the United States Centers for Disease Control and Prevention says that individuals aged 75 and over – along with other categories of essential workers – are next in line for vaccines . In an increasing number of states, the elderly are already being vaccinated or will be vaccinated soon.
What happens when older adults are vaccinated but their children and grandchildren are not? Can grandparents now be able to visit the family safely, or is there still some care they need to take? We turned to CNN medical analyst, Dr. Leana Wen, emergency physician and visiting professor at the Milken Institute School of Public Health at George Washington University, for guidance.
CNN: Let’s start with time. When does the vaccine give you protection after vaccination? How much protection it offers?
After the second dose, it probably takes another two or three weeks to develop the optimal degree of immune protection.
Say you received a dose of the vaccine. After a week or two, you have some level of immunity, but you can certainly get Covid-19 if you are exposed to the coronavirus. A few weeks after the second dose, studies have shown that the vaccine’s effectiveness is approximately 95%. This is a very high level of protection, but it is not 100%. So even after receiving both doses of the vaccine, you can still receive Covid-19, but your chance is much less. And if you got it, according to what we know from clinical trials, you will probably have a less serious illness than if you hadn’t had the vaccine.
CNN: After an older adult receives the second dose, and three weeks have passed, can he visit his grandchildren?
Wen: Perhaps. The answer is not as simple as saying that someone who has been vaccinated can return to pre-pandemic life. Here’s why.
First, the vaccine is not 100% effective. There is still a chance that someone who received the vaccine could get Covid-19. This is particularly true because many parts of the country are experiencing substantial outbreaks of infection. The rate of transmission in the community is very high, so there will still be a chance of getting the coronavirus even after vaccination.
Second, the vaccine has yet to show reduced transmission of the virus. We don’t know if vaccinated people can still carry the virus, even if they don’t get sick. This means that you can be protected if you are exposed to someone with a coronavirus, but you can still be a carrier of the virus. When you get together with your loved ones, you can spread it to those who are not vaccinated.
If your grandchildren live in the area, you can definitely see them safely outside, 2 meters away. If you want to see them inside the house, there will be some level of risk. This risk will be much less than if you were not vaccinated, but the risk will still exist for you. And you can still be a risk to the unvaccinated members of your family, as you can be an asymptomatic carrier that you transmit to them.
If you really want to spend time with your grandchildren inside the house, the safest way to do this is still for everyone to be quarantined for at least 10 days and decrease the risk during those 10 days. Quarantining for seven days and a negative test is also an option, but everyone should also quarantine – a negative test alone is not enough.
CNN: What is the purpose of the vaccine if I still have to be quarantined before I see people?
Wen: As far as we know so far through clinical trials, the vaccine offers a lot of protection. This will also bring you peace of mind. It reduces your chance of getting the virus and becoming seriously ill with it. We know that the elderly and those with chronic medical conditions have a very high risk of serious illness and death, and the vaccine will substantially reduce these results.
Since you have a very low risk as a result of getting the vaccine, it is a personal judgment as to which activities you value most and may want to take back. It may be very important for you to hug your grandchildren. If you do, recognize that it is not a zero risk activity, for you or for them. It is still better for everyone to wear masks while hugging, and to do so outdoors and preferably with their faces facing each other.
It may be very important for you to have a meal together. I would still advise different dishes, no buffet-style dining and eating outdoors instead of indoors.
If you live far from your grandchildren, you can think of traveling to see them if it is extremely important to you. Of course, continue to obey all the rules of disguise and social detachment. And know that you are still at risk of both acquiring the virus and transmitting it.
Remember that the risk increases. Getting the vaccine reduces your overall risk, but that does not mean that you should now perform all high-risk activities. Perhaps now you are choosing to have dinner with your grandchildren and hug them. Also, do not decide that you should go to a covered restaurant with your friends and go to a crowded cinema. You should still try to reduce the risk in your life as much as possible.
CNN: What if I also have friends who got the vaccine? Can I see them without my mask, indoors?
Wen: It is probably very safe to see other people who have also been vaccinated after everyone has received both doses and has waited a few weeks.
In a way, you can see that getting the vaccine is like being quarantined. If both parties have been quarantined, it is likely to be a very low risk to see each other safely. Likewise, if both parties received the vaccine, you can probably see yourself with relative safety. But, as we do not know whether vaccinated people can still be asymptomatic carriers, if you participate in risky behaviors, you can infect other people with whom you have close contact and who have not been vaccinated.
Let’s say you live with people who have not yet been vaccinated. You would not want to engage in activities where you could potentially acquire the coronavirus and then pass it on to others. This includes seeing other people who have been vaccinated but without a mask – as far as we know now, they can have the virus and pass it on to you, and you can pass it on to the people you live with. A lot of caution is still a good idea.
CNN: What is needed for us to socialize as we did before Covid-19?
Wen: The end of Covid-19 can come as soon as we reach collective immunity. We don’t know exactly how many people will need to develop immunity to reach this point, although experts like Dr. Anthony Fauci estimate that it could take up to 85% of Americans to be vaccinated. At this level of community immunity, the coronavirus would have nowhere else to spread and could die.
With the speed of the vaccine’s release so far, getting close to that level will take some time. In addition, clinical trials are just beginning on children, so it will probably take until summer or autumn for children to be vaccinated.
We have to define vaccination differently. Vaccination is not a “do what I want” pass, but another tool to reduce our risk. Wearing a mask is another tool, as is social detachment, and we want to continue using as many tools as we can to protect ourselves.
Getting the vaccine helps our community to enable us to achieve collective immunity more quickly. It also gives us permission to do a few more things we like – although we should still try to keep ourselves as safe as possible.
CNN: When will your children see their grandparents?
Wen: We are planning the summer or early fall of 2021 for my father to visit us from Vancouver, Canada. My husband’s mother is in Johannesburg, South Africa. We hope to visit her at Christmas 2021, if everyone is vaccinated by December. They haven’t seen my 3-year-old son in over a year, and it will be the first time they’ve met the baby – who is now 9 months old. We cannot wait – although we are patient and keep us safe in the meantime!