You are fully vaccinated against coronavirus – now what? Do not expect to remove the mask and return to normal activities immediately.
This will be a disappointment, if not a shock, for many people.
In Miami, 81-year-old Noemi Caraballo received her second dose on Tuesday and is looking forward to seeing friends, resuming gym classes and running errands after almost a year of being extremely cautious, even asking for groceries online.
“Her sentence is, ‘I’m tired of talking to cats and parrots,'” said her daughter Susan Caraballo. “She wants to do things and talk to people.”
But the Centers for Disease Control and Prevention have not yet changed their guidelines: at least for now, people should follow the same rules as everyone else about wearing a mask, keeping a distance of 1.8 m and avoiding crowds – even after they have received the second dose of the vaccine.
Vaccines in use so far require two doses, and experts say do not let your guard down after the first dose.
“You are asking a very logical question,” replied Dr. Anthony Fauci, the leading infectious disease specialist in the United States, when a 91-year-old California woman recently asked if she and her vaccinated friends could resume their mah- jongg.
In that exchange of webcast, Fauci was only able to point out the CDC’s recommendations, which so far are silent on exceptions for vaccinated people to meet. “Wait a minute,” he told the woman, saying he expected updates to the guidelines as more people received the coveted doses.
What experts also need to learn: vaccines are highly effective in preventing symptomatic COVID-19, especially serious illness and death – but no one yet knows how well they block the spread of coronavirus.
It is great if the vaccine means that someone who would otherwise have been hospitalized is just sniffling or even without symptoms. But “the imminent issue,” said Fauci during a coronavirus response briefing at the White House last week, is whether an infected person despite the vaccination can still unintentionally infect another person.
Studies are underway to find out, and tips are starting to emerge. Fauci pointed to a recent survey in Spain that shows that the more coronavirus an infected person has – what is called a viral load – the more infectious he is. This is not surprising, as with other diseases.
Some preliminary findings from Israel suggested that people infected after the first dose of the vaccine, when they are only partially protected, had lower viral loads than unvaccinated people who were infected. This is encouraging if the findings are valid. Israel vaccinated a large fraction of its population and scientists around the world are watching how the outbreak responds as vaccinations increase.
It is also critical to monitor whether vaccines protect against new mutant versions of the virus that are spreading rapidly in some countries, added Dr. Walter Orenstein, an infectious disease specialist at Emory University. He was vaccinated and strictly follows the CDC guidelines.
There are practical reasons. “It is difficult to say who was vaccinated and who was not if you are just walking around the supermarket,” noted University of Pennsylvania immunologist E. John Wherry.
And experts like Wherry are asked repeatedly: Yes, there are rules for being in public, but what is it safe for Grandma to do at home, with family or close friends, after being vaccinated?
Not everyone is stimulated the same way with vaccines – so someone with cancer or frail elderly people may not receive as much protection as a sturdy 70-something.
But most people should feel “more confident to go shopping, for example, or to see their grandchildren, or to hug their daughter,” said Wherry.
This is because the chances of a fully vaccinated person becoming seriously ill, although not zero, are low.
“Friends who come to dinner, we should try to follow the guidelines,” added Wherry. “You never know who is compromised, where the vaccine may not work as well.”
What if fully vaccinated vaccines are exposed to someone infected? The CDC recently simplified these rules: No quarantine, as long as the vaccinated person has no symptoms and at least two weeks have passed, but no more than three months, since the second dose.
Catching a plane?
Vaccinated or not, the CDC still recommends only essential trips.
International travel is an even more difficult prospect. Expect countries that already have different quarantine and testing requirements to have varying post-vaccination guidelines – especially since several types of vaccines, some more proven than others, are used around the world. There is also a concern to take these worrying changes from one country to another.
Watch for updates on advice as more people get vaccinated. In the meantime, don’t underestimate how important it is for vaccinees to feel less anxiety while running errands or going to work while following public health measures, said Dr. Luciana Borio, a former scientist at the Food and Drug Administration.
Even with a trip to the supermarket, “there was always this anxiety: ‘Was this the contact that was going to infect me?’” Said Borio. “This is a very powerful change in a person’s life situation.”