“The current response is far from satisfying. The Centers for Disease Control and Prevention’s official guidance is that vaccinated people need to keep masking, physical distancing and basically following all pre-vaccine precautions. Those eager to fly across the country to see loved ones might hesitate because they are warned against viewing vaccination as a “free pass to travel.” The only area where the CDC has relented is in its quarantine guidance: It now says that starting 14 days after receiving the second dose of vaccine, and for a period of three months, fully vaccinated people don’t need to quarantine after being exposed to someone with covid-19.
While that is surely a relief, it’s hardly a strong selling point. After all, the Pfizer and Moderna vaccines are 95 percent effective at preventing symptomatic illness and nearly 100 percent at preventing severe disease. These are astounding results, and essentially mean that covid-19 in a vaccinated person is no worse than a bad cold or the flu.
However, because the research isn’t definitive on whether vaccinated people can transmit covid-19, people are advised that they shouldn’t change their lifestyles. Such caution is understandable, but the lack of guidance may cause so much frustration that some people go to the extreme: I’ve had patients talk about discarding masks and going barhopping. Others could question what the purpose of the vaccine is if their lives don’t change at all. It’s not enough to explain the societal goal of reaching herd immunity months or years down the line; we need to articulate freedoms people can enjoy now because of the vaccine.
I hope the CDC will provide more specific post-vaccination recommendations based on the best available data, even if they are incomplete. There is growing evidence that, just as with many other vaccines, those receiving coronavirus inoculations shed less virus and are less contagious after exposure. Two preliminary studiesfrom Israel found a decline in viral load after the Pfizer vaccine. A preprint reported that the AstraZeneca vaccine reduced positive test results by 67 percent. Data from Moderna’s vaccine also suggest that it reduces asymptomatic infection. Together, these results should allow the CDC to provide a preliminary road map to post-vaccine life.
The easiest decision point is around essential activities people previously considered to be too high-risk. Those who put off medical appointments such as cancer screenings or dental visits should get them taken care of now. Those not working solely because of fear of exposure could return knowing that they’re reasonably protected from serious illness.
I think the guidance can go further and say that some nonessential activities are okay, too, with precautions. People longing to go to the gym or out to a restaurant should be able to, as long as they continue to abide by rules like masking and distancing in case they are infectious to others. I’d still warn against the newly vaccinated going to crowded bars, and they should take particular caution if they live with unvaccinated people to not bring the virus home.
If everyone in a household is vaccinated, I believe recommendations can allow for more activities previously deemed high-risk. A couple who want to get together with another fully vaccinated couple are probably fine to do so, including to hug and see one another indoors, without masks. They should probably still avoid large gatherings, because risk increases with exposure, and there’s no guarantee that everyone who says they’re vaccinated truly is.
What about grandparents who want to see their families? If the reason the visits didn’t occur earlier was concern for the elderly, then many families may decide it’s fine now because the grandparents are protected. The likelihood of contracting the coronavirus during travel is already pretty low, and with vigilant masking during plane rides, grandparents would pose only a low risk to unvaccinated family members. That risk can be reduced further by vaccinated visitors avoiding other social gatherings before travel.
Some might say that there isn’t sufficient data to make these recommendations. To be sure, we won’t know for certain until there is real-world testing and contact-tracing results. If it turns out that many new covid-19 infections originated from vaccinated people, or if emerging variants evade existing vaccines, the guidance can be adjusted — perhaps the vaccinated will need to abide by more restrictions again.
But if there is anything we’ve learned during the pandemic, it’s that people need clear, practical guidance for how to navigate their lives, and they need it now. We finally have vaccines that provide extraordinary protection. Let’s help people use them to protect themselves while reclaiming some degree of normality and giving everyone hope for a post-pandemic future.