Where is the CDC’s guidance to the vaccinated?

First, the Centers for Disease Control and Prevention guidance on what fully vaccinated people can safely do was expected on Thursday. Then the release got pushed back. On Friday, CDC Director Rochelle Walensky said it would not happen that day, either, but that guidance would come “soon.”

These unacceptable delays illustrate a larger problem in communication about the coronavirus vaccines: Public health officials have chosen caution over celebration. If this doesn’t change, Americans could be dissuaded from being vaccinated, and our country might never achieve the goal of herd immunity.

So far, more than 8% of Americans are fully vaccinated. As vaccinations have ramped up, with an average of 2 million shots per day going into arms, clinicians have been bombarded with questions from people eager to plan trips, see their loved ones and generally return to their pre-pandemic lives.

In the absence of CDC guidance, we in the medical community have been giving patients our best advice. It’s fine to see other fully vaccinated people, for example. Grandparents can travel to see the rest of their family. In public places, vaccinated people should still wear masks, but they can take off their masks around loved ones, in small-group settings.

Patients understand that we don’t have all the answers. We don’t know for sure that vaccinated people won’t spread the coronavirus, but the likelihood is probably greatly reduced. We can’t predict exactly how much risk is reduced by getting inoculated, but we can say with certainty that the chance of vaccinated people getting severely ill is very low.

This is more than enough information for the CDC to issue preliminary guidelines. On Friday, Walensky said the CDC is weighing “complex issues” and wants to “take the time to get this right.” I understand the impulse to be cautious, but there is a cost to waiting. Some governors are ending mask mandates and allowing all businesses to return to 100% capacity, regardless of workers’ or patrons’ vaccination status. Individuals are changing their behaviors accordingly. Every day that passes without guidance, the CDC becomes less relevant to decision-making.

This overly timid approach also means that public health officials continue to undersell the incredible benefits of the coronavirus vaccines. If the vaccines are so good, why can’t it be clearly articulated what people can do after getting them? Right now, there is more demand than vaccine supply, but this will change soon. By July, and possibly earlier, the barrier to reaching herd immunity will be vaccine hesitancy.

What public health officials need to do, now, is unequivocally endorse vaccination as the path to normalcy. The CDC has an opportunity to give all the examples of things fully vaccinated individuals can do that the unvaccinated cannot. For example, officials could say that vaccinated people are not only able but also encouraged to travel; on the other hand, unvaccinated people should still limit travel to essential trips and must be tested before and quarantine after. Vaccinated nursing home residents could have vaccinated visitors; unvaccinated people cannot. The CDC could say that it’s low-risk for vaccinated people to return to restaurants, churches and museums; it could go further and urge business owners and policymakers to enact different rules for them.

Some might say that such recommendations would be irresponsible if there are still risks – what if vaccinated people can still infect others? I don’t disagree: There will be some risk. But this risk is low, and it must be balanced against other risks, including the continuing impacts of isolation and economic hardship, and the concern that people won’t see the point of vaccination. Others will argue for fairness: What about those who haven’t been inoculated due to access? I’ve strongly advocated for speed and equity in vaccine distribution, and a lot of work remains to be done on both fronts. But just because some people can’t yet enjoy certain freedoms doesn’t mean that they must be denied to all others. It’s only a matter of a few months before all who want the freedoms can have them, and it’s essential to incentivize vaccination so we can collectively reach herd immunity.

Come on, CDC. Please give Americans the exhilarating news and the hope that we’ve been longing for. The perfect cannot be the enemy of the good. There is a real cost to continued inaction.