So you’ve been vaccinated. Now what?
Let’s say you’ve gotten both doses of the vaccine and 20 days have gone by. Can you take off your mask and not feel guilty? Can you see your grandkids again? Can you go out on a date inside a restaurant?
The answer is, not surprisingly, not a very simple one.
The CDC has set some basic guidelines, such as “vaccinated persons with an exposure to someone with suspected or confirmed COVID- 19 are not required to quarantine.” But, ultimately, it comes down to acceptable levels of risk, as Yale- New Haven Health’s director of infection prevention, Rick Martinello, explained.
“To a reasonable extent, having been fully vaccinated is a factor in how we make those personal decisions,” he said. “It doesn't impact the law. It doesn't impact public health guidance, but it is going to impact how we as individuals, and as families, make decisions about what's right for us.”
A question of risk
The available vaccines are, Martinello explained, approximately, 95 percent effective at preventing severe reactions to the coronavirus. Studies have shown that they are also somewhat effective at preventing an infected person from transmitting the virus to someone else.
But 95 percent is not 100 percent. There is still a measure of risk to yourself and to the community.
“One thing that's really important is, while it's 95 percent effective, it's still not perfect. So, yes, there is still some risk, but that risk is markedly less than what we had before,” Martinello said. “But beyond that risk to you as an individual is the risk to your family, if you were to bring it home.”
Your risk goes down after you’ve been vaccinated, but vaccinations are not the only such tool. Your risk goes down if you keep 6 feet of distance. Your risk goes down if you wear a mask. The risk of helping the virus spread through the community goes down, too
There’s also the issue of what Martinello called
“risk compensation,” which he defined as an over- inflated sense of security.
“If you're doing something to decrease your risk with one action, such as getting vaccinated, it's going to alter your behaviors that may actually increase your risk,” he said.
Vaccines do offer a sense of security, Martinello said, but “there is no single action that keeps us perfectly safe, with the exception of totally isolating yourselves from others.”
What matters is not what we can do after you or I get vaccinated, but what we can do after everyone is vaccinated, according to Martinello.
“One thing that's different about vaccination is it’s going to provide us immunity, and that immunity will lead us to freedom,” he said.
Herd immunity
If, as Martinello said, herd immunity will mean freedom, the question then becomes, when might we see herd immunity in Connecticut?
According to Pedro Mendes, director of UConn’s Center for Cell Analysis and Modeling, herd immunity will be reached when 80 percent of the population is immune to the coronavirus.
His model estimates that, currently, “we have around 20 percent of the Connecticut population immune.”
That counts both people who have contracted the virus and survived, and people who have been fully inoculated. Mendes’ model only counts people who have been fully vaccinated.
Mendes’ baseline of 80 percent, though, could change depending on how widespread more transmissible variants become.
“Since the B. 1.1.7 ( also known as the U. K. variant) has about 50 percent higher infectivity, that raises the level of the herd immunity, from 70 percent to 85 percent,” he said. “It is unknown how prevalent it is ( or will be), so I am assuming 80 percent for herd immunity.”
Depending on how fast everyone is vaccinated in the state, Mendes said hopefully the herd immunity threshold could be reached sometime late this summer.
Right now, Mendes said Connecticut is issuing about 5,500 second doses a day and, at that rate, “we would only get close to herd immunity by the end of the year.”
“However if we go up to 10,000 doses a day then we would reach herd immunity sometime in August,” he said. “I believe that with the increases in dose distribution promised by the feds, the state should be able to meet that 10,000 per day number,” Mendes said.
Years of waves
Martinello explained that viruses, specifically those that attack the respiratory system, come and go naturally in waves.
“What happens is, it literally takes years for this to work through the population and for that population to develop herd immunity,” he said. “And, of course, there's a great deal of tragedy along the way, with the millions who are dying as herd immunity develops in that population.”
“Then things get back to whatever that new normal is, but it takes a few years to get there,” he said.
Vaccines are, Martinello said, a bit of a shortcut to herd immunity, cutting those years down into smaller pieces. But that doesn’t mean other mitigation strategies can be abandoned.
“We're mitigating and, quote, flattening the curve with our public health interventions of masking, distancing, etcetera,” he said. “But it's still that long, painful road without vaccination. Vaccination allows us to accelerate the development of herd immunity, and get us to that point where we can decide what that new normal is going to be.”
Will grandparents be able to see their grandkids? Will people go out on dates and eat inside restaurants without fear? Probably. But that doesn’t mean the new normal is going to be the same as the old normal.
“That new normal, we’re going to be going back to school, with kids in school, but are you still going to be working from home?” Martinello asked. “Are health care workers going to always be wearing . masks? That may be our new normal in the future.”