What experts know about vaccines

When will our lives return to normal?

As coronavirus vaccines arrive in the Bay Area, there are as many reasons to feel hopeful as there are questions about how quickly things will change after nearly a year of living with the pandemic. How soon can I see grandma after getting vaccinated? When will I be able to board a plane for a tropical vacation? What are the odds of seeing the Rolling Stones on yet another farewell tour in 2021?

For many answers, we must, as the old Magic 8Ball would say, “Ask again later.”

With the record speed development of coronavirus vaccines, there is still a lot to learn. But infectious disease experts have some clues as to what we can expect in the months ahead.

Here is what we know so far:

Q: When can I get vaccinated?

A: The general population in California can expect vaccines to become widely available sometime around April or May, if there are no hitches in production, distribution or handling.

The initial vaccine doses are being distributed to Bay Area nurses, doctors and other health care workers caring for COVID19 patients. Next in line are staff and residents of skilled nursing facilities, according to the

California Department of Public Health’s vaccine allocation guidelines.

After that will be essential workers, including teachers, people working in retail and food service industries, and public servants such as police officers and firefighters. They will be followed by people who are over 65 and those who have preexisting conditions.

Even with detailed guidelines in place, experts say things could get messy.

“It gets a little dodgy trying to figure out how we’re going to sort those groups out,” said Dr. Bob Wachter, an infectious disease expert with UCSF, speaking at a Commonwealth Club event. “Are they going to be asking you to prove that you’re a teacher? To prove that you work in a grocery store? And how is that going to work? I don’t think anybody has any idea.”

Once we get through the distribution hurdles, you will probably be able to get vaccinated at a pharmacy, like CVS or Walgreens, or at a medical provider’s office, in a process that is similar to getting an annual flu shot.

Q: Will I still be able to get COVID19 after I am vaccinated? A: Studies show that the first two vaccines available to Bay Area residents, developed by Pfizer and Moderna, will effectively prevent you from having a severe COVID19 outcome once you get the second dose.

What is less clear is whether or not people will remain infectious once fully inoculated and whether they can spread the disease. Vaccine maker Moderna claims that its vaccine can prevent asymptomatic, as well as symptomatic, infection. But this information has not been confirmed by an independent authority and will most likely take months to verify.

“For now, you should presume you will be 95% protected from disease, but not from infection and spread,” said Ken Kelley, a pandemic adviser to the National Institute of Allergy and Infectious Diseases, speaking at the Commonwealth Club event. Q: Can I stop wearing a mask after I am vaccinated?

A: Health care experts say that you will have to continue wearing masks, social distancing, and following other coronavirus safety measures through the summer, at the very least.

Because it is not clear whether or not you are infectious after you are vaccinated, and not everyone will get a vaccine at once, consider yourself a potential spreader of the virus.

“I will continue to wear a mask until I am absolutely sure I am not carrying it,” said Wachter.

The U. S. will not effectively suppress the pandemic until 75% to 85% of the population gets fully vaccinated, Dr. Anthony Fauci said in a virtual conversation with Facebook CEO Mark Zuckerberg.

“The challenge is going to be to convince people to get vaccinated,” the nation’s top infectious disease expert said. “If you want to be part of the solution, get vaccinated. Say, ‘ I’m not going to be part of the stepping stone of getting the virus to other people. I’m going to be a deadend to the virus.’ ”

Q: Will I be able to choose which vaccine I get?

A: It is unlikely that people will choose which vaccine they receive. Those in the front of the line for inoculations will either get the Pfizer or Moderna vaccines. While we could see other candidates, such as those produced by Johnson & Johnson and AstraZeneca, be approved before the summer, what is available to you will probably be determined by your health care provider.

As far as vaccine quality goes, the experts say it should not be an issue.

“I would get whichever vaccine I can get, as soon as possible,” said Kelley, pointing out that the vaccine efficacy numbers are probabilistic. “Even when half the country is vaccinated, you still run the risk of getting infected, getting very sick, and dying. Period. So get the first vaccine you can get and don’t comparison shop.” Q: Should I be worried about the side effects of the vaccine?

A: Infectious disease experts say people should not worry about side effects that may accompany coronavirus vaccine shots.

“With any vaccine, when you get an injection, you induce a response. Some people don’t feel anything. Some people might feel an ache in an arm. Some people will get chills or feel fluish. Almost all of this goes away in 24 to 48 hours,” Fauci said.

Adverse effects are low grade.

“They’re not serious. They’re not prolonged. What your body is telling you is it’s responding well to the injection. It’s making the kind of response you want,” Fauci said.

There is no evidence of any longterm severe side effects to the coronavirus vaccines currently being distributed, and experts say the benefit far outweighs the risk of contracting a potentially deadly disease.

“Any robust vaccine may generate some discomfort but it is worth the mild side effects — these side effects are not extraordinary — to be immune against this circulating new pandemic,” said Dr. Monica Gandhi, an infectious disease physician at UCSF.

Q: Will I need to prove I am vaccinated to go back to work?

A: Many companies will probably be able to require workers to be vaccinated against the coronavirus.

While making the vaccine mandatory could create friction, it could cause legal complications to require employees to return to offices among colleagues who have refused protection against the virus.

“In a setting like that, you have to have everybody vaccinated,” said Dr. John Swartzberg, an infectious disease specialist at the UC Berkeley School of Public Health.

The federal Equal Employment Opportunity Commission, which handles enforcement of workplace laws, said it is studying the issue.

“The commission continues to closely monitor the developments of a COVID19 vaccine and is actively evaluating how a potential vaccine would interact with employers’ obligations,” spokeswoman Christine Nazer said in a statement.

Q: When will it be safe to visit my grandmother?

A: Even though vaccines will become widely available over the next few months, highrisk activities such as seeing older relatives, traveling and going to the barber will be on hold until we have better information about the vaccines.

“We can do it in the back half of 2021,” Fauci said, calling vaccines a gamechanger. “I believe as we get into the second quarter, we can have a degree of protection that we can approach normality in many of our activities.”

But experts warn that the virus may not entirely disappear even with vaccines.

Wachter forecasts that things will get somewhat back to normal once the risk of COVID19 is akin to the risk of the flu, which kills about 40,000 people a year.

He thinks we will reach that stage in approximately six months, when people become tired of wearing masks and not seeing loved ones while vaccines and treatments become effective enough to minimize deaths.

“I think we will probably declare victory and say let’s go back to normal,” he said. “Whether it’s the right moment or we should have waited a month from then, who knows? It’s not going to be zero cases or zero deaths. It’s going to be when we reach the ‘ like the flu’ stage.”

He optimistically predicts that by the Fourth of July we may be attending picnics and parades, if not baseball games.

“Maybe congregating in a large stadium will be the last to go,” Wachter said. “As an individual, if I and the people around me have gotten the vaccine, I think we will be comfortable congregating in a way we just weren’t six months ago.”