What’s OK and what’s not after vaccination?
Caution will still be the operative word moving ahead
Vaccines are here, bringing hope of the pandemic’s end. But even when you get your dose, it won’t mean an immediate return to life as you knew it.
Scientists cite several reasons for staying masked and cautious as you start your post-vaccine life. Vaccines don’t offer perfect protection; we don’t yet know whether vaccinated people can spread the virus; and coronavirus is likely to continue its rapid spread until a large majority of the population is vaccinated or has survived a natural infection.
Because vaccines will not be a ticket back to 2019, Uma Karmarkar, a neuroeconomist at UC San Diego, recommends that people think about “how we are moving forward” instead of “getting back to normal.”
When it comes to thinking
about what’s safe, it may help to think of post-vaccine life in several phases.
• What’s safer to do once I’m vaccinated?
When people are fully vaccinated (a week or two after the second dose), but most others aren’t yet, their lives probably shouldn’t change very much, experts say. It will most likely be safer for them to do things like visit the grocery store or the post office. But vaccinated people should still wear masks and avoid large groups and indoor gatherings when possible.
That’s important for both their health and the health of others, experts said. Scientists are waiting to learn if vaccinated people can spread the virus to others.
Also, while early evidence suggests that the first vaccines in the U.S. reduce people’s risk of developing COVID-19 by about 95%, that still means a small fraction could get sick, and as long as the virus is as widespread as it is now, even that small share could be a big number.
“Five percent of a really high number is still a high number, and what you want is 5% of a relatively medium or low number,” said Dr. Ashish Jha, a physician and the dean of the School of Public Health at Brown.
In an informal survey of 700 epidemiologists by The New York Times, less than a third said they would change their behavior after they were vaccinated; half said they would wait until at least 70% of the population was vaccinated.
• What’s safer to do once my friends and family are vaccinated?
If you and the people you want to see are all vaccinated, it should be safer to socialize with them, including indoors, experts said. But being in large groups or traveling, when there’s no way to know if the people around you have been vaccinated, will remain risky, they said.
Eric Lofgren, an infectious disease epidemiologist at Washington State University, said at that point, he would restart in-person board game nights and oneon- one meetings with students, but he wouldn’t fly on vacation or go to a movie theater.
“Immunity is not an on/ off switch; it’s a dial,” he said. “If you’re below herd immunity, the virus is still happily circulating in the population and there’s always a chance the vaccine isn’t working for you.”
In some ways, this may be the hardest phase of post-vaccine life to navigate. Deciding which risks to take will involve calculations that can prove exhausting, said Elizabeth Dorrance Hall, an assistant professor of communications at Michigan State University: “Our brains just get so tired of weighing each and every thing that we just run out of brainpower on gradients.”
• What’s safer to do once most of the population is vaccinated?
It should be much safer to move around once your community achieves herd immunity, which is the point when the virus can’t ea sily spread because enough people have become vaccinated or have already had the illness. This also helps protect people who can’t get vaccinated for health reasons and people who work in crowded or indoor places.
Many scientists think at least 70% of people need to have acquired immunity for the whole community to be protected. That number is just an estimate, though, and might need to be revised once we know more about how vaccines affect the virus’s ability to spread.
When a majority of people are vaccinated, scientists said, it will be safer to do things in your community, like eat at indoor restaurants, attend a party or ride a bus. Next Christmas, families can probably gather in ways they should avoid this year, they said.
It’s too early to know exactly when we’ll hit that threshold. Although federal officials have said the United States should have the resources to vaccinate hundreds of millions of people by summer, many scientists say that timeline is optimistic. There could be logistical challenges to vaccinating everyone and some people have expressed hesitancy about getting the vaccine.
Also, experts stressed that even when herd immunity is reached, COVID-19 is not likely to disappear outright. Outbreaks could still be likely, probably in winter.
“Winter is going to start being flu and COVID season,” said Andrew Noymer, an epidemiologist studying COVID-19 at UC Irvine.
The last things he will return to, he said, are international travel and crowded events like concerts, but he expects to do those again at some point.
“I intend to go back bit by bit,” he said.
• What will the new normal look like?
Scientists said they were waiting to learn many things before they would feel comfortable doing more high-risk activities, like how many people wind up being vaccinated, how long immunity lasts (after vaccination and after infection) and whether the virus evolves.
This coming summer will probably be more open because more people will be vaccinated and the virus seems to slow in warmer months as people can more easily socialize outdoors. But expect an uptick in cases and hospitalizations next winter, scientists say.
“It’s a really exciting time for science, but I would maintain that caution,” said Delivette Castor, an infectious disease epidemiologist at Columbia. “For me
personally, I will not be at ease until we have sufficient coverage in the community and we’ve had it for a durable period of time.”
In the new normal, there may be more mask-wearing during flu season or in crowded places because awareness has been raised. And there will probably be more systems in place to prevent pandemics from being as deadly, Castor said. These include methods for tracking emerging infections and screening before activities like flying.
That is a hopeful development, experts say. This year, rates of seasonal flu are substantially lower than usual, a shift they say is partly explained by the widespread use of masks and physical distancing. If we keep them up, the changes that coronavirus has wrought — like the decline of handshaking — may have payoffs in reducing risks of other diseases in the future.
“Immunity is not an on/off switch; it’s a dial,” he said. “If you’re below herd immunity, the virus is still happily circulating in the population and there’s always a chance the vaccine isn’t working for you.” — Eric Lofgren, infectious epidemiologist at Washington State University