Albuquerque Journal

‘HERE TO STAY’

5 REASONS TO WEAR A MASK EVEN AFTER YOU’RE VACCINATED

- BY LIZ SZABO Kaiser Health News (KHN) is a national health policy news service. It is an editoriall­y independen­t program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

As an emergency physician, Dr. Eugenia South was in the first group of people to receive a COVID-19 vaccine. She received her second dose last week — even before President Joe Biden.

Yet South said she’s in no rush to throw away her face mask.

“I honestly don’t think I’ll ever go without a mask at work again,” said South, faculty director of the Urban Health Lab at the University of Pennsylvan­ia in Philadelph­ia. “I don’t think I’ll ever feel safe doing that.”

And although COVID-19 vaccines are highly effective, South plans to continue wearing her mask outside the hospital as well.

Health experts say there are good reasons to follow her example.

“Masks and social distancing will need to continue into the foreseeabl­e future — until we have some level of herd immunity,” said Dr. Preeti Malani, chief health officer at the University of Michigan. “Masks and distancing are here to stay.”

Malani and other health experts explained five reasons Americans should hold on to their masks:

1 NO VACCINE IS 100% EFFECTIVE

Large clinical trials found that two doses of the Moderna and Pfizer-BioNTech vaccines prevented 95% of illnesses caused by the coronaviru­s. While those results are impressive, 1 in 20 people are left unprotecte­d, said Dr. Tom Frieden, a former director of the Centers for Disease Control and Prevention.

Malani notes that vaccines were tested in controlled clinical trials at top medical centers, under optimal conditions.

In the real world, vaccines are usually slightly less effective. Scientists use specific terms to describe the phenomenon. They refer to the protection offered by vaccines in clinical trials as “efficacy,” while the actual immunity seen in a vaccinated population is “effectiven­ess.”

The effectiven­ess of COVID-19 vaccines could be affected by the way they’re handled, Malani said. The genetic material used in mRNA vaccines — made with messenger RNA from the coronaviru­s — is so fragile that it has to be carefully stored and transporte­d.

Any variation from the CDC’s strict guidance could influence how well vaccines work, Malani said.

2 VACCINES DON’T PROVIDE IMMEDIATE PROTECTION

No vaccine is effective right away, Malani said. It takes about two weeks for the immune system to make the antibodies that block viral infections.

COVID-19 vaccines will take a little longer than other inoculatio­ns, such as the flu shot, because both the Moderna and Pfizer products require two doses. The Pfizer shots are given three weeks apart; the Moderna shots, four weeks apart.

In other words, full protection won’t arrive until five or six weeks after the first shot. So, a person vaccinated on New Year’s Day won’t be fully protected until Valentine’s Day.

3 COVID-19 VACCINES MAY NOT PREVENT YOU FROM SPREADING THE VIRUS

Vaccines can provide two levels of protection. The measles vaccine prevents viruses from causing infection, so vaccinated people don’t spread the infection or develop symptoms. Most other vaccines — including flu shots — prevent people from becoming sick but not from becoming infected or passing the virus to others, said Dr. Paul Offit, who advises the National Institutes of Health and Food and Drug Administra­tion on COVID-19 vaccines.

While COVID-19 vaccines clearly prevent illness, researcher­s need more time to figure out whether they prevent transmissi­on, too, said Phoenix-based epidemiolo­gist Saskia Popescu, an assistant professor in the bio-defense program at George Mason University’s Schar School of Policy and Government.

“We don’t yet know if the vaccine protects against infection, or only against illness,” said Frieden, now CEO of Resolve to Save Lives, a global public health initiative. “In other words, a vaccinated person might still be able to spread the virus, even if they don’t feel sick.”

4 MASKS PROTECT PEOPLE WITH COMPROMISE­D IMMUNE SYSTEMS

People with cancer are at particular risk from COVID-19. Studies show they’re more likely than others to become infected and die from the virus, but may not be protected by vaccines, said Dr. Gary Lyman, a professor at Fred Hutchinson Cancer Research Center.

People with lung cancer are less able to fight off pneumonia, while those undergoing chemothera­py or radiation treatment have weakened immune systems. Leukemia and lymphoma attack immune cells directly, which makes it harder for patients to fight off the virus.

Doctors don’t know much about how people with cancer will respond to vaccines, because they were excluded from randomized trials, Lyman said. Only a handful of study participan­ts were diagnosed with cancer after enrolling. Among those people, COVID-19 vaccines protected only 76%.

Although the vaccines appear safe, “prior studies with other vaccines raise concerns that immunosupp­ressed patients, including cancer patients, may not mount as great an immune response as healthy patients,” Lyman said. “For now, we should assume that patients with cancer may not experience the 95% efficacy.” Some people aren’t able to be vaccinated. While most people with allergies can receive COVID-19 vaccines safely, the CDC advises those who have had severe allergic reactions to vaccine ingredient­s, including polyethyle­ne glycol, to avoid vaccinatio­n. The agency also warns people who have had dangerous allergic reactions to a first vaccine dose to skip the second.

Lyman encourages people to continue wearing masks to protect those with cancer and others who won’t be fully protected.

5 MASKS PROTECT AGAINST ANY STRAIN OF THE CORONAVIRU­S, IN SPITE OF GENETIC MUTATIONS

Global health leaders are extremely concerned about new genetic variants of the coronaviru­s, which appear to be at least 50% more contagious than the original.

So far, studies suggest vaccines will still work against these new strains.

One thing is clear: Public health measures — such as avoiding crowds, physical distancing and masks — reduce the risk of contractin­g all strains of the coronaviru­s, as well as other respirator­y diseases, Frieden said. For example, the number of flu cases worldwide has been dramatical­ly lower since countries began asking citizens to stay home and wear masks.

“Masks will remain effective,” Malani said. “But careful and consistent use will be essential.”

The best hope for ending the pandemic isn’t to choose between masks, physical distancing and vaccines, Offit said, but to combine them. “The three approaches work best as a team,” he said.

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CATHRYN CUNNINGHAM/JOURNAL

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