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You got your COVID-19 vaccine! Now what?

Having an effective vaccine against COVID-19 has been the end goal since the pandemic began. Thanks to advanced technologies, incredibly intelligent scientists, and significant government funding, several different effective COVID-19 vaccinations have been developed within record time. This feat deserves a major celebration, such as a Zoom happy hour or a vaccine dance party in the kitchen with your household members. But for now, it should be a celebration that maintains our current infection prevention practices. Large, unmasked gatherings remain in the distant future.  

We all want the “old” normal back.

There are several reasons why we can’t return to life as usual just yet. The first is that vaccine distribution will take time. Healthcare workers and those at highest risk of exposure and severe illness have been prioritized to get the vaccine first. The early vaccine rollout has been slowed by supply and distribution challenges to date. It is difficult to know when most Americans will have access to the vaccines, and they are not yet approved for use in children. 

Eradicating COVID-19 through vaccination will eventually require the vast majority of us to undergo vaccination. This is because of the concept of herd immunity. Herd immunity occurs when enough of the population has protection from a virus as a result of vaccination, and the virus can no longer spread. Those who are not already immune then benefit from indirect protection. Scientists estimate that approximately 70% of the population must be immune to COVID-19 to reach this level of protection from herd immunity.

A second reason for taking serious precaution is that we don’t know if the COVID-19 vaccines prevent asymptomatic spread of the virus. This question was not addressed in the large clinical trials, and further data will be required to confirm this. Until we are certain, continuing to wear masks and maintaining other prevention practices is important even after vaccination.

A final reason is that a small number of people may still go on to develop COVID-19 despite vaccination. While the vaccine studies show very high efficacy rates—around 95%—they aren’t perfect.  Statistics show that some people may not mount protective immunity after vaccination. However, if the COVID-19 vaccines follow suit with other vaccines, like the flu shot, we would anticipate a vaccinated person’s illness to be mild. It is not clear how long the immunity from the vaccine will last or if new strains of the virus will decrease their effectiveness. Widespread vaccination around the globe will likely help to reduce the risk of further viral mutations though. To quote the marvelous Dr. Fauci, “Viruses cannot mutate if they can’t replicate.” For all of these reasons, everyone who can safely receive a COVID-19 vaccine should get one as soon as it is available to them. 

So, what can we change?

If you ask healthcare professionals, the answer right now is probably going to be “not much,” because of all of the reasons discussed above. I just received my second dose of the Moderna vaccine this week, but I won’t be making any significant changes to my behavior yet. Will I feel safer when I go to the grocery store? Yes, but I will still wear my mask and maintain distance from other shoppers. Will I feel comfortable to invite my vaccinated coworker into my home for a meal? Yes, and this is something that I was not doing prior to my vaccination. With a new and unpredictable disease like COVID-19, it is best to take baby steps toward the future.  But even these small steps will bring us closer to each other again, and closer to life before COVID-19. 

Socializing in smaller groups with vaccinated friends and family will be significantly safer than prior to vaccination, and this is certainly something to look forward to. Many people want to know if they can hug their vaccinated friends and family. This is a real world scenario that just can’t be studied, so the answer is not simple. The risk of transmission will not be zero, though this risk is much, much smaller than without the vaccine. Emotional benefits of touch and hugging also play into the equation, and for many, these benefits may outweigh the significantly reduced risk of infection after vaccination. 

Keep in mind, the emerging variant strains of the COVID-19 virus could change things in the future. If someone does choose to begin hugging, dining with friends, and socializing in small groups, then wearing a mask or doing so outdoors can also help to lower risk. Socializing with unvaccinated friends and family will remain risky. Again, since we don’t know if the vaccine protects against asymptomatic infection, someone could possibly carry and transmit the virus to others without feeling ill despite being vaccinated. We all certainly want to keep our loved ones safe, so masking and distancing are still strategies to use when interacting with those who are not yet vaccinated. 

Events with large groups that may include unvaccinated people will carry even more risk.  Traditionally large events such as weddings or funerals are probably still best to avoid until that herd immunity threshold is reached, even if you have been vaccinated. Closed, crowded indoor spaces with poor ventilation will still pose a hazard for some time. 

It is also important to remember that we still don’t fully understand COVID-19 yet.  Even after a year, there are many things we still do not know about this disease, such as why certain healthy people become severely ill while others remain asymptomatic. Current treatments for those with severe illness from COVID-19 remain limited, and only one drug (remdesivir) currently has full FDA approval. It is likely that as vaccinations continue and herd immunity is achieved, then current preventative measures will be slowly lifted.  The vaccines are excellent, but for now, we must continue to proceed with caution.

 It is difficult to predict exactly what the future may hold, but many anticipate that COVID-19 will be with us for a long time. It is possible that we may experience continued intermittent outbreaks of the virus or its variants. Benefits of continued mask wearing, hand hygiene, covering coughs and sanitizing surfaces may include reduced rates of other infections, such as the common cold, influenza, or even strep throat. My two young children have not had any sniffles or sore throats this winter season, likely because of these virus transmission prevention measures.

My eight-year-old son said that he wants to hold a “mask-burning party” when COVID-19 is over.” In theory, I would love to light that match, but for now, I’m keeping our extensive mask collection around for safekeeping.

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