By Elisabeth Buchwald and Andrew Keshner
Coronavirus vaccines are the light at the end of a very dark tunnel — a pandemic that has resulted in 2.78 million fatalities around the world and almost 550,000 in the U.S. alone.
The good news and the bad news: While the light may be closer as more people get vaccinated, the end of the tunnel is still far away — even for those people who have received a vaccine.
A U.S. Centers for Disease Control and Prevention study released Monday provided a little more hope.
After the second dose of vaccines from Moderna or Pfizer and BioNTech, a person’s risk of infection fell 90% at least two weeks afterward. After the first dose, the risk of infection fell 80%, according to the study, which looked at almost 4,000 health care workers, first responders and essential workers.
Both vaccines gained emergency-use authorization from the Food and Drug Administration for their effectiveness preventing disease from COVID-19. This study reviewed “vaccine effectiveness against infection, including infections that did not result in symptoms,” the CDC noted.
“These findings should offer hope to the millions of Americans receiving COVID-19 vaccines each day and to those who will have the opportunity to roll up their sleeves and get vaccinated in the weeks ahead,” CDC Director Rochelle Walensky said in a statement.
The same day, however, Walensky urged people to keep their guard up in the face of a plateauing case count, as well hospitalization and death rates edging up. “Right now, I’m scared,” she said.
In the U.S. more than 95 million Americans have received at least one dose and 52.6 million people have been fully vaccinated, according to data published by the U.S. Centers for Disease Control and Prevention.
Both of the two-shot vaccines take at least two weeks from the receipt of the second dose to build up an immune response, so people are considered fully vaccinated two weeks after their second shot. The Pfizer/BioNTech (NYS:PFE) (NAS:BNTX) vaccine offers 95% efficacy while the Moderna (NAS:MRNA) vaccine offers 94% efficacy, according to late-stage trials.
These efficacy rates for both vaccines means there’s a “94% chance of not getting seriously ill,” said Dr. William Schaffner, a CDC advisor and infectious disease specialist. “That’s very very successful.”
With flu shots, he said, “we don’t get anywhere close to that success. Year in and year out, it’s roughly 45% [effective].”
“We have been gathering information gradually from this study and other sources,” Schaffner, a professor at Vanderbilt University Medical Center, said of the latest CDC findings. “This is strong additional information that really shows [vaccination] reduces your chances of becoming a carrier asymptomatically and transmitting it to others.”
Does that mean that those approximately 52.6 million fully-vaccinated Americans can safely return to living their pre-COVID lives two weeks after they received their second dose?
“There’s still a small but finite chance you could actually transmit infection to others,” said Dr. Thomas Russo, chief of infectious disease at the University at Buffalo in New York. A person’s own behavior plays into the equation, as well as the amount of cases circulating around them, he noted.
That’s why Russo, who received his second dose of the Pfizer vaccine on Jan 5., said he’s only comfortable interacting with people who are also at least two weeks fully vaccinated in non-masked settings.
“I would go to a dinner party with my vaccinated friends because the likelihood that we are infectious is low,” he said. He recently had an outdoor gathering with a small number of other fully-vaccinated people. “Outdoors is always safer than indoors,” he said.
Russo really has not changed his behavior he said. Most of all because his wife only became vaccinated earlier in March. “If you’re fully vaccinated, it’s not all about you, it’s about all those loved ones” who may not be vaccinated, he noted.
Do the efficacy rate differences matter?
The 0.9% difference in efficacy rates between the Pfizer and Moderna vaccines is “meaningless,” said Dr. Gregory Poland, an infectious-disease expert and director of the Mayo Clinic’s Vaccine Research Group in Rochester, Minnesota.
Then there’s the Johnson & Johnson (NYS:JNJ) vaccine. The Food and Drug Administration gave it emergency-authorization use approval in February. The U.S. arm of the clinical trials showed a 72% efficacy rate and 85% rate against severe or critical disease.
People should not compare the vaccines, Russo said, because it may be an apples-to-oranges comparison. Besides, he added, “It doesn’t matter for the most important metric, which is keeping people out of the hospital and all those bad outcomes.”
Both the Pfizer and Moderna vaccines pose low risks in terms of dangerous side effects. There were 10 cases of anaphylaxis among the roughly 4 million doses administered between Dec. 21 and Jan. 10, the CDC reported.
Do I need to continue to wear a mask, even after I’m fully vaccinated?
Even if you’ve been fully vaccinated, it’s important to continue to wear a face mask and practice social distancing in public settings like supermarkets, restaurants and transportation where you’re likely to encounter more people who haven’t been vaccinated and could potentially get infected by you.
Not wearing a mask around older relatives and in public places even if you’ve been fully vaccinated “creates uncertainty and stress for other individuals because they don’t know whether you’ve been vaccinated,” Russo told MarketWatch.
New CDC recommendations released earlier in March say it’s OK to gather inside without masks with other fully-vaccinated people, so long as it’s been at least two weeks since everyone had their second shot.”
If I have been vaccinated, can I eat inside restaurants now?
Because diners typically don’t wear masks inside restaurants, there is a greater chance that you or another person will come into contact with respiratory droplets that can transmit coronavirus.
Outdoor dining is considerably safer than indoor dining, health experts contend, because virus-containing droplets have more room to disperse. It may also be easier to space tables more than six feet apart outdoors.
In the earlier stages of the vaccination effort, Russo cautioned against indoor dining even for vaccinated people. Now, that’s changed as vaccination rates have climbed and more studies have come out on the vaccines’ results. If people are fully vaccinated, not going out and about, masking and staying socially distant elsewhere, dining with other fully-vaccinated people is fine in Russo’s view.
“The risk is minimal,” although, he advised, “You never could get the risk to zero in the age of COVID.”
As vaccination rates climb, Schaffner said he would be comfortable with a trip to a restaurant and a movie — taking proper precautions, of course, like masking and social distance. “Would I go to a large group event? No, I’m not there.”
Is it OK to get on a plane?
The CDC is still urging people , regardless of their vaccination status, to avoid non-essential travel.
Round-trip domestic flights on average were 25% cheaper last year than 2019, according to data from travel website Hopper. But prices are expected to go up later this year as more people get vaccinated, according to some travel experts.
If you’ve been fully vaccinated, you don’t necessarily need to pass up travel steals. In fact, Russo hasn’t canceled a cruise trip he and his wife booked two years ago that’s scheduled to take place in late August this year. He’s “moderately optimistic” he will still go.
He would feel comfortable going on the trip now that his wife is also fully vaccinated and if everyone else on board was fully vaccinated and tested before they set sail.
The idea of vaccine passports is starting to take hold. On Friday, New York State announced it will launch the “Excelsior Pass,” a free and voluntary pass a person can use to show proof of vaccination or negative COVID-19 tests as they go to stadiums, weddings or other large events. Madison Square Garden is one of the venues that will start using the pass, the announcement said.
Can I visit my grandparents now that I’m vaccinated?
Coronavirus has taken a disproportionate toll on elderly people, especially those who live in long-term care facilities. Their documented vulnerability and susceptibility to contracting and potentially dying from coronavirus is why they are receiving priority access to the vaccine in the U.S., and other parts of the world.
Many nursing homes during the height of the pandemic banned visitors and people stopped interacting with elderly people in person. As a result, older people have experienced unprecedented rates of social isolation throughout the pandemic, which has been found to increase the risk of developing dementia.
If you and an older friend or relative have both been fully vaccinated “the benefits of the visit will outweigh these small risks that they could have of developing a severe case of coronavirus,” Russo told MarketWatch.
Likewise, Ashley Ritter, a geriatric nurse practitioner and postdoctoral fellow at the University of Pennsylvania School of Nursing, said she’ll feel more comfortable visiting her dad who is immuno-compromised and recently had a kidney transplant once she is fully vaccinated.
But Ritter, who also serves as chief clinical officer and vice president of the science-communication project Dear Pandemic , won’t visit him until he has also been fully vaccinated for two weeks.
“I haven’t seen him in so many months, so there will be so much more comfort in being in his company,” she told MarketWatch in late January. She and her father still plan to wear masks around each other to make sure they’re not inadvertently asymptomatically infecting one another.
Ultimately, a return to normal hinges upon getting as many people vaccinated as possible, Ritter said.
Health professionals say a vaccination rate of 70% to 80% would be close to bringing about herd immunity, where those who have the vaccine help prevent those who are not vaccinated from contracting the virus.
This story was originally published on Jan. 26, 2021 and was updated on March 29, 2021.
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