What's safe once you've had your COVID-19 vaccine?
By Michael Merschel, American Heart Association News
Carl Bradford's life got upended by the pandemic.
The Vacaville, California, artist lost chances to exhibit at galleries. He's been unable to see his far-flung family or go to the gym. The 65-year-old steps out to volunteer with his church's food pantry but stays carefully masked and distanced.
He's also just had his second COVID-19 vaccine dose. So is he ready to resume his old life, maybe hop on a plane to see his children and grandchildren?
"Everybody's trying to stay smart," he said. The family made a pact: They won't get together until they get the official all-clear from health experts.
And the official word is: Once you're vaccinated, sit tight a while longer. Things will be better soon, experts say. But vaccination is not a get-out-of-jail-free card.
"It would be lovely to think that that was the case," said Dr. Donald Lloyd-Jones, a cardiologist, epidemiologist and chair of the department of preventive medicine at the Northwestern University Feinberg School of Medicine in Chicago. "But unfortunately, we're not at the state in the science to understand that we can turn people loose after they've gotten both of their vaccinations."
The Centers for Disease Control and Prevention agrees. Until researchers know more, even vaccinated people are advised to wear masks in public, keep at least six feet from other people, avoid poorly ventilated spaces and keep their guard up.
"Clearly, currently available vaccinations do protect one against severe COVID infection," said Lloyd-Jones, president-elect of the American Heart Association. "But we are just beginning to get data about whether someone who has been vaccinated can still transmit the virus."
A vaccinated person can still test positive for the virus in their nose, he said, and it's unclear if that material is infectious. "Given that we don't know and given that we know what the consequences of keeping this pandemic going are, we have to err on the side of safety." The so-called variants – mutated versions of the virus – also are cause for precaution even after vaccination.
So if you're vaccinated, you can feel good about being safe from severe infection. But "don't really change your behavior yet until we know more," Lloyd-Jones said. And that applies to people with underlying heart conditions. Their rules for post-vaccination safety are the same.
Dr. Monica Gandhi, an infectious disease doctor and professor of medicine at the University of California, San Francisco, emphasized optimism in her advice.
The vaccines available in the U.S., she said, are "really, really good" at protecting people from severe COVID-19. The problem is, "going out – you don't know if everyone in the grocery store is vaccinated or unvaccinated. So the recommendation is going to be we all mask and distance around each other until we get to herd immunity."
Gandhi, director of the UCSF Center for AIDS Research, said preliminary evidence from Israel about the BioNTech/Pfizer vaccine's ability to limit virus transmission looked promising.
She thinks vaccinated people should feel safe going to the gym – if they stay masked and distanced. "This is going to be the rule until we're all vaccinated."
She also said there was good reason to believe vaccinated people could feel safe around small groups of other vaccinated people. But Lloyd-Jones said the scientific evidence can't rule out the possibility that people could spread the virus in such situations.
Intuition might suggest a small gathering of fully vaccinated people might be relatively safe, he said. "But I wouldn't want to bet the farm on it until we get to herd immunity."
Gandhi emphasized concerns about mental health and the potential damage caused by loneliness. For vaccinated people wanting to visit unvaccinated family or friends, extra precautions such as COVID-19 testing, masking and maybe even quarantining would be necessary, she said.
Although Lloyd-Jones agreed mental health concerns are important, "we're just not ready" for large gatherings or footloose travel yet. If someone absolutely has to travel, he said, "think about maybe skipping the food and keeping the mask on for the whole flight, if that's at all possible."
Gandhi is hopeful things will be close to normal by fall. "By Christmas 2021, plan your trips, do whatever you want."
Bradford can wait.
He has been treated for prostate cancer, and his wife has diabetes – both underlying conditions that can put someone at risk of severe COVID-19, as can heart disease, which runs in his family. His mother had heart issues, and his father – one of the legendary Tuskegee Airmen of World War II – died of a heart attack at age 73.
Bradford is eager to travel again to see family on the East Coast and down in Florida. But "I'm not jumping on a plane to go see them, and they're not jumping on the plane to come see me." Staying a little bit scared is healthy, he thinks.
Gandhi sees a bright future, though.
"We will all get through this, and we will get to a normal life," she said. "It seems almost completely unbelievable, because life is so abnormal – but we will."
Editor's note: Because of the rapidly evolving events surrounding the coronavirus, the facts and advice presented in this story may have changed since publication. Visit Heart.org for the latest coverage, and check with the Centers for Disease Control and Prevention and local health officials for the most recent guidance.
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