For those now fully immunized against COVID-19, the rules havent changed – yet – MLive.com

February 6, 2021

Janet Hanson hasnt had anyone inside her home outside of maintenance workers for almost a year.

Because of the pandemic, the 86-year-old -- who lives in the Friendship Village senior citizen complex in Kalamazoo -- cant travel to see her daughter in Arizona. Hanson saw her son only in outdoor venues until it got too cold, and now theyre limited to phone calls. Her social life these days are limited to outdoor walks with several neighbors, all fully masked.

But on Friday, Hanson got her second dose of the Moderna vaccine. In two weeks, she will be considered 95% protected against COVID-19.

And yet its unclear when Hansons life will change; she still needs to adhere to the strict rules put in place by Friendship Village.

And its not just Friendship Village. Hanson is one of a quarter-million Michigan residents who have gotten two doses of a coronavirus vaccine so far, and public-health experts and infectious-disease doctors are saying all those individuals need to continue with masks and social distancing for now.

We havent gotten to the point yet where we say, OK, you can go go around maskless even after vaccination, even two weeks after the second dose, said Dr. Frank Rosenblat, an Oakland County infectious disease specialist with McLaren Health.

The issue is this, say Rosenblat and others: The data is clear that the vaccines greatly reduces the risks of being hospitalized or dying of COVID-19. What is much less clear is whether the current vaccines protect against asymptomatic cases.

And if, in fact, vaccinated people can still be infected with the virus, that means they could infect others and put them at risk of severe illness or death.

So whats happening now is, in effect, a real-world experiment to see what happens, and help public-health experts craft appropriate guidelines.

We have a pretty good confidence level that the vaccines prevent serious illness associated with COVID, Rosenblat said. But we dont know if people who are vaccinated can still transmit the virus to others. Theres no real data yet. Were experiencing and collecting the data as we go.

So Im telling my patients to stay safe, he said. Continue to put a mask on and do all the things you were doing before with social distancing and all that stuff until we have some better data, which Im pretty confident well have in the coming months.

Dr. Anurag Malani, an Ann Arbor infectious disease specialist with Trinity Health, said hes also telling his patients to stay the course on coronavirus mitigation strategies for now.

If you look at the Pfizer and Moderna vaccine trials, the vaccines were 95% effective in preventing symptomatic COVID infection, he said. But we dont have the answers yet on whether people can still be infected and infectious. And the other thing thats really important is you dont necessarily know whos had the vaccine.

For those reasons, he said, the guidance around masking and social distancing, thats not going away right now, and I dont see that changing in the near future.

That said, Malani said that researchers will be looking closely at different metrics to see how fast the nationwide vaccination program can bring down the number of COVID-19 cases and deaths, and at what point herd immunity kicks in -- which means case rates fall low enough that even unvaccinated people are unlikely to get the virus.

While doctors stress the importance of masking and social distancing in public venues, they do say people who are fully immunized can start weighing the risk of increased interactions with friends and family in private settings, particularly with others who are also immunized.

If youve had the vaccine and someone else has had the vaccine, that kind of changes things in terms of rules for interaction, Malani said. The risk of spending time together is going to be significantly less, if theres any risk at all.

Its been almost a month since Dr. Maureen Ford, an emergency department physician at Bronson Methodist Hospital in Kalamazoo, got her second dose of vaccine. Shes still masking and social distancing around those outside her household.

I definitely havent changed my immediate behavior, she said.

But once her parents and in-laws get fully immunized, Ford said that she may loosen things up a bit with them -- although one factor is that Fords husband and children will still be unvaccinated.

We may hang out indoors, but I honestly think well still mask, she said. And hopefully, in the spring and summer, we can do more -- especially outdoor stuff -- and be able to see each other more regularly.

Ford said there are tentative plans for a summer camping trip with extended family. Were optimistic that can happen, she said.

Dr. Dennis Cunningham, an infectious disease specialist with Henry Ford Health System in metro Detroit, said the vaccine does give more protection, which means, say, sharing a meal with people outside the household becomes less risky.

But even with the vaccine, he said, theres still a 5% risk for a vaccinated person to have a symptomatic case of COVID. You have to think about whether its worth the risk, he said. It can be a pretty brutal infection, so I would advise people to be more conservative in relaxing the rules.

But Mulani also acknowledges that many people -- especially senior citizens -- have had severely constricted social lives for almost a year, and the risk vs. benefit calculations have shifted as the pandemic has continued.

COVID has taught us that nothing is 100% risk free, right? he said. Its all about risk mitigation.

So yes, I think even if youve been vaccinated, you need to avoid a Super Bowl party with people you dont know, he said. But there are situations where the risk is low enough that Id be willing to consider the potential upside, like grandparents seeing their family members. Vaccinated people getting together with other vaccinated people.

He and others also said that as more people become vaccinated and, hopefully, coronavirus case levels diminish, public-health recommendations are likely to loosen in upcoming months.

The way we move towards a time where were not wearing masks is by having enough of population immune -- herd immunity -- and were nowhere near that now, Mulani said. But as more people get vaccinated, every day is hopefully a step in the right direction.

It cant come fast enough for Hanson and her friends in Friendship Village.

A lot of us do feel its about time to start the change in moving back to normal, Hanson said. Change at least some things. Im looking forward to it.

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