The elderly are one of the priority groups for vaccination. After vaccinating health care workers and nursing home residents, the U.S. Centers for Disease Control and Prevention said individuals 75 and older – along with other categories of essential workers – are next in line to get vaccines. In a growing number of states, older people are already vaccinated or soon to be vaccinated.
What happens when the elderly are vaccinated, but their children and grandchildren are not vaccinated? Can grandparents now visit the family safely, or are there still certain precautions they need to take? We turned to CNN medical analyst Dr. Leana Wen, an emergency physician and visiting professor at George Washington University’s Milken School of Public Health, for guidance.
CNN: Let’s start with the timing. When does the vaccine give you protection after vaccination? How much protection does it offer?
After the second dose, it may take another two or three weeks for the development of the optimum degree of immune protection.
Suppose you have received one dose of the vaccine. After a week or two, you have a certain level of immunity, but you can definitely catch Covid-19 if you are exposed to the Coronavirus. A few weeks after the second dose, studies have shown that the vaccine’s effectiveness is close to 95%. This is a very high level of protection but it is not 100%. So even after getting two doses of the vaccine, you can still get Covid-19, but your chance is much lower. And if you get it, according to what we know from clinical trials, you are more likely to develop a less serious disease than if you did not get the vaccine.
CNN: Once an adult receives the second dose, and it’s been three weeks, can he visit his grandchildren?
Wen: Could. The answer is not as simple as saying that a person who is vaccinated can return to life before the pandemic. Here’s why.
First, the vaccine is not 100% effective. There is still a chance that a person who received the vaccine will become infected with Covid-19. This is especially true as many parts of the country are experiencing a spike in infections. The rate of community transmission is very high, so there is still a chance of contracting the Coronavirus even after vaccination.
Second, the vaccine has not yet been shown to reduce transmission of the virus. We don’t know if the vaccinated people are still carriers of the virus, even if they don’t get sick. This means that you can protect yourself if you are exposed to someone with coronavirus, but you could still be a carrier of the virus. When you meet your loved ones, you can spread it to those who have not been vaccinated.
If your grandchildren live in the area, you can definitely see them safely outside, 6 feet away. If you were to see them indoors, there would be a certain level of risk. This risk will be much lower than if you weren’t vaccinated, but the risk still remains for you. And it can still pose a risk to your unvaccinated family members, as you could be an asymptomatic carrier it passes on to them.
If you really want to spend time with the grandchildren indoors, the safest way to do so is for everyone to quarantine for at least 10 days and reduce their risks during these 10 days. A seven-day quarantine and a negative test is also an option, but everyone also has to go into quarantine – a negative test alone is not enough.
CNN: What is the purpose of a vaccine if I still have to quarantine before seeing people?
Wen: From what we know so far in clinical trials, the vaccine offers a lot of protection. It will also bring you peace of mind. It reduces your chance of contracting the virus and getting very sick from it. We know that the elderly and those with chronic medical conditions have a very high risk of serious illness and death, and a vaccine will significantly reduce these outcomes.
Since the risks are greatly reduced as a result of getting the vaccine, this is a personal judgment of the activities you value most and may want to consider taking back. Maybe it is really important that you hug your grandchildren. If you do, know that it is not a risk-free activity for you or them. It’s still best for everyone to wear masks while hugging, and to do it outdoors and ideally with faces away from each other.
It might be really important to eat a meal together. I still recommend different dishes, no buffet style dinners, and al fresco dining instead of indoors.
If you live far from your grandchildren, you may consider traveling to see them if this is of great importance to you. Of course, keep abiding by all rules of social distancing and anonymity. Know that you still have some risk of contracting the virus as well as transmitting the virus.
Please bear in mind that the risks increase. Getting vaccinated reduces your overall risk, but that doesn’t mean you now have to do every high-risk activity. You may now choose to have dinner with your grandchildren and cuddle them. Also don’t decide that you have to go to an indoor restaurant with your friends and go to a crowded movie theater. You should still try to reduce the risks in your life as much as you can.
CNN: What if I have friends who also got vaccinated? Can I see them without my mask inside?
Wen: It may be very safe to see others who have also been vaccinated, after everyone has had the two doses and waited a few weeks.
Somehow, you can see getting vaccinated as though he’s in quarantine. If both parties are in quarantine, there is likely to be very little risk of seeing each other safely. In the same way, if both parties get vaccinated, you are likely to see each other relatively safely. But because we do not know if vaccinated people are still carriers of symptoms, if you engage in risky behaviors, you may infect others in close contact with them who have not been vaccinated.
Suppose you live with people who have not yet been vaccinated. You will not want to engage in activities where you could potentially contract the coronavirus and then pass it on to others. This includes seeing other people who have been vaccinated, but not wearing a mask – based on what we know now, they could be infected with the virus and pass it on to you, and you can pass it on to the people you live with. An abundance of caution is still a good idea.
CNN: What does it take to be able to socialize like we did before Covid-19?
Wen: The end of Covid-19 could come once we reach herd immunity. We don’t know exactly how many people will need to develop immunity to get to this point, although experts such as Dr. Anthony Fauci estimate this could take up to 85% of the American people to be vaccinated. At this level of immunity in society, the Coronavirus has nowhere to spread and can essentially die.
With the vaccine rollout so fast, getting close to this level will take some time. Also, clinical trials in children have begun, so it will likely take until summer or fall for children to be vaccinated.
We have to frame grafting differently. Vaccination is not a “do what I want” statement, but rather another tool to reduce our risks. Wearing a mask is another tool like social distancing, and we want to keep using as many tools as possible to protect ourselves.
Getting vaccinated helps our community allow us to achieve herd immunity faster. It also gives us a license to do some of the other things we enjoy – although we still have to try to keep it as safe as possible.
CNN: When will your children see their grandparents?
Wen: We are planning summer or early fall 2021 for my father to visit us from Vancouver, Canada. My mother-in-law is in Johannesburg, South Africa. We hope to visit it at Christmas 2021, if everyone gets vaccinated by December. They haven’t seen my 3-year-old in over a year and it will be the first time they have met the baby – who is now 9 months old. We can’t wait – though we’ll be patient and stay safe in the meantime!