More than 95 million people have received at least one dose of the three available COVID-19 vaccines that are currently available in the United States. President Joe Biden has said that most American adults will be eligible for vaccination by April 19 — which means we’re all one step closer to getting our lives back.
But what does “back” actually mean when the U.S. is still very much in the grips of the coronavirus pandemic, and the country is in a race against a potential fourth surge? Is it safer now to spend time around friends, family or other daily contacts who haven’t gotten their shots? Can you see someone who has been vaccinated even if you have not? And what if you’ve received one shot in a two-shot regimen, but not both?
Here’s what you need to know:
Getting vaccinated doesn’t offer immediate protection.
Both the Pfizer and Moderna vaccines appear to be remarkably effective based on the data currently available. And yes, there is now pretty solid evidence that getting just one dose offers good protection. A recent Centers for Disease Control and Prevention study in healthcare workers found that one dose of the Pfizer or Moderna shots was 80% effective in preventing coronavirus infection.
But two shots are definitely still better than one, and the two vaccines are 90% effective (or perhaps more) two weeks after the second dose. Also those shots must be spaced out quite a bit (21 days between doses for the Pfizer vaccine; 28 for the Moderna).
“It takes a while for immunity to build up,” explained Edgar Sanchez, the vice chairman of the infectious disease group with Orlando Health in Florida. When he spoke to HuffPost in January, he’d just received his second vaccine dose, but explained that did not mean he would immediately start behaving differently.
“It doesn’t mean today I’m free to just do whatever I want,” Sanchez said during the conversation. “I saw COVID-19 patients today, and I was taking just as many precautions as I did yesterday before I was vaccinated.”
The timeline for the Johnson & Johnson shot is a bit different, because it only requires one dose — and people who receive that shot are considered fully vaccinated two weeks after they roll up their sleeves. At that point, current evidence suggests it is 66% effective at preventing symptomatic disease, 85% at preventing severe disease, and 100% against hospitalization and death.
Once you’ve been fully vaccinated, your own risk of getting COVID-19 goes way down.
The good news?
“If you have been vaccinated, you can believe that your own risk of getting symptomatic or severe COVID-19 disease is significantly reduced,” said Eric Robinette, a pediatric infectious disease specialist with Akron Children’s Hospital in Ohio.
But “significantly reduced” is not the same as nonexistent.
Even though both vaccines appear to be highly effective at protecting individuals against COVID-19, it’s still possible for a person who has received both doses to catch the virus.
Indeed, cases of COVID-19 among fully vaccinated people, which are sometimes called “breakthroughs,” really are expected, experts say — particularly as more and more Americans get their shots. As Katherine Wu recently wrote in The Atlantic: “Immunity is not a monolith, and the degree of defense roused by an infection or a vaccine will differ from person to person.”
The variants that have emerged over the past several months ― and that are circulating widely across much of the U.S. ― likely play a crucial role in breakthrough cases as well. While the three vaccines available now appear to do well in protecting against the major variants of concern, it’s not fully clear just how effective they are yet. Also, more variants could pop up and begin to spread.
It *appears* you can’t spread the virus to others after you’re fully vaccinated, but researchers are still conducting studies.
For months, one of the biggest questions around vaccination has been whether people who are fully immunized can still transmit the virus to others.
CDC director Rochelle Walensky recently made one of the strongest statements about whether getting vaccinated protects a person from spreading the coronavirus to others to date, saying: “Our data from the CDC today suggests, you know, that vaccinated people do not carry the virus, don’t get sick — and that it’s not just in the clinical trials, but it’s also in real world data.”
So far, there haven’t been major peer-reviewed studies showing that is definitively the case, but experts are hopeful.
“I am optimistic based on the basic science information previously described that the vaccine will at least reduce transmission risk,” Robinette said. “For now, the safe thing is to assume that only the person who has received the vaccine is protected from COVID-19.”
In some situations, it’s OK to go mask-free.
A lot has changed in terms of what public health officials think is safe for fully vaccinated people to do — which is really welcome news for a lot of Americans. The CDC now says that if it’s been two weeks since you received your second shot of the Pfizer or Moderna vaccines, or two weeks since you received the Johnson & Johnson vaccine, you can gather with other fully vaccinated people indoors without a mask. And you can gather with unvaccinated people from one other household without a mask, as long as they don’t have anyone who is at a greater risk of severe disease.
But there’s also a lot that is still the same, whether you’re fully vaccinated or not. You should still wear a mask and try and maintain social distance if you’re in public settings, if you’re getting together with unvaccinated people from more than one household, or if you’re seeing someone who is at greater risk of becoming really ill if they are infected with COVID-19.
Also, everyone should still be avoiding medium and large-size gatherings, regardless of vaccination status, the CDC says. And people should continue to put off non-essential domestic or international travel — again, even if you’re fully vaccinated.
It’s going to take a while until we reach herd immunity.
Infectious disease experts have waffled on what it will take to reach herd immunity in the U.S. Initially, they estimated that 60% to 70% of the population will need resistance to COVID-19 in order to stop it from spreading; now they’re saying it is probably more like 75% to 85%, or perhaps even higher.
While the pace of vaccination has increased significantly over the past month, we are still a long way off from those kinds of numbers. Also, children — who play a key role in our ability to reach herd immunity — cannot get vaccinated yet. And again, it’s also unclear how variants could hamper efforts to fully eradicate COVID-19. Some experts are warning that herd immunity is likely impossible.
All of which means we’re likely going to be living with relatively easy, low-cost public health precautions — again, like masking in public settings — for some time. Especially while millions of Americans must continue to wait for their vaccination slots, and then wait the requisite amount of time before they’re considered fully vaccinated.
“I hope,” Robinette said of those who receive both doses of the vaccine relatively early on in the rollout, “that people will use their newfound freedom to help others who haven’t yet been fortunate enough to be able to get the vaccine.”
This post has been updated to include more recent information and safety guidance from the CDC regarding the coronavirus vaccines.
Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.