After you get a COVID-19 vaccine, what can you do safely?

As more people are fully vaccinated, certain activities will become less risky, but experts still recommend holding on to precautions for the near future.

Published 11 Feb 2021, 12:39 GMT
As more people are vaccinated, how to reenter society safely becomes an important question.

As more people are vaccinated, how to reenter society safely becomes an important question.

About a year into the global pandemic, as the worldwide death toll exceeds a dizzying 2.3 million, hope has arrived in the form of multiple vaccines created in record time that have shown impressive success in preventing COVID-19.

“What all the vaccines have been is very highly protective against severe disease, hospitalisation, and death,” says William Moss, executive director of the International Vaccine Access Centre at Johns Hopkins Bloomberg School of Public Health. That, he says, is the most important success story of COVID-19 vaccines and will help bring this brutal pandemic under control.

With the number of vaccinated individuals growing daily, many wonder: What previously risky activities, such as meeting up indoors with friends or going out shopping without a mask on, are now safer with a vaccine? This is what the experts say about how to calculate the risks of some common activities after you’ve been vaccinated.

How long after being vaccinated does 'full' immunity kick in?

The two mRNA vaccines that are currently approved for use in the U.S., Moderna and Pfizer-BioNTech, involve two doses spaced three or four weeks apart. It takes one to two weeks after the second shot to achieve the maximum level of protection from COVID-19. In clinical trials, these vaccines are each about 95 percent effective in preventing cases of COVID-19. In the UK, the two approved Pfizer-BioNtech and Oxford-Astrazeneca vaccines are also delivered in two doses, with the latter's second dose advised 3-12 weeks after the first

At this point, it is unknown how long immunity will last after a person is fully vaccinated, and only time will reveal the answer. The COVID-19 vaccine could become a yearly shot, similar to the flu shot; its benefits could last for a shorter time, or longer.

Can vaccinated people have no symptoms and still spread the virus to the unvaccinated?

This question is critical, but has not been rigorously studied yet. The data available so far indicate that vaccination significantly curbs infection in people who show no symptoms. In Moderna’s phase 3 clinical trial, a diagnostic test before the second dose of the vaccine showed 89.6 percent of asymptomatic and symptomatic cases were prevented by the first dose.

Preliminary results from phase 3 trials of the Oxford-AstraZeneca vaccine showed a 67 percent reduction in positive swab tests after one vaccination.

That result is “really encouraging,” says John Swartzberg, clinical professor emeritus at University of California Berkeley’s School of Public Health. “That's going to make me feel, as a responsible person, that I can more safely be around other people.”

How safe is it for vaccinated people to get together?

The decision for vaccinated people to gather involves mental “calculus,” says Swartzberg, which should take into account how likely anyone is to be exposed to the SARS-CoV-2 virus, vaccinated or not, because there is still a small chance even a vaccinated person could become infected.

As time goes on, when more people are vaccinated and the number of infected individuals continues to drop, Moss says a gathering among vaccinated people “will be a safe one” and continue to get safer.

“To be on the safe side,” says Cynthia Leifer, associate professor of immunology at Cornell University, “we should still practice distancing measures as much as we can in the shorter term until we get broader distribution of the vaccine.” She recommends people continue to follow the guidelines of avoiding large groups, wearing masks and staying at least six feet apart.

There are also unknowns surrounding how effective the vaccines will be against new variants that haven’t been discovered.

“The more that COVID is circulating right now, the more potential there is for variants to arise,” Leifer says. “We can’t predict when a new variant might arise that is perhaps not covered by the vaccine.”

The Novavax vaccine, which is not approved for use, showed a sizeable drop in efficacy—from 89.3 percent to 49.4 percent—against a variant that originated in South Africa, but has since spread internationally. Pfizer and Moderna are still testing how well its vaccines work against a more contagious variant first discovered in the U.K.

Should vaccinated people still wear masks in public places?

Experts agree that everyone should wear masks, at least for the time being. Beyond not knowing who is vaccinated and who isn’t, which could potentially lead to awkward and confusing situations, each person can have a different immune reaction to a vaccine.

“So, you immunise 100 people, they're all going to have varying levels of response to that vaccine; some may be not good enough to protect them,” Leifer says. There is really no way to know what kind of response your own body had to the vaccine, so wearing a mask adds an extra layer of protection. There is also still the open question of how much people who have had the vaccine will be able to transmit the virus.

“I look at the vaccine as a big patch, but there are other patches we can have to protect ourselves, Swartzberg says. “The vaccine is probably the biggest one.” Another such patch is a mask, and he does not think anyone should stop using one.

Is it safe to travel after I am vaccinated?

For many, it has been months or over a year  since they have been able to meet family and friends face to face, but getting the vaccine doesn’t automatically mean it is entirely safe to travel the world.

Regulations aside, “I think it comes down to what people feel comfortable with, but they need to be aware that we can't at this time predict when new variants will arise, where they will arise, and whether you'll be protected,” Leifer says. “It's not like when you get the vaccine, you all of a sudden have a Captain America shield around you.”

Swartzberg says while he may soon feel safe socialising in small groups with other vaccinated individuals, air travel is a different story: “I'm not going to know who's in the airport, who's in the airplane...so it's going to be much longer before I'm confident that there aren’t going to be a lot of unvaccinated people on that airplane or in that airport.”

How long will it be until enough people are vaccinated to go 'back to normal?'

The easygoing world of 2019 may now be a distant memory, but with the vaccine rollout underway, a cautious sense of normalcy—eating at a restaurant, going to school, karaoke night with friends—seems within grasp.

So far, over 107 million people have been vaccinated worldwide. In the UK, currently 13 million people - almost 20% – have received their first dose of a vaccine.

On the road to herd immunity, there will be signs that normalcy may be returning. Swartzberg says he will feel better as the number of new cases decreases, lessening the chance of being exposed to the virus.

“The way I see this playing out is that it's going to be kind of a phase transition back to pre-pandemic times,” says Moss. The first step is to reduce cases, hospitalisations, and deaths through vaccination so thorough contact tracing can be implemented in an effective way. 

Leifer is hopeful that the vaccine rollout can speed up with creative distribution and manufacturing plans. “My vision would be that we get there by the end of the summer, so that students can go back to school,” she says.

A vaccine isn’t a golden ticket, but it provides people a way to reduce their risk and get back to their loved ones sooner.

“I haven't hugged my grandchildren and children, going on 10 months now,” Swartzberg says, “At some point I really need to do that.”

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