More than 27 million Americans who are fully vaccinated against coronavirus will have to wait for guidance from federal health authorities on what they should and should not do.
The Biden administration said today that it is focused on getting the guidance right and accommodating new science, but the delays add to the uncertainty surrounding bringing a pendemic to an end as the country’s virus fatigue grows.
“These are complex topics, and science is evolving rapidly,” said Rochelle Walensky, director of the Centers for Disease Control and Prevention today. “We are taking care of and taking the time to rectify this and we will release this guide soon.”
Such guidance will address a stream of questions coming in from people who have been fully vaccinated against COVID-19: Should I still wear a mask? Can I go to a bar now? Can I finally see my grandchildren?
The need has slowly grown since January, when the first Americans began completing the two-dose series of COVID-19 vaccines that were available. Now, more than half of those 65 and older have received at least one shot, according to Andy Slavitt, a senior administration adviser on the pandemic.
In the state of Washington, Raul Espinoza Gomez has 22 grandchildren and great-grandchildren and an appointment Saturday for his second dose of coronavirus vaccine.
This Easter, the 77-year-old’s immune system is ready to protect him from the virus. But how the family celebrates will depend on government advice, said Melissa Espinoza, 47, of Carnation, Washington, who plans to drive Gomez, her father-in-law, to get her second shot.
“We did not gather as one big family at Christmas,” she said. “We follow what state and federal guidelines recommend. We have had family members who are negatively affected by COVID. We know the risks are serious. ”
The Biden administration is concerned about persistently high cases and deaths and has condemned efforts to ease state virus restrictions and begged the public for more months of patience.
The caution has drawn critics pointing to the administration’s own warnings that “fatigue is gaining ground” as evidence that they need to be more optimistic about the road ahead of ensuring co-operation between those yet to be vaccinated.
“I think it’s going to be way too descriptive and conservative, and that’s the wrong message,” former FDA Commissioner Scott Gottlieb told CNBC on Wednesday about the upcoming CDC guide. “If we remain highly described and do not give people a realistic vision of what a better future will look like, they will begin to ignore the public health guidelines.”
Dr. Jeremy Faust, an emergency physician at Brigham and Women’s Hospital in the Department of Health Policy and Public Health, urged the CDC to be clearer about when and how it plans to produce guidelines for the vaccinated.
“Making the decision to go after science also makes the decision that you will have to make a decision, which is really difficult when science is not settled,” he told the AP. “They drink from a fire snake of science, and sometimes it gets messy.”
More than 54 million Americans have received at least one dose of vaccine, and just over half – almost 28 million – have received the recommended two doses. Single dose Johnson & Johnson shot soon will add a few million more Americans with questions about what new freedoms they can surely enjoy.
“I hope I get to see my great-grandchildren more,” said Rolando Solar, 92, who received his second dose in Miami on Wednesday. “But I know things will not return to normal, and for an old man like me, this is as good as it will be.”
Tami Katz-Freiman, 65, from Miami, got her second dose three weeks ago and plans to see the Miami Film Festival almost Sunday at the home of unvaccinated friends. Everyone wants to wear masks.
“We did not need to discuss it with each other, because it is very clear to me that when there is doubt and you do not have a CDC rule, you should rather be on the safe side and take care of yourself,” Katz – Freiman said.
Three weeks ago, the CDC announced that fully vaccinated people do not need to be quarantined if they have contact with someone with a confirmed infection (for 90 days after the last shot). But the agency said nothing beyond that, noted Dr. Leana Wen, an emergency physician and public health professor at George Washington University.
“It (quarantine guidance) seems to suggest to me that your chances of getting COVID-19 and being a carrier for others are pretty low,” said Wen, who previously headed Baltimore’s health department.
”(But) we have to focus on what is most relevant to people’s lives, and my patients do not come in and ask me, ‘If I am vaccinated, do I still have to be quarantined if I am exposed to it? ‘” went on.
“I would say the most common question I get is ‘Can I visit my grandchildren?’,” Wen said.
Experts say it is understandable that the CDC has been cautious when there are still many scientific questions, including how long vaccine-induced immunity lasts, and whether vaccinated people are still able to transmit the virus to others. The answers are important when advising someone on what type of risk they face in different settings and how great a risk they are to others.
“The vaccines, at their best, in the clinical trials were 95% effective, I did not say 100%. And that’s why we have to keep wearing masks most of the time, ”said Dr. William Schaffner, an infectious disease expert at Vanderbilt University.
But the CDC has needed to come up with something more for vaccinated people than sticking to the same old mask wearing, socially distant guidance, he added.
“People are so eager to do something and they want to see a concrete benefit from the vaccines. Americans are impatient. They will continue to do so, ”Schaffner said.
In fact, there is “a real cost to postponing this guidance,” when people turn to their own doctors for advice or just make their own assumptions and decisions, Wen said.
Waiting too long may diminish the agency’s relevance to this type of case, said Wen, who believes the CDC should have had some sort of guide for vaccinated people back in January.
Clearly, vaccinated people should have been encouraged to get cancer screening, dental care, or other necessary medical appointments. CDC officials could also have said it is OK for small groups of fully vaccinated people – perhaps for example two or three couples – to gather for a dinner or other small gathering, she said.
In terms of smaller gatherings among people who have been fully vaccinated, “the relative risk is so low that you do not have to wear a mask that you can have a good social gathering at home,” said Dr. Anthony Fauci, the government’s leading infectious disease physician during a recent White House briefing.
Some experts discussed the possibility that cinemas or cruise ships or certain other companies could open up to vaccinated people and ask for proof of vaccination status. The Israeli government has begun issuing a “green pass” vaccination certificate to anyone who has received two doses of COVID vaccine through an accredited vaccination service.
“I do not know if we in this country will tolerate the federal government issuing a kind of passport, as they did in Israel,” Wen said. But companies may want such passes, and they will be an incentive that can help the overall vaccination rate, Wen said.
The only incentive Espinoza’s family needed for vaccination was to see her and her husband hospitalized with COVID-19 this winter. She is still recovering and using oxygen at home.
Vaccination of the family elders means a step closer to returning to traditions they love: Church on Palm Sunday and a week later an Easter egg hunt for the kids and a meal of slow-cooked barbecue, a Mexican beef dish.
“I hope people will stay home and be as safe as possible until we can all be vaccinated and eradicate this disease,” Espinoza said.