CDC Director Rochelle Walensky today announced that people who are fully vaccinated against COVID-19 can gather in small groups indoors without wearing masks. They can also be with unvaccinated family members who are at low-risk for a serious case of the disease.
“Fully vaccinated” is key, meaning two weeks have passed since someone’s final shot, whether it’s Johnson & Johnson’s single dose or Pfizer or Moderna’s second dose. In public, fully vaccinated people must still wear masks and practice social distancing.
KCRW looks at details of the new guidelines with Monica Gandhi, infectious disease specialist and professor of clinical medicine at the University of California, San Francisco.
KCRW: It seems like double masking, vaccines, vigilance and other factors helped positivity rates decline in California. Are you feeling hopeful?
Monica Gandhi: “I am very hopeful. I think we do have to keep some of our restrictions on, clearly, as we mass vaccinate. We're about 30 million Americans having been mass vaccinated, doubly vaccinated. And so I think what California is doing is wise, because we're keeping some of our restrictions on, but we're easing up on some to make ourselves have some economic and social outlet.”
What do you make of this new set of guidelines from the CDC? Can you expand on them? Apparently it's okay to gather in small groups, but what does that mean? Small gatherings of fully vaccinated people? What is right?
“They kept it sort of vague, actually. So essentially, what they're saying is vaccinated people can be together without masks, without distancing in small gatherings. And they literally use the word small, but they don't want medium or large gatherings. I mean, honestly, there was [sic] no numbers.
… It means we're going to judge for ourselves. I do think that if you're fully vaccinated, the number of people actually is immaterial. … But we're not getting to 1000 people in a room right now. … You shouldn't open for that because we don't know who's vaccinated. We don't know who's unvaccinated. We don't have bands in our arms. And we've decided as a nation not to have immunity passports, and I think that's really fair.”
Why not have immunity passports? Israel is doing that, and it’s proved to be quite an incentive. You can go out to theaters, clubs, etc. So some people are agreeing to get the shots.
“That's completely fair, and I've debated in my head a lot of times. Because the idea was that it would ... decrease vaccine hesitancy. I've just had a normal life, I can go to the movies.
I mean, we decided as a country not to do this here because … we don't still have the full vaccine access that they had in Israel. They rolled it out super quick. There are people who are waiting desperately for their vaccine [in the U.S.]. And there's this kind of unfair element. … It's not that I have vaccine hesitancy, I want my vaccine, I'm just not in the tiered system, I can't get it yet. And it sort of feels like you're rewarding the people we just happen to choose first.
… I feel like it's a couple of months. I know it feels like a long time, but we're all going to get there, whoever wants it. And then we'll be free.”
If I am an owner of a restaurant or an airline, why can’t I require people to have had the vaccine before I allow them in?
“Well we have actually allowed or ensured that sometimes you have to test before you're allowed in. For example, there are places in the country that you can't go without testing. So I think that's for the airline industry to decide.
I would rather people get vaccinated to prove that they could go to Hawaii, for example, than get tested. Because it's just so much easier, and it's quite a bunch of public health resource dollars to test.
… The CDC guidelines … there's an inconsistency. They said don't travel. Of course vaccinated people are going to travel. … For the airline industry to think about that is actually a very wise idea.
The thing about a restaurant — and again, every business can decide for themselves — we haven't decided this as a country. And so do you bring in that you've had one dose or two doses, is Johnson & Johnson as good as Moderna and Pfizer? It’s easier in Israel because it was one vaccine, fast rollout.”
There's also the guideline that fully vaccinated people can see their unvaccinated relatives who are at low risk for the disease. What does that mean?
"Can vaccinated grandparents see unvaccinated children? And essentially what the CDC guidelines did for us today is say the answer to that is yes. Because low-risk individuals are essentially children. … In this country, over 520,000 adults have died of COVID-19, but about 247 children have died. And that discrepancy is stark.
… Children are going to be vaccinated soon. We're finishing the trials for about 12 to 15 year olds. The trials for even younger are not there, they're going to happen eventually.
… Grandparents can go and visit adult children who are vaccinated with little children who are unvaccinated, and it is safe. And I thought that was a wonderful caveat to put in. It also acknowledged the data that transmission is likely very low if you've been vaccinated.”
What if you're an unvaccinated adult child of an older vaccinated person?
“These guidelines leave open the interpretation of that because they said, ‘Okay, you can go see the unvaccinated depending on their risk. … I would literally go to the CDC website and see what the risk is for a 50 year old getting sick from COVID without comorbidities. … We have stratification of who gets sick and who doesn't get sick. Comorbidities including obesity, hypertension, renal disease, pulmonary disease, cardiovascular disease … I wouldn't want my vaccinated person even around an unvaccinated person who could get sick.”
… I think allowing that interpretation for families is really fair of the CDC to do. It's acknowledging that the vaccines are getting us to normal life.”
We still don't know for sure whether or not vaccinated people can pass on this disease, even if they have no symptoms.
“We don't know for sure. But I don't want us to go back to December 2020, where we could say we don't know at all. We actually know quite a bit more since then. We've had seven studies now — one published in the New England Journal, one in The Lancet — [saying] that the risk of asymptomatic infection, if you've been vaccinated, is much lower. … Also some additional data [show] that if you even get it [coronavirus] in your nose after vaccination, you have very low viral loads.”
President Biden said last week that anyone who wants a vaccine can get one by the end of May. What do you envision after that for the summer?
“I do envision that we're going to have a really nice summer, actually. We don't need 100% of people in this country to get 100% effective vaccine[s] to get to the concept that our hospitalizations are already reducing and will massively reduce with vaccination, because it really blocks severe disease to a high degree. And that transmission will slow down because we're vaccinated, and we can't pass it on as well. Those two things will happen once we can get anyone who wants it to get it. We don't all have to get it. I hope a lot of people will.
And by allowing everyone with a choice … say everyone gets [a shot] at the end of May, give them three to four weeks for their second dose, think about mid-July as a pretty nice month in the United States.”