Coronavirus: Information & Resources

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A Series of Articles on the Science Behind COVID-19

Life after Vaccination — To Mask or Not to Mask — That Is the Question

By: Ahmad M. Rashid, MD, pulmonary and critical care physician, National Jewish Health
March 4, 2021

Before COVID-19 vaccination began, social distancing and wearing masks have been our main methods of protection against the potentially deadly, airborne COVID-19 infection.

As the vaccination roll out continues, and more and more people acquire immunity, it is natural to hope for a day, not far in the future, where we do not have to wear masks all the time or practice strict social distancing to return to “normal life.”

It is also natural to ask, “I have been vaccinated and am protected from this disease, then-why do I have to keep wearing a mask? “

Here are some reasons why we should still wear masks and avoid crowded indoor gatherings for now, even if we have been vaccinated.

March 8, 2021 Update

If you’ve been fully vaccinated:

You may gather indoors unmasked with other fully vaccinated people
You may gather indoors with unvaccinated people from your same household
You do not need to quarantine if exposed to COVID-19
You must still wear a mask and observe social distance while in public

Source: The Centers for Disease Control and Prevention

1. Vaccines are great-but DO NOT provide a 100 percent protection
Both the Moderna and Pfizer vaccines showed about 95 percent effectiveness in preventing COVID-19 in clinical trials. But, clinical trials do no simulate actual day-to-day life accurately because most of the trial participants were more likely to continue practicing safety precautions after receiving the vaccine. Until a sizable number of the population have acquired immunity and active transmission of the virus has stopped, it’s important to stay protected even after getting vaccinated.

2. There is no “instant immunity”
Both of the vaccines approved in this country so far, need a booster shot after the first dose, within a three to six-weeks. The second dose provides maximum immunity. There is some degree of protection after the first dose, but you are still vulnerable to getting infected between the first and second doses. Research has also shown that a robust immunity does not develop until 30 to 45 days after the first dose, or 1 to 2 weeks after the second. This timeline can vary from person-to-person based on other health conditions that may be present. This fact is another reason that should prevent us from letting our guard AND mask down too early.

3. You can still spread the virus after being vaccinated
From the research done so far, it is very clear that vaccines significantly reduce the risk of getting sick with COVID-19. It is not as clear whether a vaccinated person can still have the live virus living in their nose and mouth, and whether this live virus can infect others who do not have the immunity. People with weak immune systems due to underlying disease conditions such as cancer, or those who need immunosuppressive drugs are far more likely to get severe disease. By wearing a mask and observing social distancing, a vaccinated person can potentially prevent infections in those who have not been vaccinated yet, or for some reason cannot get vaccinated.

4. Masks still provide protection against the more contagious variants
Recently, different strains of the coronavirus-SARS-CoV-2, have been emerging in the U.K., South Africa and different parts of the world. Some of these variants appear to be more contagious, and more evasive. The studies done so far show that the current vaccines do seem effective against the new strains by preventing severe disease effectively. There are still some questions about vaccinated people getting mild to moderate disease from these new variants or if the strains will survive in the respiratory system of the vaccinated individuals, and spread to others more readily. What still works against these more contagious variants are the tried and tested methods of keeping the mask on and observing social distancing along with frequent handwashing.

Are we stuck with masks forever?

No, we are not.

In the (not too distant future), enough people in society will become immunized against the disease, so that the spread of the virus will become limited. At this point the spread would be so limited that even people who cannot get the vaccine due to a medical condition would be protected as well. This is the “herd immunity”, that everyone keeps talking about. At that time, the masks and social distancing requirements in public will go away.

What is herd immunity?

A percentage of population that needs to be immunized to achieve “herd immunity” and that percentage differs for different infectious diseases. For example, this number for measles, which is highly contagious, is close to 95 percent. Epidemiologists are not sure about the required number for COVID-19. Initial estimates put the number at 70 percent of the population being immunized, but lately this estimate has been revised upwards, to over 80 to 90 percent.

Even if we need to get to the higher number, with the current rate of vaccination, and a third, single shot vaccine available soon, it looks like we will reach the goal by late summer or early fall 2021.

At that time, we can expect to ease up on the mask requirements, the restrictions on indoor gatherings and sporting events. We can see the examples of this type of easing restrictions in Australia and New Zealand now. We may still need masks in certain situations, in hospitals and health care settings, and international travel to places where the vaccination program is not as robust.

We now have a path to herd immunity. All of us have suffered through these dark times, now that we can sense the end, let us be vigilant and considerate, let us keep masking, and observing social distancing for few more months, to keep ourselves and our loved ones safe.

In football terms-let us not fumble the ball this close to goal line!