ROCHESTER, Minn. — Infectious disease experts on Wednesday, March 10, addressed the impact of new Centers for Disease Control and Prevention interim public health recommendations for fully vaccinated people.
Speaking via Zoom from Mayo Clinic, infectious disease expert Dr. Gregory Poland says the new guidance "begins to give vaccinated people the sense of moving back toward normalcy," calling them "a reward for being fully vaccinated."
The guidance, which was released Monday, March 8, is the first tangible dial back in federal health recommendations concerning what's considered reasonably safe during the pandemic.
It says fully vaccinated people in regions with low levels of spread can safely gather indoors in small groups in private settings with other fully vaccinated people and not wear masks or keep their distance. The guidance does not apply to a health care or congregate living settings.
"Fully vaccinated people have a very small risk of transferring the virus to someone else," Poland said. "These recommendations key off of that."
The CDC now says it's reasonable risk for fully vaccinated people to skip quarantine if they are exposed to someone with COVID-19. It also allows fully vaccinated persons to gather with unmasked and unvaccinated persons — provided those unvaccinated persons are at low risk of serious outcomes, and from a single household.
"They are a step toward decreasing the social isolation that many have experienced," Poland said.
The CDC does not yet counsel that it is reasonably safe for fully vaccinated people to take off their masks in public locations indoors, or outdoors where they cannot maintain a safe distance, or for high-risk vaccinated people to visit with the unmasked who have no shots.
Travel guidance for the fully vaccinated is also unchanged.
To be considered fully vaccinated, two weeks should have passed following a second dose of an mRNA vaccine, or a first dose of the Johnson & Johnson vaccine. The guidance is expected to become continually more liberal as a greater portion of the population becomes vaccinated.
Poland addressed some of the grey area in the new advisory.
"The primary limitation is that it requires people who might gather in your home to be willing to divulge private information to you. Are you willing to divulge to me whether you are immunized or not before you come over to my home? I would say most people are willing to do that," Poland said. "But if you are un-immunized, are you willing to tell me if you have a high-risk medical condition? It would be in your interest to do so, because then we all wear masks. But that is private information you may not want people knowing."
It's also unclear if high-risk, fully vaccinated persons can safely host unvaccinated maskless persons.
"These recs are silent on that topic," Poland said. "If I were 70 and immunocompromised, I would probably still wear a mask, because I would be thinking nobody's studied protection in people like me."
The duration of protection is another gray area. "We don't know that regarding the current variant," Poland said, "much less the variants to come that we don't know about."
Poland described the state of spread in the U.S. as a "high valley," a cautionary depiction denoting that the country has 60,000 new cases a day, and in a setting with less testing. Because of this, he advises against spring break travel.
"What we have seen over the last year is that every time we have a big travel holiday in the U.S., we can count on a surge in cases over the two to six weeks following that, followed by increases in hospitalization, followed by death. We've done that experiment."
Poland says he believes the granting of FDA approval to the vaccine will eventually trigger immunity passports. He said airlines, colleges and health care employers will all likely one day require proof of vaccination for COVID-19.
"We don't want to pass anything on to our patients, right?" he said. "We want to care for them well. At the Mayo Clinic that is a simple seven words that all 70,000 employees know. The needs of the patients come first. And I think that will be true in other businesses that are 21st-century savvy."