Grandparents and vaccines: Now what?

Ellen S. Glazer, LICSW

Guest Contributor

As COVID-19 vaccines roll out across the US, many grandparents — including one co-author of this blog post — are thrilled to hold out their arms for a jab. In some parts of the country, these vaccinations began as early as mid-January. By mid-February, legions of energized and relieved seniors were trading selfie shots of their newly vaccinated arms.

Grandparents, like other seniors, wanted the vaccine to keep themselves safe. However, there was another compelling reason: the desire to hug grandchildren. Ellen Glazer, LICSW, asked fellow grandparents in different states — some of whom live minutes away from grandchildren, and some who are separated by continents — what they look forward to once fully vaccinated.

Below, Amy Sherman, MD, an infectious disease specialist and instructor in medicine at Harvard Medical School, weighs in on a number of hopes and questions — some very specific, and some that can help everyone. Keep in mind that experts may disagree about what is or isn’t safe to do after vaccination. Also, advice is likely to change as we learn more about the vaccines and as a larger number of people get vaccinated, bringing herd immunity closer.

While some of the current messages — stay cautious, practice protective measures — may feel frustrating for grandparents relieved to have gotten the vaccine, they’re necessary. Reflecting on the past year, many realize that practices that seemed so difficult at the start of the pandemic, such as wearing masks and engaging in some degree of social distance, have become part of our lives. These new habits enable us to move forward with small, well-informed, and hopeful steps toward our new normal.

Can I make others sick? Is it safe to see (and hug) grandkids and family who haven’t had the vaccine?

Studies show both mRNA vaccines (Moderna and Pfizer/BioNTech) and the newly authorized Johnson & Johnson vaccine are extremely effective in reducing severe disease, hospitalizations, and deaths. (Click here for more information about these vaccines.)

But we don’t know if these vaccines prevent asymptomatic infection — that is, being sick with the virus without symptoms like fever, cough, and shortness of breath. So it’s possible that you could have the virus without symptoms, and spread the virus to others.

Generally, the more closely people interact and the longer they spend with others, the higher the risk of getting or spreading the virus, according to the Centers for Disease Control and Prevention (CDC).

With those words of caution, it is reasonable to see and hug your family and grandkids if you are fully vaccinated. That means at least 14 days have passed since you had your second dose of the Pfizer/BioNTech or Moderna vaccines, or your single dose of the Johnson & Johnson vaccine.

The new recommendations below are based upon the vaccination status of yourself and your family members. As we learn more, these recommendations may change.

If you are fully vaccinated and visiting fully vaccinated family or friends

  • Indoor visits without masks are okay and likely low-risk.

If you are fully vaccinated and visiting healthy, but not yet vaccinated grandchildren and adult children living in a single household

  • Indoor visits without masks are okay and likely low-risk. Although spreading the virus is still possible, the risk of healthy and, particularly, young individuals developing severe COVID-19 is low.

If you are fully vaccinated and visiting a single household of family or friends who are not yet vaccinated, and are at risk for severe COVID-19 due to age (65 or older) or health conditions

  • All of you should wear well-fitted masks and stay six feet away from each other when indoors. If possible, hold the visit outdoors or in a well-ventilated space to reduce risk.

Mixing two or more households that have people who aren’t yet vaccinated raises the risk for getting the virus that causes COVID-19 for anyone who isn’t vaccinated.

When possible, everyone gathering for a visit can lower risk further by avoiding contact with people outside their household for 14 days before a visit, and/or by getting tested for the virus one to three days before a visit.

What should I do in public settings?

In public settings, everyone should continue to take protective measures to stay healthy, regardless of personal vaccination status:

  • Wash hands often.
  • Wear masks that fit well.
  • Limit time spent with family members who are not yet vaccinated.
  • Hold visits outdoors if you can.
  • Avoid large in-person gatherings.

Can I still get sick?

I like to think of these vaccines as being a water-resistant jacket, as opposed to a waterproof jacket. With the vaccine, you may still get wet, but not soaked. As explained above, it is still possible to develop asymptomatic or mild illness. A small proportion of people may get more severe illness despite vaccination. Further, it’s important to note that

  • vaccines do not always provide robust immune responses in people ages 65 and older, because the immune system normally weakens with age. Therefore, even if vaccinated, you may not have the same high level of protection against moderate to severe disease described in the studies.
  • we are still learning about variant strains now circulating. We do not yet know how the vaccines perform in the real world against these variants. Early indications suggest the mRNA vaccines may not be as effective against some variants, but still seem to help avoid hospitalizations and death.

What if I live with someone who hasn’t had the vaccine?

It’s best to continue the safe behaviors you were doing pre-vaccination to help protect your spouse or others that you live with. The vaccine is another layer of protection for you, and also helps protect your spouse or others in your immediate household. However, transmission is still possible.

Can I visit with nearby friends or family who have had the vaccine — for example, have a meal together indoors or have a grandchild stay with us?

If you and your family or friends have been vaccinated, you should consider spending time together. Talk to your family or friends before gathering, to ensure everyone is comfortable socializing in person and with the general precautions others are taking. Also remember that a person is considered fully vaccinated two weeks after receiving the second vaccine dose (for Moderna or Pfizer/BioNTech), or two weeks after receiving the single-dose Johnson & Johnson (Janssen) vaccine.

Can I travel on a plane safely?

Please check the CDC web site for recommendations about domestic travel and international travel because this information changes rapidly. Currently, the CDC says it is safe to travel within the US if you are fully vaccinated, although it is still possible to get or spread COVID-19. Also check local and state requirements at your destinations, including any need for COVID-19 tests or quarantine.

Take standard precautions while traveling:

  • Wear a well-fitted mask on public transport and in public places
  • Avoid crowds and stay at least six feet away from anyone not traveling with you
  • Wash your hands often (or use hand sanitizer).
  • Follow state and local recommendations or requirements.
  • Self-monitor for COVID-19 symptoms. If you develop them, isolate and get tested.

What precautions do I still need to take outside my household, and why?

COVID-19 rates remain very high in the community, and variants of concern will continue to circulate. If you are exposed to the virus, you are not 100% protected from illness even if you’ve had the vaccine.

Until a high proportion of the population is vaccinated, the CDC recommends maintaining familiar precautions outside of the home, especially in public settings: wash hands often, wear masks, practice physical distancing. We need herd immunity in the community before we can relax any of these protective measures. Even if you’ve been vaccinated, you should continue to be mindful that you can still potentially spread the virus to others.

As we learn more about how long the vaccines will protect us and the circulating variants of the virus, these guidelines will continue to evolve.

Related Information: Harvard Health Online

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