How should vaccinated grandparents now approach their visiting relatives

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The elderly are one of the priority groups for vaccination. After vaccination of healthcare workers and nursing home residents, the US Centers for Disease Control and Prevention has said people aged 75 and over – along with other categories of essential workers – are as follows for vaccines. In a growing number of states, older people are already getting vaccinated or soon will be.

What happens when older adults are vaccinated, but their children and grandchildren are not? Is it safe for grandparents to visit their family now, or are there still some precautions to take? We turned to CNN medical analyst Dr. Leana Wen, an emergency physician and visiting professor at the George Washington University Milken Institute School of Public Health, for advice.

CNN: Let’s start with the timing. When does the vaccine protect you after you have been vaccinated? What protection does it offer?

After the second dose, it probably takes another two or three weeks to develop the optimum level of immune protection.

Let’s say you received a dose of the vaccine. After a week or two you have some level of immunity, but you could definitely get Covid-19 if you are exposed to the coronavirus. A few weeks after the second dose, studies have shown that the vaccine’s effectiveness is around 95%. It’s a very high level of protection, but it’s not 100%. So, even after receiving both doses of the vaccine, you could still get Covid-19, but your luck is much lower. And if you got it, from what we know from clinical trials, you’re probably going to have less severe disease than if you didn’t get the vaccine.

CNN: After an older adult has received the second dose, and it’s been three weeks, can they visit their grandchildren?

Loupe: May be. The answer is not as simple as saying that someone who is vaccinated can return to pre-pandemic life. Here’s why.

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First, the vaccine is not 100% effective. There is still a chance that someone who received the vaccine could contract Covid-19. This is all the more true as many parts of the country are experiencing significant outbreaks of infection. The community transmission rate is very high, so there will always be a chance of contracting coronavirus even after being vaccinated.

Second, the vaccine has not yet been shown to reduce the transmission of the virus. We do not know if those vaccinated could still carry the virus, even if they do not get sick. This means that you could be protected yourself if you are exposed to someone with coronavirus, but you could still be a carrier of the virus. When you get together with your loved ones, you can pass it on to those who are not vaccinated.

Xiaolu Wen (right), father of Dr Leana Wen, has not seen his grandson Eli (left) for over a year.

If your grandchildren live in the area, you can certainly safely see them outside, 6 feet apart. If you want to see them indoors, there will be some level of risk. This risk will be much lower than if you were not vaccinated, but the risk will still be there for you. And you could still pose a risk to unvaccinated family members, as you could be an asymptomatic carrier who passes it on to them.

If you really want to spend time with grandchildren indoors, the safest way to do that is always to quarantine everyone for at least 10 days and lower their risk for those 10 days. Quarantine for seven days and a negative test is also an option, but everyone should also quarantine – a negative test alone is not enough.

CNN: What’s the point of the vaccine if I still have to quarantine myself before I see people?

Loupe: From what we know so far from clinical trials, the vaccine offers great protection. It will also give you peace of mind. This reduces your chances of contracting the virus and becoming seriously ill from it. We know that the elderly and those with chronic illnesses have a much higher risk of serious illness and death, and the vaccine will significantly reduce these results.

Since you are at much lower risk from the vaccine, it is a personal judgment of which activities you enjoy the most and may want to consider bringing back. Maybe it’s really important for you to give your grandchildren a hug. If you do this, recognize that it is not a zero risk activity, neither for you nor for them. It is always best for everyone to wear masks while hugging, and to do so outdoors and ideally with their faces turned away from each other.

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Maybe it’s really important for you to have a meal together. I would always recommend different plates, no buffet dinner and eating outside rather than inside.

If you live far from your grandchildren, you might consider traveling to see them if this is something extremely important to you. Of course, continue to abide by all social distancing and masking rules. And know that you always have a risk of both acquiring the virus and transmitting the virus.

Please keep in mind that the risk adds up. Getting the vaccine lowers your overall risk, but that doesn’t mean you now have to do all high-risk activities. Maybe you now choose to have dinner with your grandchildren and kiss them. Also, don’t decide to go to an indoor restaurant with your friends and go to a crowded movie theater. You should always try to reduce the risks in your life as much as possible.

CNN: What if I also have friends who have received the vaccine? Can I see them without my mask, inside?

Loupe: It is probably pretty safe to see other people who have also been vaccinated, after everyone has received both doses and waited a few weeks.

In a way, you might think of receiving the vaccine as being in quarantine. If both parties have been in quarantine, the risk of seeing each other safely is probably quite low. Likewise, if both parties have received the vaccine, it is probably safe to see each other. But because we don’t know if those vaccinated could still be asymptomatic carriers, if you participate in risky behaviors, you could infect others with whom you have close contact who are not vaccinated.

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Let’s say you live with people who have not yet been vaccinated. You would not want to engage in activities where you could potentially acquire coronavirus and then pass it on to others. This includes seeing other people vaccinated, but not wearing masks – based on what we now know, they could have the virus and pass it on to you, and you could pass it on to people you live with. Great caution is always a good idea.

CNN: What will it take for us to be able to socialize like we did before Covid-19?

Loupe: The end of Covid-19 could come once we obtain collective immunity. We don’t know exactly how many people will need to develop immunity to get to this point, although experts like Dr Anthony Fauci estimate it could take up to 85% of Americans to get vaccinated. At this level of immunity in the community, the coronavirus would have nowhere to spread and could essentially disappear.

With the rapidity of vaccine deployment so far, getting closer to that level will take time. In addition, clinical trials are only just beginning on children, so it will probably be necessary to wait until summer or fall for children to be vaccinated.

We need to frame vaccination differently. Vaccination is not a “do what I want”, but rather another tool to reduce our risks. Wearing a mask is another such tool, as is social distancing, and we want to continue to use as many tools as possible to protect ourselves.

Dr Wen and her husband Sebastian Walker (right) hope to travel with their children to visit his mother Veronica (left) in Johannesburg for Christmas 2021.

Getting the vaccine helps our community to enable us to achieve herd immunity faster. And it also gives us the license to do a few other things that we love – although we should always try to be as safe as possible.

CNN: When will your kids see their grandparents?

Loupe: We are planning summer or early fall 2021 for my dad to visit us from Vancouver, Canada. My husband’s mother is in Johannesburg, South Africa. We hope to visit him for Christmas 2021, if everyone is vaccinated by December. They haven’t seen my 3 year old for over a year and this will be the first time they have met the baby – who is now 9 months old. We cannot wait – although we will be patient and stay safe while we wait!

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