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Americans vaccinated against COVID-19 still wait for advice

The delays add to the uncertainty around bringing about an end to the pandemic

Karen Callejas, a US woman who said she was afraid of needles, nervously waits to receive Pfizer's COVID-19 vaccine at a vaccination site in Long Beach, Calif | AP Karen Callejas, a US woman who said she was afraid of needles, nervously waits to receive Pfizer's COVID-19 vaccine at a vaccination site in Long Beach, Calif | AP

More than 28 million Americans fully vaccinated against the coronavirus will have to keep waiting for guidance from federal health officials for what they should and shouldn't do. 

The Biden administration said Friday it's focused on getting the guidance right and accommodating emerging science, but the delays add to the uncertainty around bringing about an end to the pandemic as the nation's virus fatigue grows.

"These are complex issues and the science is rapidly evolving, Centers for Disease Control and Prevention Director Dr. Rochelle Walensky said Friday. We are making sure and taking time to get this right and we will be releasing this guidance soon.

Such guidance would address a flood of questions coming in from people who have been fully vaccinated against COVID-19: Do I still have to wear a mask? Can I go to a bar now? Can I finally see my grandchildren?

The need has slowly grown since January, when the first Americans began to complete the two-dose series of COVID-19 vaccines then available. Now, more than half of people 65 and older have received at least one shot, according to Andy Slavitt, a senior administration adviser on the pandemic.

In Washington state, Raul Espinoza Gomez has 22 grandchildren and great-grandchildren and an appointment Saturday for his second dose of coronavirus vaccine.

By Easter, the 77-year-old's immune system will be ready to protect him from the virus. But how the family celebrates will depend on government advice, said Melissa Espinoza, 47, of Carnation, Washington, who plans to drive Gomez, her father-in-law, to get his second shot.

"We didn't gather together as a big family at Christmas," she said. "We go by what the state and federal guidelines recommend. We've had family members adversely affected by COVID. We know the risks are severe.

Worried about persistently high case loads and deaths, the Biden administration has condemned efforts to relax states' virus restrictions and pleaded with the public for several months more patience. 

The caution has drawn critics, who point to the administration's own warnings that fatigue is winning as evidence that they need to be more optimistic about the path ahead to secure the cooperation of those who are yet to be vaccinated. 

"I think it's going to be overly proscriptive and conservative and that's the wrong message," former FDA Commissioner Scott Gottlieb told CNBC Wednesday of the forthcoming CDC guidance. If we continue to be very proscriptive and not give people a realistic vision for what a better future is going to look like, they're going to start to ignore the public health guidance.

Dr. Jeremy Faust, an emergency physician at Brigham and Women's Hospital in the Division of Health Policy and Public Health, encouraged the CDC to be clearer about when and how it plans to produce guidelines for the vaccinated.

Making the decision to go by the science is also making the decision that you're going to have to make a decision, which is really difficult when the science isn't settled, he told the AP. They're drinking from a firehose of science, and sometimes, it gets messy. More than 55.5 million Americans have received at least one dose of vaccine, and slightly more than half of those  28.7 million  have gotten the recommended two doses. The single-dose Johnson and Johnson shot soon will add a couple million more Americans with questions about what new freedoms they can safely enjoy.

"I do hope I get to see my great-grandchildren more," said Rolando Solar, 92, who received his second dose in Miami Wednesday. But I know things will not go back to normal and, for an old man like me, this is as good as it will be.

Tami Katz-Freiman, 65, of Miami, got her second dose three weeks ago, and plans to watch the Miami Film Festival virtually Sunday at the home of unvaccinated friends. All will wear masks.

We didn't have to discuss it with each other, because it's very clear to me that when there is a doubt and you don't have a CDC straightforward rule you better be on the safe side and take care for yourself, Katz-Freiman said.

Three weeks ago, the CDC announced that fully vaccinated people do not have to go into quarantine if they have contact with someone with a confirmed infection (for 90 days after the final shot). But the agency said nothing beyond that, noted Dr. Leana Wen, an emergency physician and public health professor at George Washington University. 

That (quarantine guidance) seems to imply to me that your chance of contracting COVID-19 and being a carrier to others is pretty low, said Wen, who previously ran Baltimore's health department.

(But) we need to focus on what is most relevant to people's lives, and my patients are not coming in and asking me: 'If I'm vaccinated, do I still need to quarantine if I'm exposed?'" she continued. 

I'd say the most common question I get is Can I visit my grandchildren?' Wen said.

Experts say it's understandable that the CDC has been cautious when many scientific questions remain, including how long vaccine-induced immunity lasts, and whether vaccinated people are still able to transmit the virus to others. The answers are important when advising someone what kind of risk they face in different settings, and how much of a risk they are to others.

The vaccines at their best, in the clinical trials, were 95% effective, I didn't say 100%. And that's why we have to keep wearing masks most of the time," said Dr. William Schaffner, an infectious-diseases expert at Vanderbilt University.

AP via PTI

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