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Vaxed? Sweet! Now What?

You're Vaccinated. Congrats! Now What Can You Do Safely?

April 29, 2021

So you've received your vaccination and you've allowed two weeks for your vaccination to take full effect. We've compiled some post vaccination FAQ's from our friends at NPR that might help shed some light on the questions running through all of our minds.

Do I still have to wear a mask in public?

We're still in a period of limbo  with many unvaccinated people, including young children too young to receive a coronavirus vaccination. We also don't know who's vaccinated and who's not. So when you're indoors in public spaces, like a cafe on Divis, a local market or grocery store, make sure that you mask up. (Dr. David Aronoff, Vanderbilt University Medical Center).

Per the CDC's most recent guidance, vaccinated people do not need to wear masks outside unless they're attending a crowded event like a sporting event, concert, or festival. Research has consistently shown that the risk of transmitting the virus outdoors is far lower than indoors. However, whenever leaving your home it as advised to have your mask with you at all times. Masking outdoors still makes sense if you're standing close to and talking to someone for more than a couple of minutes- and you're unsure of their vaccination status. A good general rule of thumb would be if you're having a face-to-face conversation with someone and they're within arm's reach for more than a minute or two, then masking is advisable.

Can I hug my friend?

If you're both fully vaccinated then hugging your friend is fine. We're all longing for the personal touch and connections we've reframed from for over a year now. If you're with someone that is not fully vaccinated, wear your mask and give them a hug then wash or sanitize your hands before touching your face.

Can I hug indoors mask-free with my friends if we're all fully vaccinated? 

Yes, please do! If it's a small group indoors and everyone is vaccinated, it's safe to drop the masks and social distancing, according to guidelines from the CDC. But the CDC says you should still avoid medium and large-size gatherings.

How many people is too many people when it comes to gathering indoors?

The CDC doesn't give a hard number for gathering sizes. Researchers suggest a good rule of thumb is no more than 10 people. Dr. Monica Gandhi, an infectious disease doctor at the University of California, San Francisco, suggests four households as a max. 

Remember, it all depends on the risk factors of the people present — what other risks they are exposed to on a daily basis, their own risk for severe disease, and their risk tolerance.

What about seeing unvaccinated friends indoors?

The CDC says to limit your indoor interactions with unvaccinated people to just one other household at a time. The agency says you can go mask-free as long as no one in the unvaccinated household is at high risk of severe COVID-19. So if your two unvaccinated best friends live together, then yes, you can all hang out indoors at the same time. If they're not roomies, it's best to visit them one at a time.

Are indoor playdates/hangouts OK if the adulats are all vaccinated but the kids aren't?

While younger children are at lower risk of severe disease if they do get infected, the risk "is not zero,". And kids can transmit to others, so you still need to be thoughtful about your social bubble. 

Outdoor playdates are safer, and  it's probably fine to let the kids go maskless if they are outside, provided there aren't variants of concern circulating widely in your community. If you want the kids to play indoors, make sure you have an honest conversation with the other family about their risk factors. Did they just fly back from vacation in a spot where variants of concern are circulating widely? Do their kids play on a sports team that just had a COVID case? Have they had a sleepover at someone else's house?  "The point is, you have shared risk and shared responsibility in terms of playdates," says Dr. Preeti Malani, an infectous disease specialist and chief health officer at the University of Michigan. 

As for how many families can join the indoor playdate? Given CDC guidelines about meeting up with unvaccinated households, Pierre suggests limiting it to one family at a time. Dr. Gandhi's interpretation is more liberal: If the kids are all low risk and the adults are all vaccinated, she'd suggest no more than four households. "It's ultimately about what your risk tolerance is," Gandhi notes — though case rates in your community should help guide your decision making.

Is it safe to go back to the gym?

If you're fully vaccinated, the risk of a gym visit is moderate, says Pierre — provided you stick to the machines, keep your mask on and maintain physical distance from other gym goers.

But keep in mind, for the unvaccinated, gyms are "one of the highest-risk settings," says Dr. Malani. That's because exercise involves heavy breathing that can send respiratory particles flying into the air. Indoor fitness classes seem to be particularly risky: Multiple outbreaks in the U.S. and abroad have been tied to indoor group classes, even when physical distancing was in place.

Of course, lack of exercise is also a big risk to health long term — which is why Dr. Gandhi says she's told her octogenarian parents to head back to the gym now that they're fully vaccinated. "They lost some muscle mass in this last year and it's worrying me," Gandhi says of her parents — though she advised them to go at times it is unlikely to be crowded.

If you do go, make sure your gym is still operating at reduced capacity, has proper spacing between machines and enforces mask wearing, which protects unvaccinated staff or other guests. The experts we spoke with agreed it's best to avoid indoor group classes for now: It can be hard to maintain distance in these classes, which often require you to jump, lunge or dance around.

Is it safe to get a massage or other services that require close contact with a technician?

Yes, go get that self-care, says Dr. Malani. "If you're both masked, it's safe and I think there's good data to show that." She points to a study published last summer that found no transmission of the coronavirus among 139 clients exposed to two hairdressers with confirmed COVID-19 at a salon where everyone was required to be masked. "The risk is higher to the technician than you because of the number of people they're exposed to," she notes. So keep your mask on to keep them safe.

What about lip waxing and other services that requires me to remove my mask?

If a service requires you to remove your mask, it's not zero risk, even if you are fully vaccinated. Many treatment rooms are cramped and often poorly ventilated. "You have to keep it all in perspective and decide," Malani says. "Frankly, if you're wearing a mask, you're covering up your face — you don't need to get your lip waxed."VPierre agrees, but says if you are determined to get this kind of service anyway, think about how long it will last, what the local transmission rates are in your area and whether variants of concern are circulating locally and then decide your risk tolerance.

My relatives are planning a family reunion. Is it safe for us to gather?

Yes, but keep it small and keep most of the activities outdoors if you can. "If you have a big family reunion, there's going to be risk," says Dr. Malani. " It's probably not a great time to hang out with 100 people. "Make sure all the vulnerable adults in the family are vaccinated and again, talk openly about the kids' risk factors. It might be a good idea to hold off on mask-less indoor playdates for a week or two before traveling to the reunion. For older kids, maybe they shouldn't be spending a lot of time unmasked with a bunch of friends before they meet up with grandparents.

What about taking a vacation with my unvaccinated kids?

If it's feasible, consider driving instead of flying, says Aronoff. If you do fly, make sure your kids know how to wear a mask properly and keep their distance from other people. Pierre, the mother of 3-year-old twins, suggests avoiding longer flights because longer exposures pose potentially higher risks. 

Also, consider your sanity: It can be hard to keep young kids masked up and entertained on long-haul flights.The biggest risk on flights is from the exhalations of nearby passengers, so seat your kids in between you and their other parent, not on an aisle, suggest Dr. Aronoff and Dr. Gandhi. Avoid busy theme parks or crowded indoor activities at your destination. 

One other thing to consider: Will your kids have to quarantine once they're back home or refrain from school sports or other activities? "Make sure you understand all the implications of traveling with your unvaccinated children," Landon says.

Is it safe to fly domestically?

Yes, according to the CDC. But you still have to wear a mask, in part to keep other travelers safe, but also yourself, "because who wants a cold on vacation?" Landon notes. Also, try to keep physically distanced and avoid crowds, and monitor yourself for any symptoms a few days after you arrive. 

The CDC does not require vaccinated domestic travelers to quarantine after travel, unless you have symptoms.

That said, until the majority of the U.S. is vaccinated, experts say the threshold for travel should be higher than usual. Consider why you are traveling and how important it is, says Dr. Saad Omer, director of the Yale Institute for Global Health. "Don't gather your square dancing group and go for a field trip," he says. But if you need to get away for your mental health or you haven't seen your mother in a year, go ahead.

What about international travel?

It's far more complicated. You have to know the rules of the country you're going to. Many still require you to quarantine when you arrive and/or show a negative COVID-19 test. The other thing to remember is, you'll need a negative test to get back into the U.S.The CDC says traveling abroad poses added risk, even for fully vaccinated travelers. For example, you could be exposed to new virus variants of concern and potentially bring them back with you. The agency's list of very high risk foreign destinations is very long.

Finally, you have to consider the health system in the country you're visiting. Is it overwhelmed with COVID-19 cases? "You may not get COVID, but if you get a heart attack or break your leg, that may not be a great place to be," says Dr. Henry Wu, an infectious disease specialist and head of the TravelWell Center at Emory University.