The imperative of getting fully vaccinated

Too many Americans don’t seem to realise just how easily the novel coronavirus spreads and how awful COVID-19 can be. It is prompting far too many either to a) avoid getting any vaccine, b) skip the second dose if their first was Pfizer or Moderna or c) assume that the vaccine they got means they are now free to gather in any way they choose without taking any public health precautions.

COVID remains a mortal threat not just for people like me in the upper decades of life but also for almost anyone, no matter how young and healthy. Like the 37-year-old pregnant woman in Illinois who was put on life support after her baby was delivered by emergency C-section. Or the 26-year-old man in Maryland who was hospitalised on oxygen for five days and now tells everyone “how bad it was and how scary it is.” Although infections, hospitalisations and deaths are down from their dreadful peaks in 2020, we are still a long way from herd immunity — if we ever get there.

Sixty-one percent of people live in counties where the risk of infection right now is very high or extremely high, and whenever someone gets infected with the coronavirus, a mutation to an even more dangerous variant could arise.

After months of uncertainty about whether any vaccine that emerged from Operation Warp Speed would be safe and effective, the final highly reassuring results from the vaccine trials late last year were almost beyond belief. The members of the vaccine advisory committee who endorsed the Food and Drug Administration’s emergency use authorisation of the vaccines are non-government experts with integrity and independent judgment. Had the government delayed the vaccine release until fully licensed, both the population and the economy likely would have been irreparably devastated.

I waited with bated breath for my turn to get immunised last winter and then for my two sons and daughters-in-law and four grandsons to become eligible this spring. All will be fully vaccinated by the end of the month when we gather for the first time in nearly two years to celebrate my 80th birthday. And all of us will continue to wear masks and maintain appropriate distance from others when we’re outdoors in close settings or indoors in public venues with people we don’t know.

In its advisory issued April 27, the Centers for Disease Control and Prevention said that fully vaccinated people can visit indoors with others who are fully vaccinated without wearing a mask or physically distancing and can travel domestically without getting tested or self-quarantining. They can also now “gather or conduct activities outdoors without wearing a mask, except in certain crowded settings or venues” like a live performance, parade or sporting event.

But the agency warned unvaccinated people that they are least safe — and should remain masked — when going to an indoor movie, eating in an indoor restaurant or bar, participating in a high-intensity indoor exercise class or singing in an indoor chorus. Dr. Rochelle Walensky, the C.D.C.’s director, said that there’s an almost 20-fold increased risk of transmitting the virus indoors.

Even for vaccinated people, she said, “until more people are vaccinated and while we still have more than 50,000 cases a day, mask use indoors will provide extra protection.”

There are good reasons for continued precautions. More than half the population, including young children, are not yet immunised. It is not known whether immunised people can acquire the virus and remain symptom-free, then unwittingly spread it to others who are vulnerable. Not everyone who wants the vaccine is able to get it for logistical or health reasons, and the vaccines may not fully protect people with immune deficiencies.

Furthermore, even though the authorised vaccines result in a stronger immune response than natural infection, we don’t yet know how long their protection will last. The Excelsior Pass I got in New York State attests to my vaccination status, but it expires mid-August, six months after my second dose, at which time a booster shot may be needed to maintain my immunity.

Speaking of which, that second shot of the Pfizer or Moderna vaccine should not be skipped. Although a delay of a few weeks in getting it is likely not critical, the immune response after one dose is relatively weak and may leave people vulnerable, especially to the more virulent variants now circulating.

Two doses are 90 percent effective in preventing infection, and that protection is expected to last much longer. You should be given an appointment for the second dose when you sign up for the first dose or when you receive it.

Some people hesitate to get the second shot because they’ve heard the side effects can be nasty. But no matter how nasty, the vaccine side effects are short-lived and not nearly as severe or persistent as the disease the vaccine protects against. After recovery from even a mild case of COVID-19, a distressing legacy like a foggy brain or chronic fatigue can persist.

And, of course, the virus can also kill, even people who are relatively young and free of underlying health risks. The fatality rate from COVID-19 based on more than 32 million confirmed cases in the United States is 1.8 percent. Over 245 million doses of COVID vaccines were administered by May 3, and a federal review of adverse events found that no deaths resulted from the vaccine.

Nearly everyone gets a temporary sore arm from the shot, but at worst people may have flu-like symptoms that last a day or two. If you have the option, consider planning a day off after the second shot in case you need to take it easy. Half my family had no reaction other than the expected arm pain. One daughter-in-law developed a fever of 102 degrees and one son was unusually tired, but I was like the Energizer Bunny the next day and accomplished twice as much as usual. Go figure!

If you have a smartphone, I urge you to sign up for the side effects monitoring system established by the C.D.C. I did and was asked repeatedly how I was faring after each vaccine dose. The system, called v-safe, can alert government health authorities to the frequency of side effects and to any previously unknown complications. It will also remind you to get your second dose of the vaccine.

And a final word: If you know people still struggling to get a vaccine appointment, please try to help them if you can.