The Hindu Explains | What changes after COVID-19 vaccination?

The story so far: More than 20 million doses of COVID-19 vaccines have been administered in India so far. However, as the vaccination drive gains momentum, questions have emerged about appropriate behaviour after being vaccinated. In the United States, last week, Texas removed its mask mandate and lifted all other COVID-19-related restrictions. In India, the Union Health Ministry on Friday said six States — Maharashtra, Punjab, Haryana, Gujarat, Madhya Pradesh and Delhi — were reporting a surge in new cases. Health officials said the rise in the number of cases across States could be because of the negligence that has set in regarding established COVID-19 protocols.

Can the mask come off?

Whether it is okay to lose the mask now is a question that some people have been asking; others feel confident in shedding their masks, after two, or even just one shot of the vaccine. However, not wearing a mask would be a bad idea, say experts. At various places, infection clusters have been reported that are linked to people who participated in group events, such as marriage ceremonies, without wearing masks or maintaining physical distancing.


Tamil Nadu’s Health Secretary, J. Radhakrishnan, is leading the efforts to stem a gradually rising COVID-19 graph in the State. “To not wear masks would be nothing short of criminal now. Just as in the case of Maharashtra, we have identified family clusters of COVID-19 cases in a couple of cities here. In most instances, it has been because of attending weddings or other family functions, and not wearing masks or being in close proximity to others. We are reinforcing the absolute need to continue wearing masks. Even a vaccine is a secondary tool for us, many may not have got it yet, but everyone can wear a mask and remain safe,” he said.

What does being vaccinated really mean?

According to the Centers for Disease Control and Prevention (CDC), being fully vaccinated means a period of two weeks or more following the receipt of the second dose in a two-dose series, or two weeks or more following the receipt of a single-dose vaccine. In India, currently, both vaccines being used — Covishield and Covaxin — follow a two-dose regimen. Typically, the immune response takes a while to build up after a vaccine shot.

In an episode of Science in 5, Katherine O’ Brien of the World Health Organization (WHO) said after the first jab of a two-dose vaccine, a good immune response kicks in within about two weeks. It is the second dose that boosts the immune response “and we see immunity get even stronger after that second dose”. But it is still unclear how long immunity lasts from the vaccines at hand now. She said whether or not the immune response is durable, how it performs with the passage of time, and how long it lasts can be found out only by monitoring people who have already been vaccinated over a period. While clinical trials have demonstrated that vaccines protect people against the disease, it is not clear if they prevent getting the infection or a severe form of the disease, or if those vaccinated can transmit the virus to others. If the vaccinated individual is still carrying the virus, the vaccine may provide immunity from severe disease for him or her, but the individual could still transmit the virus to someone who is not yet vaccinated, and therefore, vulnerable.


The Union Ministry of Health and Family Welfare’s FAQ document on vaccines says, “Protective levels of antibodies are generally developed two weeks after receiving the second dose of COVID-19 vaccine.”

In a tweet, United States’s White House adviser and top infectious disease specialist Anthony Fauci said, “Currently we do not have enough data to say with confidence that the vaccines can prevent transmission. So, even if vaccinated, you may be able to spread the virus to vulnerable people.”

What changes after you get a vaccine shot?

“After vaccination, your risk of severe disease from COVID-19 goes down dramatically. Once 70-80% of a population has been vaccinated, many current restrictions may be lifted,” said Priya Sampathkumar, infectious diseases consultant and medical director, infection prevention and control, Mayo Institute, U.S. However, there is concern that vaccinated people may get asymptomatic COVID-19 and transmit it to others. “So, until a large proportion of the population is vaccinated, please wear a mask to protect others,” she added.



The CDC on its website also highlights the need to continue with masks: “While available COVID-19 vaccines have demonstrated high efficacy at preventing severe and/or symptomatic COVID-19, there is currently limited information on how much the vaccines might reduce transmission and how long protection lasts. In addition, the efficacy of the vaccines against emerging SARS-CoV-2 variants is not known. At this time, vaccinated people should continue to follow current guidance to protect themselves and others, including wearing a mask, staying at least six feet away from others, avoiding crowds, avoiding poorly ventilated spaces, covering coughs and sneezes, washing hands often...”

Dr. O’ Brien pointed out in the episode that while we are still learning about what vaccines can do, there is out-of-control transmission in many countries.

There is not enough evidence yet of vaccine response for some age groups, and vaccines are in short supply in the community. Hence, following COVID-19 protocols is essential, she added.


Dr. Sampathkumar dealt with another question in a Twitter thread recently — what if everyone in a small family or social group is vaccinated? “In a small group in which everyone has been vaccinated, it is okay to meet without masks. The risk is low. In work settings, masks are still recommended as verifying vaccination and the health status of co-workers is tricky,” she said.

She added that one may visit a fully vaccinated family member if they have also been fully vaccinated. However, travelling freely might not yet be safe. “Also, a lot depends on what we learn about the ability of vaccines to prevent asymptomatic infections and stay effective against COVID-19 variants,” she said. However, if you have been fully vaccinated, as per the recommended dosage, you can safely go eat indoors in restaurants, and the risk would be extremely low.

The CDC urges that even fully vaccinated people who get exposed to COVID-19 but do not quarantine should watch for symptoms for 14 days following the exposure. If they experience symptoms, they should be clinically evaluated for COVID-19, including SARS-CoV-2 testing, if indicated.


For how long should we continue following safety protocols?

“Time is going to tell. Once we get broad vaccination coverage ... we can slowly start taking our foot off the pedal,” said Dr. O’ Brien. Meanwhile, with cases rising in India, States are hustling to reinforce COVID-19 protocols, impose fines for violations, and reintroduce a diluted version of restrictions. After rules were relaxed gradually following an exhaustive year-long campaign and pandemic fatigue set in among people, safety measures were overlooked. However, unless there is evidence that vaccination prevents transmission, or until herd immunity is achieved with a combination of vaccination and natural immunity from infection, it is clear that giving the mask up or other safety measures is dangerous. To do so would be to keep alive the cycle of transmission of the virus in the community.

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Printable version | Apr 20, 2021 5:25:33 AM |

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