New COVID-19 guidance for those fully vaccinated—what do we need to know?

black woman putting on protective mask
Photo by Sora Shimazaki on Pexels.com Photo by Sora Shimazaki on Pexels.com

The new CDC guidance last week that stated fully vaccinated individuals no longer need to wear a mask or physically distance in most settings is a huge step toward life returning to “normal” during this global pandemic. This new guidance also led to Governor Tim Walz lifting the statewide mask requirement.

Dr. Zeke McKinney

Even though this may seem to be a sudden change, it is simply a shift due to the increasing amount of evidence about how effective the COVID-19 vaccines are at preventing someone from catching COVID-19, from being very ill if they still do get COVID-19, and from spreading COVID-19 to others.

If you were waiting for strong evidence that these COVID-19 vaccines work, now you can see it in action. Hopefully, this new guidance may help those considering whether or not to be vaccinated.

The problem is, there is no way to know that someone walking around without a mask has actually had the vaccine. For those of us that are vaccinated, that is no big deal. Yet for those that have not had their vaccine, or for those that cannot get a vaccine, this is still a concern.

The good news is that the Pfizer vaccine recently had an emergency use authorization (EUA) granted by the FDA for their vaccine to be given to teens ages 12-15, expanding on the earlier authorization for ages 16 and up.

It is expected that the Moderna vaccine, which has had similar success in trials in teens, will also be granted emergency use authorization in that age group very soon. On the other hand, it is still not clear when children under age 12 will be able to get a COVID-19 vaccine. Also, there are still a small number of individuals that will not be able to get the vaccine because of health issues that may make it unsafe for them.

The bigger concern is that until we reach a point of “community immunity”—where enough of us are vaccinated that the disease cannot spread anymore—there is still a chance that further variants (mutations of the virus) will develop.

The concern with new variants is that they will become resistant to the vaccines, they will be more infectious, and they will cause worse disease. So, the longer that we don’t have community immunity, the more likely it is for new variants to appear. Good evidence of this issue is the fact that most cases in the United States and in Minnesota are with the B.1.1.7 variant (the “UK variant”).

What we want to avoid is what we are seeing in India right now, where low vaccination rates (because it is not widely available there) and the loosening of COVID-19 restrictions has led to a new variant (B.1.617, first found in India) thought to be responsible for much higher rates of disease and death after a period of lower infection rates.

This is unlikely here in the U.S. where much of our population has already been fully vaccinated but within individual communities where vaccine rates are lower, this is still possible.

Because COVID-19 infections, severe disease, and death have been higher in the Black community due to more common chronic disease and more chances for exposure due to essential jobs—especially jobs that cannot be done remotely—all of these issues are extremely important for us. What we can and must do is continue to support vaccination in our community as the primary method to reduce the spread of this disease.

If you’re already vaccinated, this means talking to your family, friends, neighbors, and community and finding out what their concerns are, or plugging them into resources such as the Minnesota Association of African American Physicians to talk about the facts.

If you are concerned about being vaccinated, look online for resources that address your specific concerns. There are many Black doctors and scientists in the local area and around the country that have talked about many of the reasons folks may not want to get the vaccine.

So, what does this all mean? There is light at the end of the tunnel; we have good weapons to fight this disease and we have to use them. But it isn’t over yet.

We also still need to minimize indoor activity and continue to wear masks to set an example for others until our whole community, especially our children, can be protected.

Dr. Zeke McKinney grew up in and lives in Minneapolis. He primarily practices clinical occupational and environmental medicine (OEM) in St. Paul and St. Louis Park, MN, and he is one of few clinicians in Minnesota who evaluates work and community-related environmental toxicologic exposures. He is also a researcher for the HealthPartners Institute, including on a COVID-19 vaccine trial. He focuses on health equity and environmental justice for all communities.