Help, I’m still anxious about getting COVID-19 even though I’m vaccinated

Once you’re fully vaccinated, it’s safe to start resuming activities like traveling and having friends over for dinner, says the Centers for Disease Control and Prevention (CDC). As of recently, you can ditch your mask in most settings, too.

These are moments many of us have dreamed about for over a year. And yet, now that they’re finally here, you may be finding yourself having trouble shaking off the fear of getting COVID-19. That anxiety? It’s totally natural, experts say, and there are ways to start managing, and conquering, it now.

We’ve spent months training ourselves to be cautious and avoid anything that could put ourselves at risk of getting COVID-19. While getting vaccinated significantly reduces that risk, vaccines aren’t an overnight cure for anxiety. Nor can they do the work to reverse all that training, says Usama Bilal, an assistant professor in the urban health collaborative and the department of epidemiology and biostatistics at Drexel University.

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“I still wear a mask outdoors half the time, even though I know that’s something I can stop doing,” says Bilal. “We’ve just experienced the worst pandemic in a century, and it’s both normal and OK for people to take the time they need to transition back to normal.”

If you’ve lost a loved one to COVID-19 or are part of a community that’s been disproportionately impacted, the transition may take longer. “I’d expect post-vaccine fear to be more prominent particularly for communities of color, and in a very valid way,” says Rachel Talley, an assistant professor of clinical psychiatry at the University of Pennsylvania. “No matter who you are, feelings are not something to be judged. We’ve collectively, as a world, went through a traumatic experience, and a pandemic that we’re not truly over yet.”

Nationwide COVID-19 case numbers are dropping, and the vaccines have proven to be highly effective. But the pandemic is still here, and until it no longer poses a significant threat, we can expect the CDC to continue to release public health guidelines about what’s safe. These recommendations are an important guide, but they’ve also been continuously changing and evolving as scientists learn more. While that’s expected, it can make things confusing — and as a result, heighten anxiety.

“A lot of what kicks up fear is uncertainty, the not knowing. And for many of my patients based on their experiences, say around structural inequity, there can be this natural instinct when information changes that it’s not trustworthy,” says Talley. “I often advise people to take a pause, and look at the possible explanations. In this case, that’s reminding oneself that COVID-19 is very new and the nature of the scientific process is sometimes a lack of predictability.”

While it’s challenging to keep track of the latest guidance, staying informed is a key piece of combatting anxiety. “It’s very common for uncertainty to throw our minds to the worst-case scenario,” says Talley.

Turn to trusted resources like your doctor to field questions, and pay attention to new federal guidance. Recently, the CDC updated its guidelines for fully vaccinated people, and the takeaway is: You don’t need to wear a mask in most indoor and outdoor settings, except where required by laws, rules, and regulations. (Prevention measures are still recommended if you’re unvaccinated.)

“In clinical trials, these vaccines are showing greater than 90% , and the real-world evidence has been overwhelmingly positive that these vaccines not only work, but exceptionally well,” says Neal Goldstein, an assistant research professor of epidemiology and biostatistics at Drexel University.

There’s still going to be a low level of risk with any situation, but that’s not new to this pandemic. If you’re following CDC guidelines and you’re fully vaccinated, Goldstein says COVID-19 becomes kind of like the flu or measles, both ongoing risks we faced before this pandemic ever arrived. “It’s background noise we’ve always lived with,” says Goldstein. “This low level of risk presents no barriers to resuming normal life.”

As of April 26, more than 95 million people in the U.S. had been fully vaccinated, and there were just 9,245 documented cases of vaccinated people infected with COVID-19, according to CDC records. That’s 0.009%.

So you’ve got the basic facts down. Now what? It’s still generally going to take some practice to dial down the anxiety. When we get anxious, our minds often get stuck in two problematic areas, says Lily Brown, an assistant professor of psychology in psychiatry and director at the University of Pennsylvania’s Center for the Treatment and Study of Anxiety.

“One, people overestimate the likelihood that something terrible is going to happen, and two, they assume they’re not going to be able to cope if the bad thing happens,” says Brown.

It may actually help to work through some of the worst-case scenarios. If your main fear is getting COVID-19, remind yourself of the facts: You’re much less likely to get sick once vaccinated. And if you do get sick, the vaccine is highly effective at preventing you from getting severely ill.

“A really simple thing you can do is to track what your brain is telling you whenever you’re feeling anxious, and start to categorize those thoughts,” says Brown. Draw on your baseline knowledge to help evaluate the validity of your thoughts. “Just tracking how frequently these thoughts are happening can be really helpful,” Brown adds.

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The more you practice, the more the anxiety will start to fade away. But you need to actually go out and face those fears, experts say, one step at a time.

“Break it down into baby steps. Sometimes that will feel silly, but it’s really how you can pace yourself towards larger goals,” says Talley.

In other words, if you’ve seldom been leaving the house, maybe your first step isn’t an indoor gathering with vaccinated friends, but a walk around the block. The next day, expand further into the neighborhood, says Talley. Eventually, try removing your mask for part of the walk, slowly working your way toward introducing other people into the picture.

“It’s almost like training a muscle — you’re training your brain that this is not actually a dangerous thing,” says psychiatrist Kimberly Best, the program director of general psychiatry at Einstein.

Best says she’s in the midst of doing some of her own anxiety training, initiating meetings with just two or three colleagues in a room where it’s possible to social distance.

“I know I’m going to be anxious about being in a classroom with other people if we’re not six feet apart, even if everyone’s fully vaccinated,” she says. “But I’ve sized up the risk, I know it’s small, and now I know I just need to practice, I need to do the thing I’m a little scared of.”

While you want to slowly start pushing your limits, it’s also OK to give yourself the time you need.

“There’s an element of not judging yourself for where you’re at,” says Talley. “If your friends are diving right in and going out to a restaurant, it’s OK to say ‘no’ and go at a different pace.”

If you’re feeling stuck, remember you can always ask for help. Therapists specializing in anxiety can coach and guide you.

“Recognize it will take some time,” says Best. “And remember, you can’t have a vacuum in your mind, so sometimes you need to focus on replacing those anxious thoughts with different ones. Think about the pleasure you’re going to have when you hug your grandchild rather than the fear, for example.”

She adds, “Life takes strength and courage, and sometimes you have to put up with a little anxiety to meet your goals.”

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