Note: Since this article was published, the CDC has released a new set of guidelines about what you can safely do post-vaccination. Learn more here.
The COVID-19 vaccine is now available for older adults, and more and more are fully vaccinated. Naturally, the first postvaccination priority for many grandparents is seeing their grandkids and family. But what would a “safe” hangout look like?
We asked experts to break down common questions, like “Is it OK to go in for a hug when I arrive?” and “Do we need to wear masks if everyone in the family is vaccinated?” The answers aren’t always straightforward, and you’ll find that experts are divided on some topics. One thing that’s agreed upon: Without a doubt, your older relatives are safer once vaccinated. But visiting with some precautions in place is still advised.
» READ MORE: Ask us a question through Curious Philly
“I think you can sleep better at night knowing that your grandparents’ risk is much lower than it used to be,” says Ayiti-Carmel Maharaj-Best, an assistant professor of clinical family medicine and community health at the University of Pennsylvania. “But people still need to be intentional if they are going to get together. The risk is not zero, and we don’t have enough information yet to know just how close to zero it is.”
Here’s how to think about risk and minimize it when visiting older relatives.
» READ MORE: How to prepare for your COVID-19 vaccine appointment
If grandma and grandpa are vaccinated, can we stop wearing masks?
Most experts say wearing masks and social distancing remain important to protect both unvaccinated and vaccinated family members.
“We still want all parties wearing masks because there is some inherent risk in that these vaccines aren’t perfect,” says Neal Goldstein, an assistant research professor of epidemiology and biostatistics at Drexel University. “But really the risk is not so much to the grandparents, but more to any unvaccinated family who are visiting them.”
Once you’re vaccinated, current data shows that your risk of getting severely ill from COVID-19 drops close to zero. However, protection isn’t perfect, which means there’s still a possibility your vaccinated grandparents could get infected. Initial clinical studies found the Moderna and Pfizer-BioNTech vaccines to be roughly 95% effective, but this was based on the prior strain or strains of COVID-19 circulating at the time. We don’t fully know yet how new, emerging variants of the virus may affect vaccine responsiveness.
“Even with 95% effectiveness, that other 5% means that five out of every 100 people who get exposed could actually develop signs of a COVID infection,” says Maharaj-Best. “The severity [of symptoms] should be decreased based on what we’re seeing from the data, but if my grandparent was one of the very few people who might still be susceptible despite vaccination, I wouldn’t want that on my conscience.”
Some good news: If a vaccinated family member ends up getting COVID-19, experts say age doesn’t appear to make as much of a difference in severity as it did pre-vaccination. You could be 25 years old or 85 years old, and the likelihood of severe or fatal illness remains low.
“We saw in the clinical trials that the efficacy for older people was as good as the younger groups, which was kind of surprising,” says Goldstein. “That really suggests these vaccines develop a very robust immune response regardless of your age.”
Guidance could change if a new variant emerges that’s more resistant to the vaccines. But right now, experts say that if you’re hanging out with family, the most risk remains for the people who aren’t vaccinated. Research is currently underway to determine if vaccinated people could be silent carriers. Theoretically, this means they could get infected but not have symptoms and spread the virus to others. Until we have more data, experts advise erring on the side of safety.
“I think that risk is small, but we don’t know for sure how large it could be,” says Robert Fischer, the head of the infectious disease program at Einstein Health.
If we change our behaviors too soon, it could create an avoidable spike in cases. Right now, time is the missing element. “By summer, we’re going to know more, and have so many more people vaccinated,” says Goldstein. “I expect I’d be more lax if we were having this conversation then.”
» READ MORE: Who should and shouldn’t get the COVID-19 vaccine
What if the whole family is vaccinated? Can we ditch the masks if everyone’s vaccinated except for the kids?
Experts say to be mindful. If you’re hanging out with your vaccinated grandpa, and you’re also fully vaccinated, your risk of getting COVID-19 is low. However, most experts agree that until we know more about the variants and postvaccination transmission, we should continue wearing masks and social distancing when possible.
Can we eat dinner together? “It’s appropriate to add that additional layer of safety, but you don’t have to be obsessive about it,” says Fischer. “Passover’s coming up, and I think we’ll have a family meal this year, with my parents at one end of the table and us at the other end, and we’ll only take masks off to eat.”
White House chief medical adviser Anthony Fauci also recently went on the record saying vaccinated family members can eat together. But without official CDC guidance released yet, it’s a topic that experts are generally divided on. One point most agree upon is to stick to masked hangouts if kids are involved.
The vaccine is not yet approved for kids under 16 years old because initial clinical trials didn’t include kids. Trials have since begun to determine vaccine efficacy and safety in children. But it could be months before we have a better idea of when vaccines may be rolled out to kids. “While the risk of severe illness in children is much smaller, I’d still recommend masking and social distancing when it’s convenient, but the definition of convenient is somewhat of a moving target,” says Fischer.
Most children who get infected have mild symptoms, or no symptoms at all, so the concern is that they could spread it to more vulnerable people. “It’s not going to cause any harm to wear a mask until more people get vaccinated,” says Goldstein. ”If a family is vaccinated, they have a low risk of getting seriously sick from an infected child, but there’s still the concern that any of the family could spread the virus to other people.”
Hugging: Is it safe while masked?
To hug, or not to hug? “It may come down to your own personal risk tolerance, but as a primary care doctor, I’m thinking about it always on a population level,” says Maharaj-Best. “If everyone started to let their guard down, what would be the outcome for the whole community?”
Doctors again are divided here, but many give the go-ahead on hugging as long as both people are wearing masks and feel comfortable. “I think it’s reasonable to have those short types of interactions. They’re important to address the psychological impacts that we’ve had,” says Craig Shapiro, a pediatric infectious diseases specialist at Nemours/Alfred I. duPont Hospital for Children.
Fischer agrees, noting, “Respiratory spread is by far the most likely mechanism for spread of this infection, so physical contact like a quick hug, as long as people are wearing a mask, doesn’t involve significant risk.”
What if my relative lives in a nursing home?
Nursing homes and assisted living facilities may have their own visitation guidelines. “There are still some places that haven’t been able to get everyone fully vaccinated, and there also may be people who can’t get vaccinated and are more vulnerable,” says Goldstein. Call ahead to ask about visitation requirements.
Ayiti-Carmel Maharaj-Best is an assistant professor of Clinical Family Medicine and Community Health at the University of Pennsylvania
Robert Fischer is head of the infectious disease program at Einstein Health
Neal Goldstein is an assistant research professor of epidemiology and biostatistics at Drexel University
Craig Shapiro is a pediatric infectious diseases specialist at Nemours/Alfred I. duPont Hospital for Children