The United States will have COVID-19 vaccine doses for every adult in America by late May, President Joe Biden announced Tuesday, moving the timeline up by a glorious two months. It may take some time after that landmark moment to get all those shots into arms, but availability by Memorial Day means we can justifiably hope for normalcy by Independence Day. The end of the pandemic is really, truly nigh.
But you might not know it from the baleful tone of many recent public health recommendations. Even after vaccination, so much of the present messaging says, you must keep wearing a mask. Keep social distancing. Keep not seeing your loved ones. Keep living your strange and difficult half-life.
"Currently, we do not have enough data to be able to say with confidence that the vaccines can prevent transmission," National Institute of Allergy and Infectious Diseases Director Anthony Fauci said last month. "So even if vaccinated, you may still be able to spread the virus to vulnerable people," he continued, and therefore you should continue to wear a mask and socially distance. Don't go back to normal, he advised, even after you've gotten the shot that is supposed to put things back to normal. In fact, we may still be in masks in 2022, Fauci added a few weeks later. Guidance from the Centers for Disease Control (CDC), expected to be released this week, strikes similar notes.
This is not how we should be talking about vaccines and the return to normalcy. However good the intent—and the intent is almost certainly to discourage reckless behavior that could undermine the vaccines' impact on disease transmission—the effect is discouraging and detrimental. Insofar as it might dissuade some people from getting vaccinated, advice like Fauci's might even be dangerous.
The relevant thing to know about the three COVID-19 vaccines approved in the United States so far (Moderna, Pfizer, and Johnson & Johnson) is that they're all good. Spectacularly good. They're better than the best-case scenario we were hoping for a year ago, when Fauci was widely dubbed pollyannaish for suggesting we could have a vaccine within 12-18 months. These vaccines were developed quickly and tested rigorously. They cannot give you COVID-19, because none contain the virus that causes the disease. The two-shot Moderna and Pfizer regimens are more than 90 percent effective at preventing infection altogether, while the single-shot Johnson & Johnson vaccine is 66 percent effective by the same measure. Most importantly, all three are 100 percent effective at preventing hospitalization or death from COVID-19.
That means if you get one of these vaccines, you will not die of COVID-19. And though it's true, as Fauci warned, that we can't say with equal certainty that vaccinated people can't transmit the disease, post-vaccine spread is quite unlikely. That's not how most vaccines work, and real-world data looks incredibly encouraging here. The vaccines are good.
Normalcy is the whole point of vaccination, and these vaccines can get us there. So when public health advice says "no" to normalcy even after vaccination, it misleads the public and wildly undersells the vaccines. A year into this, that's cruel and dispiriting. For some, it needlessly raises fears that we're stuck in lockdown limbo forever; for others, it suggests there's no reason to keep being careful.
What would better messaging look like? I'm not an expert in public health or public relations, but three things come to mind.
First, we should say loudly and repeatedly how great the vaccines are and how much good they can accomplish. (Dolly Parton and Bill Gates—an odd couple!—are doing this better than many public health professionals.) Recognizing these truths doesn't preclude ongoing risk mitigation while vaccine distribution is underway, and this positive slant will help overcome some people's vaccine hesitancy.
Next, we should increasingly distinguish between public and private social interactions (and, to the agency's credit, the forthcoming CDC guidance moves in this direction). In private gatherings among a known group of people, there's no reason for vaccinated people to be masked, distanced, or—as some scientists in the U.K. absurdly advised—refusing to hug their kids. After vaccination, we can hang out with friends, family, and maybe even coworkers, depending on workplace format, without the precautions we continue to take among strangers.
Meanwhile, in public, indoor spaces where we interact with people we don't know, it makes sense to keep the masks and distancing going, including for the vaccinated, until vaccine distribution is complete. That's not because vaccinated people still spread the disease in any significant way. It's because other people in the grocery store have no way of knowing who's vaccinated and who's merely irresponsible. Dropping masks early would for that reason create unnecessary fear and chaos.
It might be tempting to shorten this phase by announcing our vaccination status with some sort of "immunity certificate," an ID indicating the bearer can appear in public without a mask. This idea has come up repeatedly, but the legal and ethical risks—fraud, invasion of privacy, enforcement overreach, and more—amply outweigh its appeal.
Finally, instead of special papers for some, there must be a firm end date to those public measures for everyone. I can't say exactly when it should be, nor do I think a single national date would make sense. I'm envisioning something like six weeks after vaccines have become available (as in, you can easily get an appointment) to all who want them in a given city, county, or state. A scheme like that would give time for immunity to build and for risk to decline to an acceptable level, even for those who can't be vaccinated for medical reasons.
And when that condition is met, masks and distancing should be done. Not prohibited for the cautious, of course, but done for all who want it. We need that goal to work toward. We need to be able to look forward to this hope as it fast approaches.