Many people hope that getting a Covid-19 vaccine will mark an immediate return to normal: no more masks, no more distancing, safe indoor dinner parties and big hugs with friends.

The reality is more complicated. For now, people who have gotten their shots must navigate decision-making in a world where the vaccinated and unvaccinated will coexist for months, even within the same household.

So what should and shouldn’t you do? The U.S. Centers for Disease Control and Prevention is expected to issue guidelines soon. “We are taking the time to get this right and we will be releasing the guidance soon,” CDC director Rochelle Walensky said Friday. “We want to make sure the communication is crystal clear.”

In the meantime, other experts are somewhat divided. Some say vaccinated people can and should have significantly more freedom, and believe it’s important to emphasize that to encourage more people to get the vaccine. Others are more conservative, saying it’s too early to drop too many precautions without more conclusive data on the vaccines’ efficacy against new variants and the potential risk of vaccinated people spreading the virus to non-vaccinated people.

Most agree that until we are closer to herd immunity—when a substantial majority of the population is protected through vaccination or natural infection so the virus can’t spread easily—mask wearing, social distancing and avoiding crowded, indoor gatherings should be standard practice in public spaces.

“Particularly for these several months where immunization coverage is low, we’re still learning about the variants, and we still need to know about this onward transmission, the public health messaging really is to maintain these behaviors,” says Chris Beyrer, a professor of epidemiology at Johns Hopkins Bloomberg School of Public Health. “Until we get out of this. We’re not out of it yet.”

A medic shows his vaccination record card.

Photo: chandan khanna/Agence France-Presse/Getty Images

Here are recommendations from scientists on how to assess the risks.

Is it OK for vaccinated people to meet with other vaccinated people?

Most experts agree that once fully vaccinated—two weeks after your second dose of the Pfizer or Moderna vaccines or about a month after the Johnson & Johnson shot—it’s safe to meet indoors with other fully vaccinated people without masks or distancing. But gatherings should be small.

Gathering with other vaccinated people is “scientifically very safe,” says Paul E. Sax, clinical director of the division of infectious diseases at Brigham and Women’s Hospital in Boston. Nothing is 100% effective but “gathering with other vaccinated people is pretty darn close,” he says.

“I don’t think people should run to a crowded bar where people are shouting at each other,” he says. “But the kind of socializing that is part of human nature and that has been put on hold for a lot of people—that can resume.”

The larger the group, the riskier the interaction, because you can’t verify that everyone is vaccinated and you don’t know what their exposures are, says Leana Wen, an emergency physician and public health professor at George Washington University in Washington, D.C. “I’m talking one other couple or maybe two other couples at most,” says Dr. Wen.

Monica Gandhi, an infectious disease physician and professor of medicine at the University of California, San Francisco, is less conservative, saying vaccinated individuals should feel more comfortable. “They can have dinner parties. They can go to restaurants. They can go to the movies,” she says. But she notes that even vaccinated people will need to follow mask and distancing requirements in those public settings until we reach herd immunity.

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What if the adults are vaccinated but the kids aren’t?

There is currently no authorized vaccine for children and adolescents under 16 years old. “This is going to be one of those issues that families are going to have to grapple with and be prudent about,” says Dr. Beyrer.

There’s a significant difference between young children and adolescents or teens in terms of both transmission of the virus as well as getting the disease, Dr. Sax says. Adolescents get and transmit Covid-19 similarly to young adults, while younger children don’t get symptomatic disease as often and don’t appear to transmit as much. “Every family and every group of friends is going to make decisions based on their own risk tolerance,” says Dr. Sax.

Immunocompromised individuals and their families should be more careful, as vaccines in general can be less effective in them, says Dr. Sax.

Dr. Wen says she recommends that families continue to take precautions during playdates when the adults are vaccinated but the kids aren’t. “If those families are also associating with other families, that’s a risky scenario that I would not recommend at this time,” says Dr. Wen of indoor gatherings. “They could be an asymptomatic carrier who then spread it to their children. And if the children are in school or daycare, there could be additional spread from that.”

What is the latest on whether vaccinated people can spread the virus to unvaccinated people?

Recent studies found that vaccination reduced asymptomatic infection more than 80% when compared to unvaccinated individuals and nasal viral loads are low and potentially noninfectious, says Dr. Gandhi. But other experts say the evidence is preliminary and more conclusive evidence is needed. And new variants raise additional questions about vaccine effectiveness.

What activities should I prioritize after I get vaccinated?

Schedule any routine medical and health appointments that you’ve been putting off, Dr. Wen says. Get your colonoscopy, mammogram or dental cleaning. Schedule an elective surgery. “Anything like that you should resume because you are well protected,” says Dr. Wen.

What about travel?

Once you are vaccinated, traveling itself is lower risk, says Dr. Wen, as is staying at a hotel or going to restaurants, so long as you follow safety protocols. But continue to be cautious about how you meet with people once you arrive at your destination, she says, particularly if they aren’t vaccinated or live in an area that has high transmission rates.

Is it safe for my elderly parents to travel for a visit?

If grandparents are now fully vaccinated, it should be safe for them to travel for a visit. “The travel itself is very low risk,” says Dr. Wen. “If they follow precautions like wearing a mask, the risk of them contracting the coronavirus and passing it on to the rest of the family is extremely low and the benefit is huge. People are eager to see their families.”

But still weigh the specifics of your situation. If you have an unvaccinated older teen and a frail, elderly grandparent, consider more precautions, says Gregory Poland, director of the Mayo Vaccine Research Group in Rochester, Minn.

Which activities are lower and higher risk, even after vaccination?

Vaccinated individuals can feel comfortable when doing quiet indoor activities where people are generally still required to be masked and distanced, such as visiting an uncrowded museum, says Dr. Sax. Outdoor activities are even safer.

Higher-risk situations include indoor dining, bars, gyms and houses of worship, where people are singing and talking. “We don’t want to push the limits of what the vaccines can do before case numbers drop,” says Dr. Sax. He and his physician wife are both fully vaccinated but won’t dine in restaurants until case numbers and hospitalizations are significantly lower, he says.

Airports in Paris and Singapore as well as airlines including United and JetBlue are experimenting with apps that verify travelers are Covid-free before boarding. WSJ visits an airport in Rome to see how a digital health passport works. Photo credit: AOKpass

Write to Sumathi Reddy at [email protected]

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