Once You’ve Been Vaccinated, Then What? CDC Offers Guidelines

The CDC released new quarantine guidelines for those fully vaccinated against COVID-19.

RICHMOND – “Although the risk of SARS-CoV-2 transmission from vaccinated persons to others is still uncertain, vaccination has been demonstrated to prevent symptomatic COVID-19…”

That’s the newest guidance from the Centers for Disease Control and Prevention. But what in the world does it mean?

Rebekah Butterfield, an epidemiologist with the Richmond City and Henrico County Health Districts, broke it down in a more easily digestible manner.

No Need for Quarantine

So first things first. The CDC now says that those fully vaccinated against COVID-19 don’t need to quarantine.

That’s the first break in the clouds to a more normal society.

“I think this is just an indication of what we all hoped: that the vaccine does prevent symptomatic illness, and that it looks like from the data we have so far, that it’s also preventing asymptomatic illness,” Butterfield said. “And so the CDC feels comfortable enough to say, you know, ‘You’re probably fully protected if you’ve been fully vaccinated.’ So sort of loosening the quarantine restrictions to allow for regular life to start to resume.”

However, the guidance comes as a total 180-degree turn from what health organizations pushed for nearly a year.

In part, that’s because health professionals know more about the coronavirus that causes COVID-19. Rather than picking up COVID from a dirty door handle, the virus more commonly travels through the air.

“We’re not seeing a lot of transmission through what we would call fomite transmission, so through high-touch surfaces. The viral load or the infectious dose that a person has to receive tends to be much higher than anything that could be picked up from touching an object that has been touched by an infectious person. That has been confirmed with what we’re seeing not just in Virginia, but really around the world,” Butterfield said. “So while cleaning is still important, I think as far as that goes, we’re not as worried about that as we were at the beginning of the pandemic before we had more information.”

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Spreading Infection

Now, health professionals believe the virus spreads from person to person through two things: extended contact and viral particles.

Butterfield explained how the two interacted to form an infection.

“Generally when you are an infectious case, you’re shedding, like, millions of viruses. Your body is basically like a virus-making machine. And of all the viruses exhaled with each breath, it takes a certain number of those viruses to successfully infect someone,” Butterfield said. “The reason it takes up to 15 minutes to be infected – that’s our estimate, our low estimate – is because you have to keep inhaling those to get enough virus to actually establish a successful infection. So if I’m exposed, I’m able to inhale those viruses. But I am not able to exhale an amount that would then infect someone else.”

The virus must first establish an infection before someone can spread it to others.

For those vaccinated against COVID-19, it appears spreading the virus to others is a slim possibility.

“People who are quarantining multiple times are looking at risks to their income. They’re looking at mental and even, I think, emotional burden of quarantine,” Butterfield said. “Vaccinated individuals or people who have had an infection and recovered in the previous three months as well don’t have to quarantine.”

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Exceptions to the Rule

The Virginia Department of Health adopted the CDC’s recommendations. However, Butterfield noted exceptions to the rule.

“One of the major caveats is that if you are a healthcare worker or a patient or in any healthcare setting, like in long term care facilities, that, like, ‘get out of quarantine free’ card doesn’t necessarily apply,” Butterfield said. “So in general, we can say that if you are two weeks after your last dose of vaccine and less than three months away from your last dose, then you don’t have to quarantine unless you’re a healthcare worker or a patient in a high-risk setting. If we’ve got a long term term care facility, you’ve got a lot of older patients. The effectiveness of the vaccine is generally lower in older populations. And this is true of all vaccines. And so our acceptable level of risk is going to be a lot lower.”

Butterfield also noted that in specific situations, epidemiologists may suggest a different plan.

“And I know that the CDC is also following up. They continue to monitor any vaccine breakthroughs and anything like that,” Butterfield said. “And I think the hope is that eventually this will go further than three months out. Once you’re vaccinated, you’re immune for a much longer period of time. But the hesitancy and the reason for the three month cap, is that everything is still so new. So CDC and VDH are continuing to evaluate the effectiveness, long-term, of the mNRA vaccines.”

Extending Precautions

Even for vaccinated individuals, the VDH still asks that they wear masks and practice social distancing.

“I realize that it seems contradictory, but at this point, we are still gathering data on shedding and exposures,” Butterfield said. “And with the new variants of concern, we’re looking at those. We’re looking to see if and where those spread in our communities.”

Masking and social distancing add an extra layer of protection.

“It is a health and safety measure and I think just safer as a society to say, ‘We are all going to participate in these things that will keep all of us safe.’ Because there are people who can’t physically distance. There are people who can’t mask,” Butterfield said. “The more of us following these safety precautions, I think the safer we are as a society, even if, probably, vaccinated individuals can’t shed virus.”

Amie Knowles reports for Dogwood. You can reach her at [email protected]