On Monday, March 8, the Centers for Disease Control and Prevention (CDC) released its first guidance on public health recommendations for fully vaccinated people.  The agency stated the guidance “will be updated and expanded based on the level of community spread of SARS-CoV-2, the proportion of the population that is fully vaccinated, and the rapidly evolving science on COVID-19 vaccines.”  A person is considered fully vaccinated two weeks after receiving their second dose from either the Pfizer or Moderna vaccine or the single dose vaccine from Johnson and Johnson.

CDC Director Rochelle Walensky said although the vaccines are very effective, there is still a small risk that people who have been vaccinated could still become mildly ill or be asymptomatic and transmit the virus.  She stated, “Importantly, our guidance must balance the risk to people who have been fully vaccinated, the risks to those who have not yet received a vaccine, and the impact on the larger community transmission of COVID-19 with what we all recognize to be the overall benefits of resuming everyday activities and getting back to … some of the things we love in life.”  In summary, the CDC stated that fully vaccinated people can:

• Visit with other fully vaccinated people indoors without wearing masks or physical distancing.
• Visit with unvaccinated people from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing.
• Refrain from quarantine and testing following a known exposure if asymptomatic.

However, the CDC said that fully vaccinated people should continue to wear a mask when out in public, practice social distancing, avoid large gatherings, and refrain from unnecessary traveling.

While vaccinated grandparents will be happy that they can visit their grandchildren indoors without wearing a mask, others were critical of the guidance as still being too restrictive considering the drop in COVID-19 infections and the increased distributions of vaccines.  Marty Makary, M.D., a Johns Hopkins surgeon and medical school professor, who stirred the COVID-19 pot in mid-February when he predicted the country would be at herd immunity by the end of Spring, stirred it again in a March 10 Wall Street Journal op-ed.  He wrote that the CDC “has lost a lot has lost a lot of credibility during the Covid-19 pandemic by being late or wrong on testing, masks, vaccine allocation, and school reopening.  Staying consistent with that pattern, this week – three months after the vaccine rollout began – the CDC finally started telling vaccinated people that they can have normal interactions with other vaccinated people – but only in highly limited circumstances.  Given the impressive effectiveness of the vaccine, that should have been immediately obvious by applying scientific inference and common sense.”

He cited an Israeli Health Ministry and Pfizer study that shows the vaccination reduced transmission by 89 to 94 percent and almost totally prevented hospitalization or death.  He argued there is little a vaccinated person should not be allowed to do, except to wear a mask in public places for a few more months to allay concerns of others.  He said that while “the CDC says risks of infection in vaccinated people ‘cannot be completely eliminated’” and reduced to zero is correct, the truth is we will never have conclusive data.  He added that we are “operating in the realm of medical discretion based on the best available data, as practicing physicians have always done.  The CDC highlights the vaccines’ stunning success but is ridiculously cautious about its implications.  Public-health officials focus myopically on transmission risk while all but ignoring the broader health crisis stemming from isolation.”

Others expressed their disappointment with the guidelines for the vaccinated.  On March 9, The Hill reported that the CDC “delivered a tough blow to the airline industry, which is struggling to recover from the coronavirus pandemic.”  An airline industry source said, “We continue to urge the CDC to establish and release a set of criteria that will be used to adjust their guidance regarding travel.”  The U.S. Travel Association said it was important to get past the pandemic, but goals need to be set to relax some restrictions.  Executive Vice President of Public Affairs and Policy Tori Barnes said, “The year-long pause of travel has kept people apart and caused serious damage to the economy and jobs, and with vaccines progressing and encouraging case trends in many areas, it should be possible to consider a time frame for a broader reopening of travel.”

The Hill further wrote that Leana Wen, M.D., an emergency physician and visiting professor of Health Policy and Management at George Washington University School of Public Health and an expert in pandemic response said, the guidance is “far too cautious” and that, “A lot of families are separated from one another and need to travel to see one another.  I’m really befuddled by why the guidance around travel was not changed.  Travel is very low risk – imagine if you’re traveling in your individual car or even by plane – whenever everyone is wearing masks, the risk of coronavirus is very low.”  

House Transportation and Infrastructure Committee member Rep. Rodney Davis (R-Ill) said, “The whole point of vaccinating Americans against COVID is to save lives while expediting our country’s return to normal.  People who continue to support the status quo of COVID restrictions even as millions more Americans are vaccinated each day will end up deterring a huge number of Americans from even getting the vaccine at all.”

Dr. Anthony Fauci fueled the cynicism when he admitted in a CNN interview that the Biden administration did not have the data when it comes to the CDC saying it is not safe for vaccinated people to travel.  He was asked by CNN's John Berman, “What is the science behind not saying it's safe for people who have been vaccinated to travel?”  He said when you do not have the “actual evidence” you make a “judgement call.”

On Friday, the White House COVID-19 Response Team announced that 55 percent of people over 65 have received at least one dose of the vaccine.  It is clear Americans are moving forward and traveling is part of that especially as spring break approaches.  The Minneapolis-St. Paul International Airport is expecting March to be its busiest month since this time last year.  Disney World said its theme parks are nearly booked for spring break and Florida is a prime vacation spot.

According to a November 20, 2020 an American Medical Association article, which was written three weeks before the FDA gave emergency use authorization to the Pfizer vaccine, the risk of becoming infected with COVID-19 during every step of air travel, including going to the airport, waiting in line to board the plane, flying to one’s destination, and reversing those steps upon arrival, is “lower than from an office building, classroom, supermarket or commuter train.”  The article noted, “there have been only about ‘60 cases over a period in 2020 during which a total of over 1.2 billion passengers have travelled by air.’” It makes no sense to provide guidance that allows people to visit their families but in effect stops them from traveling to get where they need to go.

The most vulnerable Americans are 65 and older, especially if they have comorbidities.  Those over 85 make up 31 percent of all COVID-19 deaths, while those 65 or older represent 81 percent, according to the CDC.  But everyone who has received the vaccine should start to live a more normal life, including traveling to be with their loved ones.  The nation cannot be kept locked down or severely restricted by timid government rules, regulations, and guidance.  Too much damage has already been done.  The incredible success and effectiveness of the vaccine should be celebrated, and Americans should be moving forward with confidence that the future is going to be brighter sooner rather than later.