May Health FYI: Real questions. Real answers.

By Lianne Jacobs and Tonja Dodd
Man opens store front wearing face mask - Vitality

*The following information is up-to-date as of June 9, 2021. Some of these answers may change in the coming months.*

It’s normal to have questions about the ever-changing COVID-19 landscape and we thank you for taking to the time to submit questions during the latest Health FYI.  While we couldn’t address all of the questions submitted during the webinar, we want to take the time to answer your questions now.

When did the vaccine pass FDA approval?

Currently, the Pfizer, Moderna and Johnson & Johnson vaccines are cleared for use under the FDA’s emergency use authorization.  Pfizer began the application process to request full approval from the FDA for its COVID-19 vaccine in early May 2021.  Moderna is expected to submit for approval in the coming weeks.  It is highly likely that both the Pfizer and Moderna vaccines will be fully approved by the FDA by the second half of 2021.

There still seems to be confusion about mask wearing and following CDC recommendations vs. state/county guidance.  How should this be approached?

The CDC guidance states that fully vaccinated people no longer need to wear a mask or physically distance in any setting, except where required by federal, state, local, tribal or territorial laws, rules and regulations, including local businesses and workplace guidance.  The CDC’s recommendation is just that – a recommendation.  You should follow your local state/county guidance on mask wearing.

Have you heard about people not wanting to get their kids vaccinated because they think their children will become sterile and unable to have kids later in life?

There is no evidence to suggest that the COVID-19 vaccine will affect fertility.

I’m concerned that non-vaccinated people who will not wear masks or social distance can spread the virus.  I’m also concerned that even though I’m fully vaccinated, I can carry it and spread it to others.  Are these real risks?

Dr. Rochelle Walensky, the director of the CDC, stated “If you are vaccinated, we are saying you are safe, you can take off your mask and you are not at risk of severe disease or hospitalization from COVID-19.  If you are not vaccinated, you are not safe.  Please go get vaccinated or continue to wear your mask.”  Her statements address the two concerns posed above.  Because many businesses and retailers won’t be able to confirm who is vaccinated as customers enter, it is possible that unvaccinated people may enter public spaces without wearing masks.  These individuals can spread the virus – however, Dr. Walensky’s statement emphasizes the fact that the real risk is to other unvaccinated individuals.  If you are fully vaccinated, you are much less likely to have asymptomatic infection and are less likely to transmit the virus to others.

My wife’s smell/taste have been distorted after having COVID-19.  Any ideas what to expect?

Although most people who get sick from COVID-19 recover within weeks, some people experience post-COVID conditions.  Long-haul symptoms, such as loss of smell or taste, have been reported, along with other long-lasting symptoms such as fatigue, headache, dizziness, fast-beating or pounding heart, difficulty breathing, and joint or muscle pain. The CDC is conducting studies to investigate how common these long-term effects are, who is most likely to get them, and whether symptoms eventually resolve.  Individuals experiencing post-COVID conditions should speak with their healthcare provider about managing or treating symptoms.

I’m planning a vacation to Hawaii and I was told that a negative Covid test is required even though I’m fully vaccinated.  Is this true? Isn’t it extreme?

While the CDC has recommended that fully vaccinated people do not need to get tested or self-quarantine, they also note that state, local and territorial governments may have additional travel requirements in place, including testing requirements, stay-at-home orders, and quarantine requirements upon arrival.  Hawaii appears to have strict requirements for entry.  They are continuing with the state’s Safe Travel pre-travel testing program, even for fully vaccinated passengers.  Travelers must have their negative test results prior to departing as an alternative to Hawaii’s mandatory 10-day quarantine.  No matter where you are traveling, make sure to check your destination’s guidelines regularly as they may change.

Any recommendations for how to handle family members who won’t get vaccinated, but we’re expected to go to outdoor and indoor family events?  I am not sure of the risk.

Outdoor activities are safer than indoor activities, as you are less likely to be exposed to COVID-19 during outdoor activities, even without the use of masks.  Studies have shown that COVID-19 spreads more easily indoors than outdoors, and that people are more likely to be exposed to COVID-19 when they are closer than 6 feet apart for long periods of time.  If unvaccinated people are attending outdoor events, they should stay at least 6 feet apart from people not in their immediate household and should limit the time around others.  Unvaccinated people should make sure to bring masks to wear in case they are unable to maintain a 6-foot distance from others.  If unvaccinated people are attending indoor events, they should be masked at all times.  If you are fully vaccinated, you should feel safe knowing you are protected.  However, children and others who have not yet been vaccinated remain at risk and safety precautions should be followed when gathering with others.

In the US, is the public health goal currently to reach herd immunity?  Will it be through a combination of those who have contracted COVID-19 (have immunity) plus those who have been vaccinated? What is the current target percentage?

Herd immunity was discussed earlier in the pandemic to signify the point in time at which enough Americans would be protected from the virus such that we would be rid of the pathogen.  Early on, it was thought that the only way out of the pandemic would be for enough people to gain immunity – through either natural infection or vaccination – that the virus would run out of people to infect.  The target threshold for herd immunity was estimated to be between 60%-70% of the population, and health experts believed that the US would be able to reach this threshold once vaccines became available.  However, the emergence of highly contagious variants drove up this threshold estimate to about 80%.  Health experts also point out that herd immunity across the US is challenging because even if the country has strong protection against the virus, if a local community has lower protection, the virus will continue to spread in that local area.

The slow rate of vaccination in the US, caused in part due to vaccine hesitancy, coupled with the emerging variants that have spread, have led health experts to predict that herd immunity is not likely to be reached.  Instead, they believe the virus will most likely become a manageable threat, rather than be eradicated, that will continue to circulate in the US for years.  COVID-19 may still continue to cause hospitalizations and deaths, but likely in much smaller numbers than we’ve seen over the past year or so.  However, we don’t have to reach herd immunity in order to get the pandemic under control.  We must achieve higher vaccination rates.  If vaccination rates are too low, over time, new variants will emerge that can break through vaccine protection and we will see a resurgence of illness every few years. 

I heard that Moderna may come out with a third dose.  What’s the update on that?  Will we need to get the shot annually (a booster) or will this be a one-time thing? How long do we expect vaccine protection to last?

Studies are currently ongoing to assess how long the current vaccines offer strong protection against the coronavirus.  Clinical trials so far have suggested that the vaccine offers high levels of protection for at least 6 months after the second dose.  Vaccine manufacturers are preparing for the possibility that a third dose or booster may be necessary within 12 months of initial vaccination.  However, at this time, we just don’t know the answers to these questions.  Dr. Fauci has stated that experts will have a better idea of the necessity of a third dose by late summer or early fall. 

For healthy and active people in their 20s and 30s with no health conditions, how effective is their natural immune system vs. the efficacy of the vaccines?  Do young, healthy people really need the vaccine?

Absolutely.  Young healthy people still need to get vaccinated, even though young adults and children are less likely to die from COVID-19 than older adults.  A more likely outcome in young adults is long-term complications associated with COVID-19 – with some long-haul symptoms lasting a year now.  Health experts have also seen cases where strong, healthy immune systems can backfire.  The immune system has been shown to overreact in younger adults, which can cause severe inflammation or other serious symptoms.  Additionally, the longer the virus continues to spread, the more chances it has to mutate, potentially leading to the emergence of new variants that can’t be fought with the current vaccines, which would set us down a dangerous path.

Young people should get vaccinated because they represent a large portion of the population, and without them getting vaccinated, the rest of the population could be vulnerable to new variants that we don’t know how to protect against.   Further, we must protect those who are not able to be vaccinated just yet, including young children.  Children are still at risk of getting and spreading COVID-19, so anyone who has a child or interacts with children should get vaccinated.  Young, healthy adults may also be at higher risk than they might think.  About one-third of young adults between 18-25 are at risk of severe COVID-19 and young adults who used e-cigarettes have been found to be five times more likely to be diagnosed with COVID-19.

When is the vaccine going to be available for kids 12 and under?

Currently the Pfizer vaccine is available for all individuals 12 years and older, and Moderna plans to request authorization for children as young as 12 years old in the coming weeks.  With regard to children younger than 12, the timeline is a little longer.  Pfizer and Moderna are currently studying the vaccine in children 6 months to 11 years, with requests for emergency use authorization for children 2-11 years predicted for early fall.  For children 6 months to 2 years, emergency use authorization is predicted to ne requested in late 2021 or early 2022.  The timelines may shift as the studies progress, but studies are underway for children 12 and under.

Everyone in my immediate family has been vaccinated except for me.  Do I need to wear a mask?

Your fully vaccinated family members can resume activities they did prior to the pandemic without wearing a mask or physically distancing, in most situations.  However, if you are not fully vaccinated, you should find a vaccine and continue to wear a mask in public and keep your distance.

Does it look stupid to wear a mask when you go shopping or do errands, even if you don’t have to?
No! If it makes you more comfortable to continue to wear a mask even after you’re vaccinated, you should do so, regardless of what others think.  There are a variety of reasons people may continue to wear a mask even after being fully vaccinated.  Parents may choose to continue to wear a mask to set a good example for their young children who are still required to wear masks in public; people who have compromised immune systems may not have the same level of protection from the vaccine or may not be able to get the vaccine at all and thus may continue to wear masks; other people may not be comfortable being in public places without a mask when there’s no way to know who is vaccinated and who isn’t.  And other people may just not be comfortable removing their mask just yet after more than a year of being in the routine of wearing masks in public.  Whatever your reason – do what makes you feel the most comfortable.

If I’ve had COVID-19, should I still get vaccinated?

It is recommended that people who have been sick with COVID-19 get vaccinated.  Due to the severe health risks associated with COVID-19 and the fact that re-infection with COVID-19 is possible, people should get vaccinated even if they have been previously diagnosed with COVID-19.  We don’t know how long people are protected as a result of natural immunity from a COVID-19 diagnosis, and so health experts recommend getting the vaccine for better protection.

How risky is it for my children to get COVID-19 if they are not vaccinated even though I am vaccinated?

Children can get sick with COVID-19; however, most children have mild symptoms or no symptoms at all.  The risk that a child gets seriously ill from COVID-19 is extremely small – a recent study showed that the risk is comparable to that children face of having serious illness as a result of the flu. Out of more than 74 million children in the US, there have been about 300 deaths and a few thousand serious illnesses.  The risk to children is continuing to decrease as COVID-19 rates fall and the chance of encountering an unmasked person who is sick with COVID declines.  Children should continue to wear masks in public settings and should get vaccinated as soon as they are eligible.  Currently, children 12 and older are eligible for the vaccine, and studies are ongoing for children 6 months to 11 years, with requests for emergency use authorization predicted for late 2021 or early 2022.


Lianne Jacobs, Product Analyst, has a master’s degree in public health from Yale University. She is the only indoor cycling instructor who can’t ride a bike. She enjoys traveling the world, laughing at her own jokes, and tricking her husband into eating baked goods made with hidden vegetables.

Tonja Dodd, MPH, is a Senior Health Strategy Analyst at Vitality Group where she translates clinical guidelines into risk appropriate health promotion strategies to engage members in healthy behaviors. Her background is in public health with 25 years of experience designing, developing and delivering health and wellness programs and products. Tonja finds her healthy place is being active outdoors and spending time with family, friends and pets.

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