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CDC's Cautious Advice for Vaccinated People Draws Criticism

By Steve Baragona March 09, 2021

The first federal recommendations for people vaccinated against COVID-19 allow cautious steps toward normal life.

Too cautious, critics say.

The guidelines that the U.S. Centers for Disease Control and Prevention (CDC) issued Monday say that vaccinated people can get together indoors with other vaccinated people without masks and social distancing.

They also can go without COVID precautions when they visit unvaccinated people who are at low risk of severe disease. Vaccinated grandparents can visit grandchildren whom the COVID-19 pandemic has kept them from seeing, for example, since children very rarely develop serious COVID-19 symptoms.

But they should not get on crowded planes, trains or buses to do it. The travel recommendation remains the same: avoid it.

Though vaccinated people are protected from severe illness, there is still a "small risk" that they could carry the virus without showing symptoms and spread it to other people, CDC Director Rochelle Walensky told reporters Monday.

With nearly 60,000 new infections still taking place every day, she said, "it is our responsibility to make sure ... that we protect those who remain unvaccinated and remain vulnerable."

Life changing

But the recommendations disappointed some health experts.

"What we have to make clear to the general public is that this vaccine changes your life," said Dr. Amesh Adalja, an infectious disease expert at the Johns Hopkins Center for Health Security. "It's not as if you get your vaccine and nothing changes. Everything changes."

Travel, movies, restaurants — if vaccinated people keep their masks on and maintain safe distancing, "you can do that, cautiously and carefully," said Vanderbilt University Medical Center infectious disease expert William Schaffner. "Go out there into the world and start engaging with each other."

By saying life after vaccination should not be much different from life before, the CDC removed an incentive for the 30% of people who say they probably or definitely will not get vaccinated, noted former Baltimore health commissioner, Leana Wen.

"The reality is that millions of Americans will not get vaccinated unless they see something in it for them. That something is the freedom to return to normalcy," she wrote in an opinion article in the Washington Post Tuesday.

"Yes, there's a risk that those vaccinated could still be low-level carriers of the coronavirus," she said. "That risk is offset by the greater risk of waiting: At some point soon, everything will be fully reopened anyway, and there will be no carrot left to offer."

Stay or go?

Wen said the CDC should even encourage vaccinated people to travel, while keeping their masks on and avoiding gatherings with unvaccinated people when they arrive at their destinations.

However, with more infectious variants of the virus circulating, CDC's Walensky said that now is not the time to travel.

"Every time that there is a surge in travel we have a surge in cases in this country," she noted. "We are really trying to restrain travel at this time period of time."

It's happening anyway, others noted.

More than half of Americans are planning or have booked a trip, according to the U.S. Travel Association, an industry group.

Public health experts have criticized Texas and Mississippi for completely reopening their economies and canceling their mask mandates. But they are not the only ones relaxing restrictions. Other states, including Massachusetts and Connecticut, are allowing restaurants to go back to full capacity.

"The CDC guidance is lagging what people are actually doing," said Adalja of Johns Hopkins, adding that the agency is risking irrelevance. "People are passing them by, and I think they're losing an opportunity to actually help people make better decisions."

Adalja also thinks the CDC would be better off approaching COVID-19 the way it does HIV/AIDS, hepatitis C or sexually transmitted diseases.

"We know that abstinence-only education doesn't work," he said.

Rather than telling vaccinated people what not to do, the CDC should explain how to lower their risks.

"Don't throw away your mask," he said. "But don't be worried about visiting your grandfather, or getting on an airplane or subway, or indoor dining. I tell people, go back to as close to normal life as you feel comfortable."

The guidance is "an important first step," Walensky added, but it's "not our final destination." The risks that vaccinated people can still spread the virus is "an ongoing area of research," she said, adding that the CDC will continue updating the guidance as new information comes in.



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