You've gotten the COVID-19 vaccine - now what? Is it safe to return to a normal routine?

Whether you’ve had 1 dose or 2, many questions remain. Here are some answers.

Update: On April 27, the U.S. Centers for Disease Control and Prevention said Americans who are fully vaccinated against COVID-19 no longer need to wear face masks outdoors when walking, running or biking alone, with members of their household or while attending small, outdoor gatherings.

Update: On March 8, the Centers for Disease Control and Prevention issued new guidelines for people who are fully vaccinated - defined as being two weeks past the second dose of the Pfizer or Moderna vaccines or of the single dose of the Johnson & Johnson vaccine. Key among the guidelines is that fully vaccinated people can gather indoors with other fully vaccinated people without wearing a mask or physically distancing. They can also gather unmasked with people in their household who are not fully vaccinated, provided the latter are at low-risk of serious disease. However, the CDC still advises even those who are fully vaccinated to continue to wearing masks, physically distance and avoid large crowds when out in public. See the CDC's complete guidelines for those who have been fully vaccinated.

You waited your turn, made it to a vaccine site and received your first dose of the COVID-19 vaccine.

“I can finally host a dinner party at home,” you think. “Or feel comfortable getting on a plane to visit family I haven’t seen for a year.”

Except experts say you shouldn’t.

Pfizer-BioNTech's COVID-19 vaccine at UCLA Health. (Photo by Ann Johansson)

Even after receiving both doses and waiting the two to four weeks it takes to develop maximum immunity, the safest way forward is to continue masking, hand-washing, social distancing and not gathering with people from outside your household, says Annabelle de St. Maurice, MD, MPH, co-chief infection prevention officer for UCLA Health.

That goes for Pfizer and Moderna vaccines and others on the horizon.

“There’s some promising data out there, but we still need more information on whether or not being vaccinated actually prevents you from carrying the virus and spreading it to others. So you still need to be cautious,” Dr. de St. Maurice says. “I hate to say it, but at this point, since we don’t have that many people vaccinated and we’re just coming from a surge, I wouldn’t recommend changing anything.”

Increasing availability of vaccines has coincided with the emergence of new variants, leading to more urgency and more questions. Dr. de St. Maurice offers some answers:

Q. So even after I’m fully vaccinated, I might still be able to spread the virus?

A: “We don’t know. We know that 95% of the time you won't get sick, but we don't know if there’s a chance that you can get infected and pass it along to others.” Dr. de St. Maurice adds that UCLA Health is among many sites conducting research into this topic.

Q: Why should we get the recommended two vaccine doses rather than just settle for the limited immunity one shot might provide?

A: “There's a few reasons. One is that these vaccines were studied as a two-dose series, so we know that the two doses provides a 95% efficacy. If you just get one dose, we know from the clinical trial data that it provides some protection, but we don't know if that protection lasts as long as if you got two doses. The other thing is when you get that second shot, it refines your immune system to be even more effective against the virus. So if you don't get that second dose, you may not have as strong of an immune response, and so for some of these variants that are out there, maybe having only one dose could be even less effective compared to when they did the clinical trial data.”

Q: But the approved vaccines from Pfizer and Moderna do appear to be protective against these variants, right?

A: “Some of the vaccines are more effective than others against some of the variants, so it really depends, but thus far, it does seem like there's at least some level of protection from the vaccines.”

Q: Navigating the county vaccine system has been difficult for many people in the 65-and-older group. Do they really need both doses?

A: “It’s probably even more important for older individuals. Your immune response when you’re older typically isn't as good as when you're younger. For influenza, for example, we give those who are 65 years of age and older an even higher dose of the vaccine compared to individuals who are younger, just because we really want to make sure to prompt their immune system to make antibodies and their immune response to be more robust.”

Q: The yet-to-be-approved vaccine from Johnson & Johnson is reportedly 72% effective against moderate and severe disease, which is lower than Pfizer and Moderna’s 95% efficacy. Is it still worth getting?

Dr. Annabelle de St. Maurice.

A: “We care about hospitalization and death, and all of the vaccines are effective against those outcomes. I think the key thing is: If you’re offered a vaccine, you should take it. Because even though we’re seeing cases decrease, we certainly don’t want you to get hospitalized or die because you’re waiting for something better. All of these vaccines are excellent.”

Q: Why can’t we get other vaccines around the time we get the COVID-19 vaccine?

A: “When vaccine schedules are created — for example with childhood vaccines, when kids are getting multiple vaccines at once — when those vaccines are studied, they're typically studied in combination with each other to make sure that giving one vaccine doesn't impair the efficacy of another. The mRNA vaccines (from Pfizer and Moderna) were studied in isolation and people were told not to get a vaccine two weeks beforehand or two weeks after, we don't have data on how effective they are in combination with the flu vaccine or another vaccine. It’s not that we think necessarily it'll be less effective, it's just we don't know for certain. That's how rigorous our vaccine studies and vaccine recommendations are – we don’t recommend taking vaccines that haven’t been studied together. So that's why it's recommended to wait at least two weeks — just to make sure there isn't some decreased efficacy because you're getting two doses of different vaccines at the same time.”

Q: Do people who’ve recovered from COVID-19 only need one dose of vaccine?

A: “I think they probably have been sort of primed, but at this time, I still recommend that they get both doses. Natural infection doesn't give you the same level of antibodies as vaccination, so that's why it's recommended that even if you had natural infection that you receive the vaccine.”

Q: Given that children aren’t yet eligible to be vaccinated, what would make returning to school safe for students and teachers?

A: “The first thing we need to do to return to school is make sure we have control of COVID in our communities, so we're seeing a lot of progress on that front in Los Angeles and nationally. For me, that's the most important thing. At this point, children have demonstrated that they can wear masks, that they can practice physical distancing, and we've also seen lots of data from the CDC demonstrating that children really aren’t vectors of disease. So to me, if we can continue to maintain low rates of transmission, then I think we can go back to school safely.”

Q: The vaccines are here, but will this pandemic ever really end?

A: “We all have to pitch in in order to help get ourselves out of it — until we have a significant portion of our population immunized, we won't be able to go back to normal. The long and short of it is that unfortunately we can't go back to normal right now, but eventually we will, if people just do their part: follow public health guidelines and get vaccinated when you can.”