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You should still be wearing a mask, even if you got the COVID-19 vaccine. Here’s why. - SFGate

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As more Americans get vaccinated — and more proof, albeit still inconclusive, emerges that the COVID-19 vaccines more than likely inhibit the spread of the coronavirus — it feels as if the light at the end of the proverbial tunnel is near.

The U.S. Centers for Disease Control and Prevention has relaxed its guidelines for social distancing and mask-wearing, permitting fully vaccinated people to congregate indoors with one another in small groups, unmasked. (There’s some caveats: If you’re immunocompromised or older, hold off on indoor gatherings for now even if you’re vaccinated.)

A CDC study of health care workers and first-line responders in the United States — some of the most exposed to COVID-19 — found that infections, including asymptomatic ones that could lead to transmission, have been reduced by 90% post-vaccine, while other global studies found major reductions in transmission.

CDC Director Rochelle Walensky also said in an interview that data suggests vaccinated people do not carry the virus.

“These findings should offer hope to the millions of Americans receiving COVID-19 vaccines each day and to those who will have the opportunity to roll up their sleeves and get vaccinated in the weeks ahead,” Walensky said at the time. (That said, those comments were met with contention by some medical experts — and the CDC issued a statement emphasizing that evidence remains inconclusive.)

Days before, Walensky also cautioned against “impending doom” as cases steadily rose over the prior week. Dr. Anthony Fauci, the nation’s leading infectious diseases expert, blamed the surge on increased travel and loosening restrictions by leaders in states such as Texas, Michigan and Iowa.

B.1.1.7, a particularly infectious strain of the virus originating from the United Kingdom, is the most prevalent one in the United States — and appears to be infecting kids and young adults at a higher rate.

With all of this in mind, experts who spoke to SFGATE said that you should still be wearing a mask when out in public settings for a multitude of reasons.

As UCSF infectious diseases expert Dr. Monica Gandhi puts it, you should still be wearing a mask to fulfill your social contract to your fellow neighbor.

“The idea that we'll all be wearing masks in public for a short period of time can be rankling to some,” Gandhi said. “But I consider it … sort of a polite thing to do.”

The way she thinks of it, there are still plenty of people out in the world who have been unable to get the vaccine, especially in California. “We're in the twilight zone,” Gandhi said. “We haven't all been able to get vaccinated.”

A passenger wears a face mask as she travels on a Delta Airlines flight Wednesday, Feb. 3, 2021.

A passenger wears a face mask as she travels on a Delta Airlines flight Wednesday, Feb. 3, 2021.

Charlie Riedel/Associated Press

That issue is exacerbated by vaccine inequities — in California, Black and Latino residents are less vaccinated than other groups. A USC study also found that Latino and Black Californians are more likely to die of the virus.

She acknowledges that some people — whether anti-maskers who want to take off their face coverings post-vaccine, or anti-vaxxers who refuse to get the shot — will be unhappy with her pleas for good manners.

“It’s almost impolite that some of us can run around scot-free and some of us have to wear a face mask and so I guess that's how I'm framing it, and I'm going to be criticized for that.”

But perhaps worth noting is that she can take this approach because people in the Bay Area, and specifically San Francisco, are getting the vaccine at higher rates relative to the rest of the country or even the state of California. A recent report found that 79% of unvaccinated Bay Area residents will consider getting the vaccine; those numbers go up in San Francisco, with 93% of residents likely to be inoculated.

Compare those numbers to the state and country: A poll by the Public Policy Institute of California found that 61% of Californians have gotten or will definitely get the vaccine; a poll by the Kaiser Family Foundation found that 62% of Americans will certainly get the vaccine.

University of New Haven professor of biomedical engineering Kagya Amoako also says it’s worth wearing a mask after vaccination, but takes a slightly different methodology.

“When it comes to being in public and in large crowds, you still have to wear your mask,” he said, “even if you're fully vaccinated because you don't know who's in the crowd, and you don't know what kind of risks they would experience should they get COVID.”

Amoako says it’s worth taking a bit more of a cautious approach on COVID-19 transmission post-vaccine.

“When we get the data, then, you know, people will feel more comfortable with that,” he said. “If you're fully vaccinated, you're hopefully not going to be transmitting the virus to other people.”

He points out that a trial backed by the National Institutes of Health is currently underway to determine whether the vaccines, specifically the Moderna version, will help stop the transmission of the coronavirus.

Like Gandhi, he understands the frustration of staying in the “pandemic environment for over a year.”

But for him, the idea of wearing masks post-immunization is about staying patient until more people get vaccinated — and cases begin to decline more significantly as new strains begin to pop up.

“We are almost there, right, we are almost there and we have to just hold on a little bit longer,” he said. “Very soon, the number of people … who will have received a vaccine will climb very fast, approaching herd immunity, right, and more safety will come from that.”

He also pointed to pandemic exhaustion and overly lax restrictions as a key reason to keep mask mandates in place for now.

“The weather is getting warmer and … people are getting tired. They want to be out,” he said. “And so I think … people are getting impatient, so we just have to speed up the vaccination. It’s been a year and the message has been very consistent. But states and individuals are choosing to do whatever they want.”

While Gandhi, the UCSF infectious diseases expert, previously pushed back on Walensky’s comments about the COVID-19 spike, Gandhi acknowledges that she’s able to make these statements because the region she lives and works in is ahead of the curve for vaccines.

“I actually think it would be really hard to be a CDC director, because you want to, you know, advise people to be cautious,” Gandhi said of her prior comments on Walensky. “But the way that you message may end up being more on the side of fear, because you are trying to urge caution.”

“I’m going to favor vaccine optimism in my own messaging,” she said, pointing to her background working through the HIV/AIDS epidemic. “As a doctor, I get to encourage vaccine uptake so I'm in a lucky position that I get to do that.”

Amoako also says that vaccines are integral to ending the pandemic. “What we have control over is getting a lot of vaccines out, and then you have to convince those who don't want to take the vaccine,” he said. “That’s another beast altogether.”

Both Gandhi and Amoako say it’ll be worth re-evaluating these policies in the coming months, especially as vaccine eligibility opens up more broadly. In California, everyone over 16 years old will be eligible starting April 15. President Joe Biden just announced that starting April 19, everyone over 16 will be eligible.

The issue will certainly come up again come June 15, the day Gov. Gavin Newsom plans to "fully reopen" the state — with a mask mandate likely intact.

“A mandate by a politician or public health [official] to wear a face mask once everyone’s had an opportunity to get a vaccine will be met with a lot of resistance,” Gandhi said.

But for now, keep your masks handy — and don’t be a jerk.

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