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After People Get The COVID-19 Vaccine, One Doctor Argues For Optimistic 'Tiered Messaging'

Massachusetts State Police worker Lisa Watson receives the Moderna COVID-19 vaccine at the Gillette Stadium COVID-19 Vaccination Center in January 2021. (Jesse Costa/WBUR)
Massachusetts State Police worker Lisa Watson receives the Moderna COVID-19 vaccine at the Gillette Stadium COVID-19 Vaccination Center in January 2021. (Jesse Costa/WBUR)

Although the COVID-19 vaccine rollout in the U.S. has been slower than most hoped for, millions of Americans have been able to get at least one dose of a COVID-19 vaccine.

But now what?

Public health officials say people who have been vaccinated should still take precautions, such as wearing masks and social distancing, because vaccines aren’t perfect. It may be possible to pass the coronavirus to people who haven’t been inoculated yet, and questions remain about the more contagious variants.

There is also concern that if you give people an inch with vaccine protection, they’ll take a mile.

Dr. Monica Gandhi, an infectious disease specialist at the University of California San Francisco, argues that those kinds of warning messages may be over simplified. She’s written about how to have nuanced conversations on navigating life post-vaccine, including motivating people by emphasizing optimism, not gloom.

Gandhi analyzed advertisements in Europe promoting COVID-19 vaccines. Many of these foreign ads show older people talking about getting the vaccine in order to see their grandchildren. In contrast, messaging in America has largely conveyed that nothing will change after getting vaccinated, which “isn’t true,” she says.

“Of course things will change after vaccination,” she says. “It will change in a tiered way, meaning vaccinated people may have a set of recommendations that will be different from unvaccinated.”

This is why she recommends a set of easily understood, layered recommendations for post-vaccine life that include getting back to normal. It’s done in HIV messaging “all the time,” she says, and could motivate more Americans to get a vaccine.

For example, among the first batch of inoculated Americans include older people, many of whom are questioning whether it’s now safe to meet with family members or hug their grandchildren.

“My guidance is use the principles of this nuanced tiered messaging and think, OK, if you’re vaccinated, you’re actually the one who’s safe,” she says.

Critically think about the chances of transmission between people, she says, adding that seeing a grandchild presents a “very, very low” chance of infection. Every family will ultimately have to decide on their own precautions.

A group of vaccinated older folks gathered together is “a perfectly safe activity,” she says.

Pandemic messaging in the U.S. has been rooted in distrust of the public, she says. And often, this messaging excludes the realities of essential workers or those suffering from loneliness.

Gandhi says “if this, then that” COVID-19 vaccine messaging is key moving forward. For example, she says messaging should include that it’s OK for two vaccinated people to hang out, and for unevenly vaccinated groups — maybe one family member is vaccinated and another is not — to make decisions for themselves based on the data.

The unvaccinated, general population can let their guards down once herd immunity is reached, she says. Gandhi hopes the Johnson & Johnson coronavirus vaccine will add more opportunities for the public to get vaccinated, thus obtaining herd immunity faster.

She predicts herd immunity could happen between fall or winter of 2021 depending on the speed of the rollout. And at that point, life “will be normal,” she says. “We will gather.”

As a health care worker, Gandhi has received the vaccine. Since she’s 14 days past her second dose, she says she is “truly immune” because the vaccine has “95% efficacy and 100% efficacy against severe disease.”

Her parents got their first dose just this week. Once her parents have been inoculated with the second dose and pass the 14-day point, she will visit them without restrictions, she says.

But being vaccinated doesn’t mean her pandemic behavior — masking and social distancing in public — is changing outside of her home. It just means there are more opportunities to meet, unmasked, with others who are already vaccinated, she says.

Ashley Locke produced and edited this interview for broadcast with Tinku Ray. Serena McMahon adapted it for the web.

This article was originally published on

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