Those Who Have Had 2 Covid Vaccines Can Skip Quarantine If Exposed (Plus, Fewer People Are Dying of Covid- YEAH!)

Since the beginning of the pandemic, the CDC has been recommending that those who wind up exposed to someone known to have Covid quarantine for 10-14 days. Now, the CDC is saying that if you’ve had two shots of the Pfizer or Moderna vaccine, if you’re asymptomatic, and if it’s been at least two weeks since your second injection and within 3 months of your last shot, you can skip the quarantine period. What we don’t yet know is how long the protection lasts. As such, the CDC is tasked with harm reduction calculations. We’re not able to reduce all harm right now, but although there are things we still don’t know about whether vaccinated individuals can spread the virus or contract it, there’s also harm in asking people to quarantine when they’re likely to be immunized, like potential job loss for essential workers who can’t work from home and mental health risks for those who live alone and are socially isolated during quarantine. These are the kinds of factors those making the recommendations are constantly charged with considering. I don’t envy them that task.

We don’t know how long this immunization is likely to last, so the CDC is playing it safe. The current recommendation is that if you’re exposed to Covid and it’s within a three month window of your second Covid vaccine, and assuming you don’t have symptoms, it’s okay to skip quarantine. We don’t know whether that will still be okay six months or a year after you’ve gotten the vaccine, but scientists are surely trying to figure that out.

Keep in mind that it’s my understanding that this new guideline is specifically about whether people who are vaccinated but are then exposed to someone with Covid still need to quarantine. It’s not my understanding that the CDC is now giving a hall pass to anyone who is vaccinated to recklessly travel without precautions, so I don’t think this means vaccinated people can ignore travel quarantines.

Did The CDC Make A Good Call?

I don’t have the expertise to question whether this is a good or bad choice by the CDC, but I sent out a letter asking for an opinion from Dr. Rick Loftus, a front line Covid ICU doctor, epidemiologist, and virologist who does.

Hi Lissa. Yes, this is after exposure to known positives, and applies to people between 2 and 12 weeks post vaccination (maybe because CDC cannot yet confirm duration of protection beyond 12 weeks, although RNA vaccine protection likely lasts for at least a couple of years, based on Shane Crotty’s work in La Jolla. I expect the range to increase as more data comes in, and may be changed to “anyone beyond 2 weeks post 2nd dose”.)

You point out the key bit, of course: This applies to people without symptoms. If you’ve been exposed to someone, and then get cold symptoms, you have to isolate and get tested, rather than saying “I’m vaccinated, so it must not be COVID.” Vaccination isn’t PERFECT protection against getting COVID, it’s just very protective. Wearing oven mitts lowers your risk of getting burned while getting a cookie sheet out of the oven, but if you’re not totally careful, you can still get burned. I still wear an N95 covered by a surgical mask and a faceshield whenever I’m in indoor spaces besides my home, even though I’ve had two doses of COVID vaccine.

Vineet Menachery of UT Galveston did a great analysis of the Moderna data a couple of days ago that indicates RNA vaccines likely don’t just protect against symptomatic infections–they probably reduce ALL infection risk almost 90%, which means transmission should also decrease 90%, once a wide population is vaccinated. This is huge, because it means that vaccination should protect against Long COVID, not just against illness, hospitalization and death. Similar data analyses at CDC probably was what led to this recommendation. 

So I agree with their advisory, although I expect it will take time for policies to catch up with it. I’m flying to New York tomorrow, for example, and fully expect to abide by the traveler’s quarantine of 3 days (we can test out on day 4 with a rapid COVID ag test). NY State may change its guidelines but I expect that will take time. But I do think this advisory is reasonable, based on our best analysis of available vaccine studies to date.

Good News About Covid Cases! AND Don’t Slack Off Now

Whether you agree with these recommendations or not, the CDC’s decision, along with the news that new Covid cases in the United States are declining sharply, vaccination rates are going up, and death rates have gone from 4000+/day to 2500+/day indicates we’re moving in the right direction. The New York Times reports that “Over the next two weeks, the number of daily deaths will probably fall below 2,000, Dr. Ashish Jha, dean of the Brown University School of Public Health, predicts, and it could drop below 1,000 by next month.” YEAH!

But now is not the time to slack off on our adherence to public health measures! We’re not out of the woods yet, but we do have reason to be hopeful. And right now, grounded hope (not magical thinking or reality denialism but evidence-based hope) is darn good medicine. With so much bad news in the past year, and with a triggering impeachment trial underway, let’s allow ourselves to feel permission for the good news that we do have.

I’m nose down in the edits of my Sacred Medicine book with my Sounds True editor Jennifer, so I’m posting less on social media right now (so I can finally get this book to those who desperately need it right now!) But this news felt important so I wanted to share a bit of hope with you all. Let’s not forget that it’s okay to celebrate the little- and big- wins.

With love- and grounded hope,

Lissa

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