Finding the 'sweet spot' between freedoms and restrictions post-vaccination

When U.S. President Joe Biden's press secretary recently reminded people that they'll still have to physically distance and wear masks even after vaccination, it sparked a backlash among some conservative pundits on social media who slammed her for such a pessimistic message.

The comments by Jen Psaki "will discourage people from getting vaccinated and will land among many as demoralizing goalpost shifting — counter-productive imo," tweeted Guy Benson, a U.S. political pundit and Fox News radio host.

Robby Soave, a senior editor for the libertarian magazine Reason wrote that it's "a demoralizing and excessively cautious point to keep emphasizing" and that "health officials are at risk of criminally underselling the miracle of the vaccines."

Psaki isn't alone in noting that preventive measures will have to continue even after vaccinations.

Timothy Caulfield, Canada Research Chair in health law and policy at the University of Alberta, points out that the World Health Organization, the Public Health Agency of Canada and the U.S. Centers for Disease Control and Prevention all state that mask wearing will have to continue even after vaccination due to uncertainty about whether the COVID-19 vaccines prevent transmission of the coronavirus.

However, some experts are suggesting it would be beneficial for public health officials to strike a more optimistic tone.  

Emphasize hope, experts say

They say that at least among groups who've been vaccinated, some physical distancing measures may be relaxed, and that advising those who've been vaccinated that they can't change their behaviour may carry its own risks.

In an article in The Atlantic last month, Julia Marcus, an epidemiologist and professor at Harvard Medical School, wrote that it may be time for public health officials to emphasize the hope that vaccines are bringing. 

While scientists are still learning how much vaccines reduce transmission of the coronavirus, "the evidence shows that their efficacy against disease is phenomenal," she wrote.

The risk isn't eliminated, but close contact between two people is safer if one has received a vaccine, and safer still if both are vaccinated, she said. 

Not all human interactions take place in public, Marcus wrote.

She cautioned that advising people to continue with extreme preventive measures after vaccination, even in the privacy of their own homes, can create the impression that vaccines offer little benefit at all, which she said isn't true.

"Vaccines provide a true reduction of risk, not a false sense of security. And trying to eliminate even the lowest-risk changes in behaviour both underestimates people's need to be close to one another and discourages the very thing that will get everyone out of this mess: vaccine uptake."

The unintended consequences of such messages, she wrote, may dissuade people from taking the vaccine and also sap the public's hope.

Michal Tal, an immunologist at Stanford University, said there are still a lot of uncertainties surrounding the vaccines, including whether someone who is vaccinated, while themselves protected, may still be capable of spreading the virus to someone not vaccinated. 

"We still need more time to find out if the vaccines are preventing spread. It's possible that even those vaccinated in the early stages of the roll out will need to continue to wear masks until everyone has had a chance to get vaccinated."

'Sneak peek' of life after COVID

However, Tal believes Marcus makes a good point about the need to emphasize hope and said that health officials need to do a better job with their messaging.

While in public, those vaccinated early in the roll out will still need to wear a mask, she said, but that's just until community transmission rates and new variants are under control.

Also, she said vaccinated individuals can overwhelmingly take comfort in the fact that they enjoy protection from serious disease or death. 

Meanwhile, in private homes, healthy, fully vaccinated individuals can start to let their guard down and get a sneak peek of what it will be like after this is all behind us, Tal said.

"If you are asking me: in your own private living room, a group of five who have all been vaccinated, could you step it down a notch and feel more comfortable? Well, of course you could."

"But if you're out and about at the grocery store and you're around people who haven't had a chance to be vaccinated yet, should you keep that mask on for solidarity and for risk reduction of those around you? Yes." 

Balance key in COVID communications

Samantha Yammine, a neuroscientist and science communicator, said that there's a certain way to convey the need for continued mask wearing and distancing from a behavioural science standpoint.

"Motivation is key to anything we do. If there's too much despair, people will feel helpless. They won't follow guidelines," Yammine said. 

But if there's too much hope and everything seems rosy, she said, people won't feel any need to follow guidelines either.

"There's this sweet spot of balance."

While vaccines are not going to be the instant hero, Yammine said they are another tool in the toolbox, and just as masks enabled people to be safer with others indoors, vaccines, too, are another layer of protection. 

"So they should enable us to have a little more wiggle room when we're doing our daily risk calculation."

Not enough celebration of vaccines

Caulfied, the Canadian researcher, said the creation of COVID-19 vaccines have "kind of been undersold" and we haven't done enough to celebrate this particular scientific achievement. 

"This is like the moon landing," he said.

And when it comes to messaging about preventive measures for COVID-19, he said it's good to lead with the positive. 

"I think we can say this: The vaccine is incredible. I think it's going to take us where we need to go. We need everyone to get vaccinated," he said.

"At the same time, there are still uncertainties. And therefore, we're asking you to continue to mask."

Caulfield said most scientists would likely agree that for those individuals who have been vaccinated, the evidence is signalling that the risk of transmission is definitely lower.

"But this isn't the message that we want to send out there right now," he said.

"Right now, public health officials are asking us, even when vaccinated, to continue to take those precautions, even around, you know, other vaccinated individuals."

Two targets to meet

However both Caulfield and Tal, the immunologist, said they certainly see a light at the end of the tunnel, when mask wearing and physical distancing could be a thing of the past.

Tal said two targets need to be met: low community transmission where the risk of catching COVID in public is very low, and when enough people are protected through vaccination and herd immunity. 

"There are days ahead where where we can forget all about these masks and get back to, you know, this kind of social behaviour that we're all missing."