Month: March 2022

This winter is brutal. The cold weather has made it hard to socialize outdoors, coronavirus variants are spreading, and the US is about to surpass half a million Covid-19 deaths. Many of us are feeling anxious about how we’re going to make it through the lonely, bleak weeks ahead.

I see a lot of people trying to cope with this anxiety by drumming up one-off solutions. Buy a fire pit! Better yet, buy a whole house! Those may be perfectly fine ideas, as far as they go — but I’d like to suggest a more effective way to think about reducing your suffering and increasing your happiness this winter.

Instead of thinking about the myriad negative feelings you want to avoid and the myriad things you can buy or do in service of that, think about a single organizing principle that is highly effective at generating positive feelings across the board: Shift your focus outward.

“Studies show that anything we can do to direct our attention off of ourselves and onto other people or other things is usually productive and makes us happier,” said Sonja Lyubomirsky, a psychology professor at the University of California Riverside and author of The How of Happiness: A Scientific Approach to Getting the Life You Want. “A lot of life’s problems are caused by too much self-focus and self-absorption, and we often focus too much on the negatives about ourselves.”

Rather than fixating on our inner worlds and woes, we can strive to promote what some psychologists call “small self.” Virginia Sturm, who directs the Clinical Affective Neuroscience lab at the University of California San Francisco, defines this as “a healthy sense of proportion between your own self and the bigger picture of the world around you.”

This easy-to-remember principle is like an emotional Swiss Army knife: Open it up and you’ll find a bunch of different practices that research shows can cut through mental distress. They’re useful anytime, and might be especially helpful during this difficult winter (though they’re certainly no panacea for broader problems like mass unemployment or a failed national pandemic response).

The practices involve cultivating different states — social connectedness, a clear purpose, inspiration — but all have one thing in common: They get you to focus on something outside yourself.

A sense of social connectedness

Some of the practices are about cultivating a sense of social connectedness. Decades of psychology research have taught us that this is a key to happiness.

In fact, Lyubomirsky said, “I think it is the key to happiness.”

That’s what Harvard’s Study of Adult Development discovered by following the lives of hundreds of people over 80 years, from the time they were teenagers all the way into their 90s. The massive longitudinal study revealed that the people who ended up happiest were the ones who really leaned into good relationships with family, friends, and community. Close relationships were better predictors of long and pleasant lives than money, IQ, or fame.

Psychiatrist George Vaillant, who led the study from 1972 to 2004, summed it up like so: “The key to healthy aging is relationships, relationships, relationships.”

Other studies have found evidence that social connections boost not only our mental health but also our physical health, helping to combat everything from memory loss to fatal heart attacks.

During our pandemic winter, you can socialize in person by, yes, gathering around a fire pit or maybe doubling your bubble. But there are other ways to make you feel you’re connected to others in a wider web. A great option is to perform an act of kindness — like donating to charity, or volunteering to read to a child or an older person online.

“I do a lot of research on kindness, and it turns out people who help others end up feeling more connected and become happier,” Lyubomirsky told me.

Lyubomirsky’s research shows that committing any type of kind act can make you happier, though you should choose something that fits your personality (for example, if you don’t like kids, then reading to them might not be for you). You may also want to vary what you do, because once you get used to doing something, you start taking it for granted and don’t get as much of a boost from it. By contrast, people who vary their kind acts show an increase in happiness immediately afterward and up to one month later. So you might call to check up on a lonely friend one day, deliver groceries to an older neighbor the next day, and make a donation the day after that.

A sense of purpose

Other practices are about cultivating a sense of purpose. Psychologists have found that having a clear purpose is one of the most effective ways to cope with isolation.

Steve Cole, a researcher at the University of California Los Angeles, studies interventions designed to help people cope with loneliness. He’s found that the ones that work tend to focus not on decreasing loneliness, but on increasing people’s sense of purpose. Recalling one pilot program that paired isolated older people with elementary school kids whom they’re asked to tutor and look out for, Cole told Vox, “Secretly, this is an intervention for the older people.”

Philosophers have long noted the fortifying effects of a clear sense of purpose. “Nietzsche said if you find purpose in your suffering, you can tolerate all the pain that comes with it,” Jack Fong, a sociologist who researches solitude at California State Polytechnic University, Pomona, told me. “It’s when people don’t see a purpose in their suffering that they freak out.”

Experienced solitaries confirm this. Billy Barr, who’s been living alone in an abandoned mining shack high up in the Rocky Mountains for almost 50 years, says we should all keep track of something. In his case, it’s the environment. How high is the snow today? What animals appeared this month? For decades, he’s been tracking the answers to these questions, and his records have actually influenced climate change science.

Now, he suggests that people get through the pandemic by participating in a citizen science project such as CoCoRaHS, which tracks rainfall.

“I would definitely recommend people doing that,” he told WAMU. “You get a little rain gauge, put it outside, and you’re part of a network where there’s thousands of other people doing the same thing as you, the same time of the day as you’re doing it.” (Notice, again, that this is really about sensing you’re part of the larger world around you.)

Other citizen science projects are looking for laypeople to classify wild animals caught on camera or predict the spread of Covid-19.

If citizen science isn’t your jam, find something else that gives you a sense of purpose, whether it’s writing that novel you’ve been kicking around for years, signing up to volunteer with a mutual aid group, or whatever else.

A sense of inspiration

Finally, some practices are about cultivating a sense of inspiration — which can take the form of gratitude, curiosity, or awe.

Regularly feeling gratitude helps protect us from stress and depression.

“When you feel grateful, your mind turns its attention to what is perhaps the greatest source of resilience for most humans: other humans,” David DeSteno, a psychology professor at Northeastern University and the author of Emotional Success, told me. “By reminding you that you’re not alone — that others have contributed to your well-being — it reduces stress.”

So one thing you can do this winter is try gratitude journaling. This simple practice — jotting down things you’re grateful for once or twice a week — has gained popularity over the past few years. But studies show there are more and less effective ways to do it. Researchers say it’s better to write in detail about one particular thing, really savoring it, than to dash off a superficial list of things. They recommend that you try to focus on people you’re grateful to, because that’s more impactful than focusing on things, and that you focus on events that surprised you, because they generally elicit stronger feelings of thankfulness.

Another practice is to write a letter of gratitude to someone. Research shows it significantly increases your levels of gratitude, even if you never actually send the letter. And the effects on the brain can last for months. In one study, subjects who participated in gratitude letter writing expressed more thankfulness and showed more activity in their pregenual anterior cingulate cortex — an area involved in predicting the outcomes of our actions — three months later.

Feeling a sense of curiosity or awe about the world around you is likewise shown to boost emotional well-being.

“Awe makes us feel like our problems are very trivial in the big scheme of things,” Lyubomirsky said. “The idea that you are this tiny speck in the universe gives you this bigger-picture perspective, which is really helpful when you’re too self-focused over your problems.”

For example, a study recently published in the journal Emotion investigated the effects of “awe walks.” Over a period of eight weeks, 60 participants took weekly 15-minute walks outdoors. Those who were encouraged to seek out moments of awe during their walks ended up showing more of the “small self” mindset, greater increases in daily positive emotions, and greater decreases in daily distress over time, compared to a control group who walked without being primed to seek out awe.

“What we show here is that a very simple intervention — essentially a reminder to occasionally shift our energy and attention outward instead of inward — can lead to significant improvements in emotional wellbeing,” said Sturm, the lead author.

So, bottom line: When the world between your two ears is as bleak as the howling winter outside, shifting your attention outward can be powerfully beneficial for your mental health. And hey, even in the dead of winter, a 15-minute awe walk outdoors is probably something you can do.

If you or anyone you know is anxious, depressed, upset, or needs to talk, there are people who want to help. Text CRISIS to 741741 for free, confidential crisis counseling.

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The good news is that the rate of Covid-19 vaccinations in the United States is increasing, while the rates of new infections, hospitalizations, and deaths are slowing. As of this week, more than 66 million doses have been administered to at least 42 million Americans, about 13 percent of the population.

But the disease is still spreading, and there aren’t yet enough vaccine doses to meet demand. And many who need a vaccine the most are having the hardest time getting one.

From signing up for appointments to securing transportation to clinics, many of the people at the highest risk for severe outcomes and death from Covid-19 — older adults, essential workers, and minority communities — are having trouble getting vaccinated when it’s their turn. At the same time, some wealthier people or people at lower risk have gamed vaccine registration systems to get to the head of the line.

“A lot of my older patients are struggling to figure out how to do it in general,” said Margot Savoy, chair of the family and community medicine department at Temple University in Philadelphia. “We’ve made it so complicated.”

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Right now, the priority for many states is scale. Some are setting up mass vaccination sites at public venues like stadiums to get as many shots into arms as possible, as fast as possible. However, some health experts argue that in addition to going big, communities should also go small, working through local clinics and community groups in order to reach the most vulnerable. It may come at the expense of speed, but it would help ensure equity in who’s getting vaccinated for Covid-19.

Vaccinating the most vulnerable people requires active outreach

No community or demographic has been spared from the Covid-19 pandemic. More than half a million Americans have died from the disease, and many more have gotten sick. But some groups are getting hit harder than others, and it’s not just the elderly.

“Throughout the pandemic, people of color have consistently been disproportionately sickened and killed by the virus,” wrote Youyou Zhou and Vox’s Julia Belluz in a recent piece. “They also died young: Of Covid-19 deaths in people under the age of 45, more than 40 percent were Hispanic and about a quarter were Black.”

These same groups are also less likely to interact with the existing health care system and are more likely to face impediments when seeking the vaccine. Technology is one barrier that’s emerged in several states. For example, the online booking system for vaccine appointments in Arizona seems to be favoring some groups over others.

“When appointments become available, it’s like a gold rush,” said Will Humble, executive director of the Arizona Public Health Association and a former state health official. “If you work at a grocery store or don’t have wifi, you’re at a big, big disadvantage.”

Arizona has set up mass vaccination sites around major metropolitan areas. That’s helping the state boost its numbers — about 15 percent of its population has now been vaccinated — but many of its most vulnerable people haven’t been able to sign up for the limited appointment slots during the few short hours when they’re open. Some also aren’t able to drive to these sites from their homes, according to Humble.

“The effect of that [mass vaccination strategy] was yes, it did speed up the administration of vaccine, but it also has disproportionately served high-income people,” Humble said. “What vaccinators tell me is they are vaccinating Teslas and Tahoes all day.”

According to a Kaiser Family Foundation assessment on February 18, about 12 percent of Arizona’s white population has been vaccinated so far against Covid-19, compared with 4 percent of Black people, 3 percent of Hispanic people, and 9 percent of Asian people.

Another issue for Arizona, like in many states, is that remote regions may not have the resources to administer both of the Covid-19 vaccines that are currently available in the US. While the Moderna vaccine has less stringent freezer demands, the Pfizer/BioNTech Covid-19 vaccine requires ultra-cold storage, so it’s being allocated mainly to larger counties that have the facilities to store it.

Humble said that one way to improve the system would be to have a one-time sign-up and then a weighted lottery to allocate appointments, so people with fast fingers, fast internet connections, and free time wouldn’t have such an overwhelming advantage.

But getting to some of the most vulnerable also requires active outreach. “We’re doing a real grassroots approach to this, which requires us going to the communities … literally knocking on doors,” said Tomas Ramos, the founder of the Bronx Rising Initiative, a group helping vaccinate Bronx residents against Covid-19. “What I get when I knock on the door and speak to an elder, they just don’t even know when to start. That’s where we come in.”

Bronx Rising Initiative is working on raising funds for local clinics to increase capacities for Covid-19 vaccination, and also for setting up remote vaccination sites in public housing. In addition, the group is seeking out seniors and other vulnerable people to sign up for vaccine appointments, following up with reminders and helping them arrange transportation if needed.

Many of the initiative’s volunteers are from the Bronx, too. And that helps build trust, fight vaccine misinformation, and coax reluctant Bronxites to get immunized.

“We are from the community, so when [volunteers] knock on the door, [residents] see someone that lives in the same community talking to them about it,” Ramos said.

Local health clinics can close gaps in vaccinations, but they need doses first

Many communities around the country have had months to set up their programs to administer Covid-19 vaccines. But supplies remain limited, and there is a frustrating lack of information about when they’ll be replenished.

“We have the whole infrastructure to give it,” said Julie Vaishampayan, the public health officer for Stanislaus County in California. “We’re getting it out into pretty good arms, but we’re not getting it out to every eligible arm and we’re not quite sure who we’re missing.”

Another complication is that local health officials have to jump through hoops to order vaccines from the county, state, or federal government. And it’s not always transparent where these vaccines are going, so health workers on the front lines don’t have much time to prepare. When vaccines do arrive, local health officials have to identify eligible recipients, round them up for appointments, administer the shots before they expire, and keep track of patients to make sure they get their second doses. There can be overlap between different areas of health coverage, so even if someone is a perfect candidate for a vaccine, it can be hard to tell which group or agency is in change giving them a shot.

“I can’t see the vaccine that’s coming from the federal government or the state government,” Vaishampayan said. “I don’t know who it’s going to. I don’t know how many doses they’ve received. I don’t know how many doses they’ve given. It makes it really difficult to set up a network or providers who are going to reach your population.”

A central information hub that tells local health officials how vaccines will be allocated up to a week in advance would go a long way toward optimizing distribution, according to Vaishampayan. Currently, many health departments have to deal with much shorter lead times for receiving vaccines.

One potential bit of good news is that the Covid-19 vaccine developed by Johnson & Johnson may get emergency approval from the Food and Drug Administration this weekend. Not only would a third vaccine help bolster the supplies, the Johnson & Johnson vaccine requires only one dose instead of two and can be stored at ordinary refrigerator temperatures.

That vaccine would be particularly suited to smaller family practices and community clinics, which are less likely to have ultra-cold freezers. These types of facilities may have a lower throughput of vaccinations (since they are equipped to handle fewer patients and may not have the facilities to stockpile vaccines), but they may be able to better identify the people in greatest need of a Covid-19 vaccine.

Having a one-dose Covid-19 vaccine that can be stored in an ordinary medical refrigerator would allow these clinics to join in and expand the scope of the vaccination campaign.

“When we get to that vaccine, all of sudden there is a real opportunity for the average family doc or primary care person,” said Savoy. “If we ever had a vaccine to actually distribute and had one we could have at the practice and store it, we would have a whole network of people ready to go.”

A panel of expert advisers to the Food and Drug Administration (FDA) voted unanimously on Friday afternoon to recommend the one-dose Covid-19 vaccine developed by Johnson & Johnson for an emergency use authorization. The next step is for the FDA to accept the recommendation, which could happen as soon as this weekend, clearing the way for distribution.

Earlier this week, the FDA posted a briefing going over the results of the phase 3 clinical trials of the Johnson & Johnson vaccine, which included 40,000 participants in several countries divided randomly into placebo and treatment groups.

The most important finding: The vaccine was 100 percent effective after 28 days at preventing deaths and hospitalizations from Covid-19 among the clinical trial participants who received the treatment. (Two vaccine recipients were hospitalized with Covid-19 two weeks after receiving the injection.)

The vaccine was also 66.1 percent effective at preventing symptomatic Covid-19 illness after four weeks, with consistent results across all age groups. When looking at blocking severe and critical cases of Covid-19, the Johnson & Johnson vaccine was 85.4 percent effective.

Mathai Mammen, global head of research and development for Janssen Pharmaceutical Companies, said during a press conference last month that the vaccine also had “plain vanilla safety results,” with the vast majority of recipients experiencing no problems. Most of the reported symptoms were mild, including fatigue, arm pain, and fever.

The efficacy levels against severe to critical Covid-19 changed depending on where the vaccine was tested. It was 85.9 percent in the United States after four weeks, while in South Africa, where a coronavirus variant with worrisome mutations that help it escape vaccines has been spreading widely, efficacy against severe disease was reduced to 81.7 percent.

Health officials say that while the Johnson & Johnson efficacy results are not as high as those from Moderna and Pfizer/BioNTech, the two vaccines that have already received emergency use authorizations from the FDA, the new vaccine’s performance is still superb.

“If this had occurred in the absence of a prior announcement and implementation of a 94, 95 percent efficacy [vaccine], one would have said this is an absolutely spectacular result,” said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, during the press conference last month. The vaccine was developed by Janssen Pharmaceuticals, a division of Johnson & Johnson based in Belgium, together with Boston’s Beth Israel Deaconess Medical Center.

But unlike the vaccines from Moderna and Pfizer/BioNTech, Johnson & Johnson’s doesn’t require a booster shot, circumventing the two-dose problems posed by its competitors. There’s no need to track people down for their second dose, which means more people could be vaccinated faster. The shots also don’t require deep-cold storage, which means they’re less costly and somewhat easier to distribute.

“It’s a complete game changer,” said Georgetown University health law professor Lawrence Gostin. “It completely changes the equation.”

The Johnson & Johnson vaccine is also different in another way. It uses an adenovirus vector to deliver instructions for making the spike protein of the coronavirus, which is also less expensive to manufacture than the mRNA platform used for the other vaccines. (It’s estimated to cost around $10 per vaccine dose — roughly half the cost of the Pfizer/BioNTech vaccine.)

Johnson & Johnson has promised enough vaccines for 20 million Americans by the end of March and 100 million Americans by the end of June despite production challenges. It would be a huge boost to the 65 million Covid-19 vaccine doses that have been administered in the US so far.

So even with an overall efficacy level that’s lower than the two other vaccines on the US market, the Johnson & Johnson vaccine could become a major player. It’s the vaccine that “can increase equity,” said Saad Omer, the director of the Yale Institute for Global Health, particularly “if it’s deployed strategically in nations that are hard to reach and where that would be a particular challenge under a two-dose schedule.” Johnson & Johnson expects to distribute a billion doses of its vaccine worldwide this year.

But as amazing as it is to see several effective Covid-19 vaccines developed in record time, it’s now clear that the technology alone won’t save the day. An orchestra of supply chains, manufacturing, logistics, staff, and public trust needs to harmonize in order to actually get billions of shots into arms around the world and finally draw the pandemic to a close. And we also have other hurdles to overcome: controlling the spread of variants that seem to be threatening the effectiveness of all the vaccines we have.

What we learned about the safety and efficacy of the Johnson & Johnson Covid-19 vaccine

Johnson & Johnson launched separate clinical trials testing both a one-dose and a two-dose regimen to see how well these strategies provided long-term protection against Covid-19. The one-dose phase 3 trial arm yielded efficacy results first.

But hints that this vaccine could be safe and effective have been trickling out for months. The company published some of its early phase 1 and phase 2 trial data in a preprint paper in September, and the final version of the paper in January, in the New England Journal of Medicine. The papers showed the vaccine was well tolerated among the participants, and seemingly very effective: With one dose, after 29 days, the vaccine ensured that 90 percent of participants had enough antibodies required to neutralize the virus. After 57 days, that number reached 100 percent.

“When I looked at that, I thought, wow, this Johnson & Johnson product is very powerful after the first dose in terms of immunogenicity,” said Monica Gandhi, a professor of global medicine at the University of California San Francisco. “The Pfizer and Moderna vaccines needed two doses to get that level of [virus] neutralization.”

Like Pfizer/BioNTech, Johnson & Johnson “didn’t rush to phase 3 [trials],” said Hilda Bastian, a scientist who has been tracking the global vaccine race. Instead, it tested multiple vaccine doses and candidates at the outset to figure out which might perform the best in humans, and then proceeded through clinical trials.

The vaccine was also tested in nine countries — the largest single international phase 3 trial in the world, with more than 60,000 participants — meaning many ethnic groups were represented in the data, Bastian said. “As if all that’s not enough, it’s one of the ones that could be manufactured in South Africa and other places,” since Johnson & Johnson has manufacturing capacity around the world, even in countries hard-hit by the pandemic that have been waiting for vaccine supplies, she added.

The day this vaccine gets approval “is going to be a big day for the future of this pandemic [and] a ticket out of this disease for a larger part of the world,” said Nicholas Lusiani, a senior adviser at Oxfam America.

How adenovirus vector vaccines work

Part of the appeal of this vaccine lies in the technology behind it. Adenoviruses are a family of viruses that can cause a range of illnesses in humans, including the common cold. They’re very efficient at getting their DNA into a cell’s nucleus. Scientists reasoned that if they could snip out the right sections of an adenovirus’s genome and insert another piece of DNA code (in this case, for a fragment of the new coronavirus), they could have a powerful system to deliver instructions to cells.

For decades, scientists have experimented with adenovirus vectors as a platform for gene therapy and to treat certain cancers, using the virus to modify or replace genes in host cells. More recently, researchers have found success using adenoviruses as vaccines. Already, an adenovirus vector vaccine has been developed for the Ebola virus.

In addition to Johnson & Johnson and AstraZeneca/Oxford, CanSino Biologics of China is also developing an adenovirus vector Covid-19 vaccine; Russia’s Sputnik V Covid-19 vaccine uses this platform, too.

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To make one of these vaccines, the adenovirus is modified so that it can’t reproduce but can carry the instructions for making a component of a virus. In the case of Covid-19, most adenovirus vector vaccines code for the spike protein of SARS-CoV-2, the part the virus uses to begin an infection.

Human cells then read those instructions delivered by the adenovirus and begin manufacturing the spike protein. The immune system recognizes the spike proteins as a threat and begins to build up its defenses.

Since adenoviruses exist naturally, they tend to be more temperature-stable than the synthetic lipid nanoparticles that are used to deliver the mRNA in the Moderna and Pfizer/BioNTech vaccines.

“The nice thing about the adenovirus vector vaccines is that they’re a little more tolerant to a longer shelf life, to the conditions of storage,” said Angela Rasmussen, a virologist at Georgetown University. Adenovirus vector vaccines can be stored at refrigerator temperatures, while mRNA vaccines need freezers, with Pfizer/BioNTech’s vaccine requiring temperatures of minus 80 degrees Celsius.

This helps lower the cost and complexity of manufacturing, distribution, and administration of adenovirus vector vaccines compared to other platforms. And simply having another vaccine on the market, made by a major pharmaceutical company with its own manufacturing infrastructure, is a big step forward. “The more vaccine doses we can have, the better,” Rasmussen said.

What comes next

The next challenge for Johnson & Johnson, after getting a green light from the FDA, is actually delivering doses to millions of arms.

But with three vaccines eventually on the market, should people hold out for any one vaccine in particular?

“Right now when people ask me, which, you know, which vaccine should I get? It’s pretty easy to answer that question because it’s whichever one you get offered,” said Paul Sax, a professor of medicine at Harvard Medical School. Vaccine supplies are limited, the transmission of the virus is high, and hospitals are close to capacity, so few people can be picky about what they get.

On the other hand, once vaccine supplies stabilize, having multiple vaccines with different characteristics could allow doctors and public health officials to optimize how the shots are distributed. “If the efficacy [of a given vaccine] is lower but still pretty good, there may be a scenario that one vaccine is recommended for low-risk populations and another one is for a high-risk population,” Omer said.

Though the Johnson & Johnson vaccine does have some key advantages over its competitors, it could face some of the same distribution snags that have hit other vaccines, like miscommunication between the government and hospitals, and production hurdles.

Researchers say that all the manufacturers also need to start working to get vaccines to the rest of the world. The new variants that have emerged in the UK, Brazil, and South Africa and have been detected in other parts of the world are reminders that the virus continues to evolve, and that a partially vaccinated population could exert more selection pressures that accelerate these mutations. So vaccination has to happen fast, and globally — and Johnson & Johnson’s vaccine may be a critical tool to do this.

“Long term, we need to be thinking about getting vaccines out equitably to the entire world, and having vaccines that are easier to distribute in terms of the cold chain requirements is going to be huge in that regard,” Rasmussen said.

But even as these vaccines roll out, there’s still more to learn: how long protection from vaccines last, whether there are any rare complications to consider, whether they prevent transmission as well as disease, and how well these vaccines work against the new variants. There are already some troubling signs of how these variants might eventually be able to evade vaccines. Continuing clinical trials will be critical, Sax said.

“You know, we’ve got millions of people who’ve received these vaccines already, which is exciting,” he added. “We’re on our way.”

You’ve been fully vaccinated: two doses of the Moderna or Pfizer vaccine, or the single-dose Johnson & Johnson vaccine, plus several weeks for your immune system to fully respond. Now what can you do?

New guidelines from the Centers for Disease Control and Prevention published Monday, March 8, offer good news: You can see your family or have other vaccinated friends over, indoors, without a mask (with a caveat).

“If you’ve been fully vaccinated,” the new guidelines read:

You can gather indoors with fully vaccinated people without wearing a mask.

You can gather indoors with unvaccinated people from one other household (for example, visiting with relatives who all live together) without masks, unless any of those people or anyone they live with has an increased risk for severe illness from COVID-19.

In other words, if you want to have other fully vaccinated friends over for dinner, the CDC says that you should go ahead. The reduced risk of infection and transmission on both sides (yours and theirs) makes this a basically safe activity.

If you want to gather indoors with relatives or friends who aren’t fully vaccinated, that also poses much lower risk now that you’re vaccinated — so you can do it. But the risk is not as low as when everyone is vaccinated, so you shouldn’t do it if anyone at increased risk of severe Covid-19 might be affected (including high-risk people who live with those who want to gather). If you have elderly or immunocompromised loved ones who haven’t yet been vaccinated, you should get them vaccinated before you hang out. The CDC also still cautions people to delay travel outside of local areas.

The CDC emphasizes that in order for these rules to apply, you must be fully vaccinated: if you got the Pfizer or Moderna vaccine, you need both doses, and for any vaccine, it should be two weeks since you got your last vaccine dose. “If it has been less than 2 weeks since your shot, or if you still need to get your second dose, you are NOT fully protected. Keep taking all prevention steps until you are fully vaccinated,” the guidelines read.

They also emphasize that even vaccinated people should keep taking precautions in public spaces shared with crowds of strangers, including masks and social distancing.

The CDC expects to revise these recommendations over the next couple of months, as more people are vaccinated and more data comes in on how much exactly the vaccines protect the people around you. But for now, vaccinated people can enjoy vastly increased freedom in private with friends and family — while still masking up in public as we fight to get the vaccine more widely available.