money Why even vaccinated Michiganians should keep masking up, experts say
Apr. 18—Even though nearly 29% of Michigan adults are fully vaccinated against COVID-19 and another 14% have received at least one dose of vaccine through Thursday, experts are warning them to keep wearing masks and social distancing because of the growth of more contagious variants.
So while residents may be tempted to drop their guard, they must continue to pursue measures like masks, social distancing and hand washing, said Nigel Paneth, a professor of epidemiology at Michigan State University.
Michigan has led the nation in new cases of COVID for the past week. Hospitalizations of adults in the state hit a record earlier this week, surpassing the peaks of the spring 2020 and fall 2020 surges.
As many as 246 Michigan residents considered fully vaccinated against COVID-19 were later diagnosed with the virus, including three who died, state officials confirmed last week. Michigan Department of Health and Human Services spokeswoman Lynn Sutfin said the cases are being reviewed because some of them may have tested positive prior to being fully vaccinated.
Individuals are also vulnerable for a short period after their final dose. A person is not considered fully vaccinated until two weeks after their final vaccine dose, according to guidance from the Centers for Disease Control and Prevention.
Someone who gets the two-dose Pfizer vaccine is supposed to wait three weeks between their two required doses. Someone who gets the two-dose Moderna vaccine is supposed to wait four weeks between the required doses.
"The vaccine is not 100% effective, and new variants might be emerging that you won't know about until several weeks or even months later," Paneth said.
Michigan has the second highest number of B.1.1.7 variant cases in the nation behind Florida, and the Centers for Disease Control and Prevention found this variant is the most dominant iteration of the virus in the United States. The United Kingdom variant is much more transmissible than the initial SARS-CoV-2 virus, and a study from the U,K. found it may also be associated with an increase in deaths.
People who receive one dose of the two-dose Pfizer or Moderna vaccines have become infected with COVID. Health authorities said these people need to recuperate from their infection first. The body will help build some natural immunity to the virus because of the infection, but people should get their second shot after they have recovered to ensure full protection, experts said.
Even those who are delayed in obtaining a second injection for some other reason should get the second dose as soon as they can, said Dr. Laraine Washer, a hospital epidemiologist at Michigan Medicine, the University of Michigan's health system.
"If someone is infected after the first dose of vaccine and before the second dose of vaccine, they need to wait at least 10 days after onset of infection or positive test and be free of symptoms before they get their second dose," Washer added.
"If waiting puts someone beyond the 21 or 28-day target for the second dose, they should get the second dose when they have recovered," she said. "They do not need to start over again with a first shot."
Variants complicate matters
COVID-19 was already considered more infectious than other, less serious viruses such as the flu. But the emergence of variants has worsened the situation.
New variants evolve when the virus jumps from one person to another and mutates to adapt to its new environment. That means a high rate of transmission and increases the probability of an even more dangerous or vaccine-resistant strain emerging.
So it's up to everybody to try to reduce transmission, even if they've been vaccinated, Paneth said.
"I still think there's something to be said for behaving a certain way so that others will behave a certain way," he added.
The predominant strain in Michigan is B.1.1.7, the variant first identified in the United Kingdom, said Dr. Dennis Cunningham, medical director for infection control and prevention for the Henry Ford Health System. Michigan has confirmed about 3,325 cases of the U.K. variant through Friday, according to the Michigan Department of Health and Human Services.
"While there is one recent study from Israel that suggested the Pfizer vaccine is less effective against this strain, I think that it is important to know that even if less effective, the vaccine is likely to prevent severe disease — cases requiring an Emergency Department visit or hospital admission," Cunningham said.
Next most prevalent in Michigan are the West Coast strains, B.1.427 and B.1.429, which emerged in California and quickly spread elsewhere, Cunningham said. They are more contagious than the original strain of the coronavirus but aren't considered more deadly. The two together are responsible for 71 cases in Michigan, according to the state health department.
The current vaccines have been shown to less effective at preventing infection by the West Coast strains, or the B.1.351 virus that emerged in South Africa and has sickened 14 people in Michigan. But the shots have reduced serious illness and hospitalizations, Cunningham said.
"The Brazil P.1 strain is a wild card. I don't think we know how well vaccines will protect against this strain," he said of the variant from Brazil. Twenty-three cases have been identified in the state, according to the Michigan health department.
"My take home message: The vaccines are still effective and I urge people to receive them," Cunningham said.
But the emergence of variants means people should sit a few feet apart while eating or drinking, and try to move activities outdoors where there's more space and better air flow, he suggested.
"With the surging number of cases in Michigan, I recommend that everyone vaccinated with one or two doses of the vaccine should continue to wear a mask when in public," Cunningham added.
"No vaccine is 100% effective, and this is a necessary step to curb the rising number of cases."
Vaccines prevent serious illness
Vaccines can prevent people who do become infected from becoming seriously ill with COVID-19, UM's Washer said.
"A primary goal of vaccination is to prevent hospitalization and death," Washer said. "The vaccines are doing that. We are seeing very few fully vaccinated people requiring hospitalization for COVID."
People who have received one-dose of a two-dose vaccine should continue to follow the recommendations for unvaccinated people, she said. Fully vaccinated people can start to unmask, but need to be careful.
"Being vaccinated does mean that you can begin to engage in limited low risk activities without a mask such as visiting with a vaccinated friend or two as long as that friend does not live with people who are at high risk of severe COVID infection and not yet vaccinated," Washer said.
"Given the high number of COVID-19 cases and community transmission in Michigan at this time, there is a good chance you may encounter someone who has COVID infection in public so you should limit interactions with large groups of people and wear your mask in public."
Twitter: @kbouffardDN
