What Level of Protection Do I Need?

The Delta variant continues to make headline news. We now know that it is easier to spread and causes more severe illness than other strains. As a result, many people are asking questions about what level of COVID-19 protection they need. As with most things, it depends.

If you are fully vaccinated in Vermont. Vermont has done an extraordinary job vaccinating its population. As a result, the Delta variant and other variants are quite uncommon. This is a direct result of our high rate of vaccination, which keeps variants from gaining a foothold. 

Fully vaccinated people can do most things (including shopping or going to the movies) without masking and without worrying that they will become infected. The vaccines work. They are proven effective, even against variants. With that said, if you are going to an indoor event with lots of people you know are not vaccinated, you may want to mask or distance. Otherwise, live your life and have a good time. Under the rare circumstance you come down with COVID-19, it will likely be a mild case or one without any symptoms at all.

If you are fully vaccinated but living in or visiting a place with low vaccination rates. The level of vaccination in your community makes a big difference. That’s why the World Health Organization is so concerned about the Delta variant. They cover the entire world. On average, the world’s vaccination rate is nowhere near as high as it is here.

Those who are fully vaccinated can be reasonably assured that they are safe when they are outside or in uncrowded areas, even in communities where fewer people are vaccinated. Enjoy events outdoors, especially if they are not crowded. If you are going to be inside with many others, I recommend masking. Any case of COVID-19 you get will likely be mild. 

If you are fully vaccinated but immune compromised. There is a lot we don’t know about how susceptible vaccinated immunocompromised people are to both the original COVID-19 virus and the variants, and we are concerned about this group. There have been low numbers of serious cases in this group. These include people on  chemotherapy treatments or biologic therapy with immune modulators, those who have had an organ transplant, and people who take medications for an autoimmune disorder.

Immuno-compromised vaccinated people should be more careful, because their immune systems are not as robust. It would be reasonable, for instance, for a vaccinated immunocompromised person to mask indoors, especially in crowded settings, even in Vermont,  but especially in areas of low vaccination. If confident that everyone in the indoor space is vaccinated, then a mask is not necessary. 

If you are not vaccinated. All unvaccinated people, including children ages 2 – 11, should mask in indoor spaces and with those outside their household. Masking outdoors is optional in Vermont unless you are unable to distance. If unvaccinated people are visiting places with low numbers of people who are vaccinated in the community, it is recommended to mask all the time.

Mitigation measures are vitally important when not vaccinated. We are already seeing doubling of spread of COVID delta variant when unvaccinated persons join together and are unmasked. Deaths and serious disease  from COVID are essentially only in unvaccinated people at this time.

Marie George, MD, FIDSA, is the infectious disease specialist at Southwestern Vermont Medical Center in Bennington.