Explainer: Do you need to wear a mask after getting the Covid-19 vaccine?

  • It is still unclear whether the vaccine stops you just from getting symptoms or getting the coronavirus, so you could potentially still spread it
  • Scientists expect masks could be part of our wardrobe for another year
Associated Press |

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Just because a vaccine is on its way, doesn't mean we'll be getting rid of masks anytime soon.

The first coronavirus vaccinations are now being distributed. The Food and Drug Administration in the US granted the Pfizer vaccine emergency authorisation for use, and it’s expected that soon it will do the same for the Moderna vaccine.

Meanwhile, the Hong Kong government announced it had purchased enough vaccines that each resident could have two, and would begin the rollout in January 2021.

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In trials, the Pfizer vaccine was 95 per cent effective in preventing Covid-19, and the Moderna vaccine stands at 94 per cent, both significantly more effective than many scientists anticipated.

“This is close to the gold standard of all vaccines, the measles vaccine,” says Eric Sachinwalla, medical director of Infection Prevention and Control at Einstein Medical Centre Philadelphia, in the US. He noted that the vaccine used to prevent measles is about 97 per cent effective.

Both versions of the vaccine require two injections. If you get them both, your chances of getting infected with the coronavirus are likely low. But even if you get vaccinated in the near future, experts say it’ll be months until you can ditch the masks and hug everyone around you.

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Why we have to continue wearing masks

The main challenge? Studies of the Covid-19 vaccines only measured whether vaccinated people developed symptoms, not whether they got infected. We know that you can become infected with the coronavirus and be asymptomatic, meaning you never develop symptoms. Asymptomatic people can still spread COVID-19 to others. So we don’t know whether a vaccine prevents asymptomatic infections and if there’s still the possibility that a vaccinated person could transmit the virus without knowing it.

“The vaccine is probably the most important tool we have right now in controlling this pandemic, but it’s not perfect and it’s not a magic bullet that can end this for good right away,” says Neal Goldstein, assistant research professor of epidemiology and biostatistics at Drexel University in the US state of Pennsylvania.

We wear masks for two reasons: to protect ourselves, and to protect others. Because there’s still a chance that you could be a silent carrier even after getting vaccinated, wearing a mask, practising social distancing, and hand-washing all remain important.

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How is it possible to be vaccinated but potentially carry Covid-19?

The Pfizer and Moderna vaccines work by generating a body-wide immune response. They are injected deep into the muscles and travel through the bloodstream where the body creates antibodies and other types of white blood cells important for immunity.

“For a respiratory germ, like SARS-CoV-2, [Covid-19], the point of entry into the body is through the respiratory tract, predominantly nose and mouth,” says Goldstein. “An important question is whether the vaccines elicit a strong immune response at these locations, [the nose and mouth], or the immune system destroys the virus elsewhere in the body.”

Researchers are trying to figure out whether you could still carry the virus in your respiratory tract, even if you’re protected from getting sick. In theory, it’s possible not enough antibodies will circulate in the blood to the mucosa, the moist tissue that lines the nose and mouth. In this case, the virus could potentially live in your respiratory tract, but not make you sick because your body is fending it off elsewhere. If it does remain in your mouth or nose, this means you could sneeze, cough, or breathe out contagious virus particles and still infect others. But the answer is still unknown.

There’s also the rare chance that you get vaccinated and still end up getting sick. While the two front-runners are “close to being perfect,” says Goldstein, no vaccine is 100 per cent effective, which means there’s always the chance you could still get infected. But again, that’s uncommon, and the more people who get vaccinated, the less easily the virus can spread.

“As long as you have enough people who are vaccinated, then if in the odd chance someone gets infected, there are very few susceptible people to spread it to,” explains Sachinwalla.

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When can we say goodbye to masks?

It’s going to be a while. For example, experts estimate that around 70 per cent of the US population – more than 200 million people – need to gain immunity, either from coronavirus infection or a vaccine, for the pandemic to end. The general public is not expected to have access to vaccines until spring.

“It’s going to take months, not weeks, but at the same time also not years, until we can end these mitigation measures. Not everyone can get vaccinated, not everyone will get vaccinated, and we’re still learning about the vaccination, so everything else we’ve been doing all along is still so important,” says Goldstein.

By mid-2021, experts predict we’ll know enough about how well this vaccine is blocking infections at a population level to determine when we can start scaling back on mitigation measures. As for when we’ll actually say goodbye to masks and social distancing all together?

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“My optimistic view on this is by December 2021,” says Goldstein. “The big unknown is whether the public will accept and get the vaccine – both doses – in sufficient numbers.”

Sachinwalla agrees that getting the public to accept the vaccine is crucial. And you need both doses, spaced three weeks (Pfizer) to four weeks (Moderna) apart, to get the maximum protection. A recent published study showed the Pfizer vaccine efficacy was 52 per cent after the first dose and didn’t reach 95 per cent until after the second.

Sachinwalla’s best guess for when we can stop wearing masks presents a slightly shorter timeline.

“I’m hoping sometime this summer, assuming we get good vaccine uptake in the community and it works as well as these initial studies have suggested,” he says.

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