You're Vaccinated, They're Not. Here Are Some Tips To Navigate Those Situations : Consider This from NPR A little more than half of adults in the U.S. have had at least one shot of a COVID-19 vaccine. That means a growing number of Americans are figuring out how to navigate life in a hybrid society where some people are vaccinated and some are not.

Two experts offer advice on how to do that: Dr. Leana Wen with George Washington University, and Dr. Monica Gandhi with the University Of California San Francisco.

In participating regions, you'll also hear from local journalists about what's happening in your community.

Email us at considerthis@npr.org.

How To Navigate Life When You're Vaccinated And Others Aren't (Or Vice Versa)

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AUDIE CORNISH, HOST:

Natalie Lane (ph) and her husband have two little kids, a 7-year-old and a toddler. Another family just down the block has kids about the same age.

NATALIE LANE: She actually told me, like, you know, my husband's gotten the vaccine. I've got my second dose scheduled. And she made the comment that, like, you know, I really hope our sons can get together this summer and play.

CORNISH: In not so many words, I hope you're getting vaccinated, too. Well, the good news is that Natalie and her husband are.

LANE: It was just - it was such a breath of fresh air to have somebody reach out and say, like, hey, our children can play together because the four adults in the group are vaccinated, and it's going to be safe.

CORNISH: The reason that felt like a breath of fresh air is that in Draper, Utah, where Natalie lives, not everyone has quite the same attitude about vaccines.

LANE: I have a neighbor who has boys the exact same age as my boys, and they seem like lovely people. And I would love to get to know them more. But when I told her from across the driveway, like, hey, I'm getting my vaccine next week, she said, oh, I don't mind about that kind of thing. That's never mattered to me. And I'm like, I know. That's why we can't hang out yet.

CORNISH: CONSIDER THIS - we are gradually becoming a kind of hybrid society.

LANE: My uncle got the shot.

CORNISH: Some people are vaccinated and some people are not...

LANE: His wife is still debating whether or not she wants the shot.

CORNISH: ...And some might never be.

LANE: My husband - his grandmother and her husband have already told us they will not be getting the vaccine.

CORNISH: Navigating this new reality isn't going to be easy.

LANE: Yeah, it's hard because I know that I live in an area where it's very mixed.

CORNISH: Coming up, two experts on what you need to know to make it in a partially vaccinated world. From NPR, I'm Audie Cornish. It's Thursday, April 22.

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CORNISH: It's CONSIDER THIS FROM NPR. Even now, more than a year into the pandemic, there is so much we can't say for sure.

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SAVANNAH GUTHRIE: Do you think that if you are outside and not close to people, you still need to wear a mask?

ROCHELLE WALENSKY: You know, this is a question that we're looking at. One of the things...

CORNISH: Thursday morning on the "TODAY" show, CDC director Rochelle Walensky couldn't give a direct answer to that question about masks outside. But she noted, a lot of people are still vulnerable.

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WALENSKY: And we will be looking at the outdoor masking question.

CORNISH: Also, an open question - when vaccinated people could safely lose the mask.

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WALENSKY: Well, you know what I will say is no vaccine is perfect. And so...

CORNISH: Same goes for the question of whether vaccinated people can transmit the virus.

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WALENSKY: It is a really important question that we're following. And there are numerous studies...

CORNISH: There are studies that show vaccinated people appear to be far less likely to transmit the virus.

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WALENSKY: And some of the questions are, does that mean that you're not getting sick or you're not getting the virus?

CORNISH: The bottom line is that vaccines have not made things automatically simpler. A little more than half of adults in the U.S. have received at least one shot, but that leaves about half of eligible people who have not.

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MONICA GANDHI: You know, it's a very interesting twilight time where everyone's sort of personal biases are coming into this in a way.

CORNISH: That's Dr. Monica Gandhi, an infectious disease specialist at the University of California, San Francisco, who recently sat down with another public health expert, Dr. Leana Wen of George Washington University.

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LEANA WEN: We as clinicians appreciate and understand what it means to operate in a gray zone, in this twilight zone, because a very few things in medicine are clear cut.

CORNISH: Wen and Gandhi spoke to NPR's Ailsa Chang about how to navigate this vaccine gray zone, where some people are vaccinated and some people are not. Here's their conversation.

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AILSA CHANG: So let's just start with the first question a lot of people are wondering about now, and that is, what can you finally do now that you are vaccinated, or more importantly, what should you still not be doing?

GANDHI: You know, I'll start because I have a very optimistic view of these vaccines because the real-world data coming out on the effectiveness of these vaccines is so profoundly good - the April 1 Pfizer press release that showed us some 44,000 people - 100% effectiveness against severe disease. That - you don't get these words 100% very often. And in addition, the accumulating real-world data on how vaccines reduce transmission, meaning hard for us to pass it on. I kind of think of it as a vaccinated person is, I can do whatever I want as a vaccinated person, but be respectful of our society where some of us are not vaccinated and some of us are. And that - for me, that respect means masking and distancing around others who are unvaccinated out in public spaces.

CHANG: OK. What do you think, Dr. Wen?

WEN: Well, I agree with Dr. Gandhi. I would add a few more things. One is that at this point in the pandemic, we really cannot answer the question of, what is safe? This is the No. 1 question that I get from patients, and so it's a bit difficult to go away from this. But I think that we need to switch the mentality from something that is 100% safe or 100% risk. That's not the reality. Actually, what we should be doing is to think about, how can we reduce our risk for us and for those around us?

And so one concept that I've been talking about is that of a coronavirus budget, just as we have a financial budget, where you realize that you can't do everything, but you also want to prioritize the things that you have to do. For example, you may have to go to work. Or sending your kids to school is absolutely essential. You want to do what you value the most, recognizing that you can't do it all. And then for those things, try to reduce your risk in those activities. Being vaccinated is a key method for reducing your risk.

CHANG: I think a lot of us who are still unvaccinated are trying to figure out how to hang out with people in this partially vaccinated universe. I'm trying to get vaccinated. I just got my appointment, but it'll be several days before I actually get vaccinated with both doses. So how should I assess my risks when people who are vaccinated or partially vaccinated are inviting me into their homes or other indoor areas and trying to reassure me it's fine because they got the shot? How do I evaluate that risk?

GANDHI: I would go to dinner there. And the reason I would say that is there's now nine studies - there was just one out of yesterday from a nursing home setting - health care workers, nursing home - and also a very large study from the CDC that swabbed first responders and shows the risk of you carrying the virus in your nose after vaccination is reduced between 80 and 94%. And that rate will go down even more when as our cases come down with vaccination. And then there's some very nice studies that show the immunoglobulin that goes into your nose and protects you, which is called IGA, are developed by these vaccines, are really generated by these vaccines. So it's very difficult to transmit the virus if you've been vaccinated.

CHANG: Well, that's encouraging.

WEN: Yeah...

CHANG: Yeah, Dr. Wen.

WEN: ...If I could add to that, here's what I find in how I talk to my patients and, I think, how others talk to their patients too is understanding what is most important to them. That's where the nuance really begins. Because initially the CDC was discouraging travel that was non-essential, so how are these grandparents supposed to see their grandkids who live from somewhere else? Or what about going to indoor church service? What about going to the gym? The CDC hasn't said you can do this, but I also think that's when it comes down to values. And I actually think that for so many of us as practicing clinicians, we understand these nuances and can advise our patients based on what is most important to them.

CHANG: OK. Well, then in the meantime, what is the responsibility of fully vaccinated or even partially vaccinated people as they move through their worlds? How would you frame it to them?

GANDHI: You know, I frame it as being polite. I really mean that. There is a social contract to be kept right now. And that social contract is - I think it's profoundly unfair for me to run, screaming around public, happily singing at the top of my lungs, I'm vaccinated, when other people have not had the chance to be vaccinated.

CHANG: (Laughter).

GANDHI: I think it's truly a social contract. And thus, I would ask vaccinated people to please keep their masks and distancing on in public spaces, on airplanes, in the grocery store until we get to a point where everyone who wants to be vaccinated has that opportunity - above 16 in the current era.

CHANG: Yeah.

GANDHI: And at that point, they'll likely be recommendations that mask and distancing can come off.

CHANG: But let's also be clear about the difference between public health guidance versus personal decisions. Like, maybe it would be OK to some people to agree to join a small group of vaccinated singers to rehearse together...

GANDHI: Yes.

CHANG: ...But it's a different thing - right? - for a state to allow churches to open with full choirs indoors.

GANDHI: When there's half vaccinated, absolutely.

CHANG: Dr. Wen?

WEN: I also, though, think it's really important for us to be clear about what are the benefits of vaccinations.

GANDHI: Yes.

WEN: Yes, there is a societal benefit, but I also think that people need to see what's in it for them. So I actually think that as we're seeing more and more reports of people going about their normal lives - visiting their grandkids, rejoining choirs, going to indoor gym classes, going on vacations - I think we should advertise this.

GANDHI: Yes.

WEN: I really disagree with the CDC in this respect. I think the CDC should actually be saying fully vaccinated people should go about their normal lives as much as possible, including resuming travel, including vacations, including going back to restaurants and bars if they feel safe doing so. And it's in seeing what that pre-pandemic life can look like again.

CHANG: Right, the before times. That's the light at the end of the tunnel, people.

GANDHI: I so agree with you. This is where we, you know, are so aligned on this. Because I call it vaccine optimism to reduce vaccine hesitancy. And I wrote a paper on this very early on, actually, before people could even be in the general population to get vaccinated, because what it does to me is that motivating factor. Because what it does is it gives people all of this excitement about, hey, I want to get vaccinated now because I get to go back to the life that I enjoyed.

CORNISH: Monica Gandhi with the University of California, San Francisco, and Leana Wen at George Washington University.

It's CONSIDER THIS FROM NPR. I'm Audie Cornish.

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