Editors' Note: This article was reported and published before Canada decided to delay second doses of COVID vaccines for much of the population. As of May 12, 2021, only a small fraction of the Canadian population had been fully vaccinated, with both protective doses.
My sleeve is already rolled up in excited anticipation of getting my COVID vaccine, but the reality is, it won’t be happening for me anytime soon. And that’s OK—I’m not a frontline worker or a high-risk individual, so I’m happy to wait my turn while people like my parents and in-laws get their vaccines earlier on.
There will probably (hopefully!) be a period this spring and summer when many grandparents will have been vaccinated, but their adult children in their thirties and forties, and the grandchildren they haven't seen in months, will still be waiting for their shots. The federal government has promised to vaccinate everyone who wants a vaccine by the end of September, and each province has shared a plan with estimated dates, but we still don’t know exactly when vaccines will be available for Canadian kids, or for most low-risk parents. (Vaccine trials in children are currently underway in the US.) And with every report of manufacturing issues or a delayed vaccine shipment, public frustration and impatience grows.
What does this mean for families who are desperate to reconnect with loved ones, planning summer childcare, or trying to envision what the next six months will look like? On social media, I've been seeing already-vaccinated American grandparents reuniting with their grandkids, and I've been wondering if that's actually safe. Can we expect to see a dramatic reduction in new cases and an eventual return to normalcy over the summer as more of us are immunized? Or will all the closures, social distancing and masking rules still be in place indefinitely?
For help with our many questions, I spoke to Abdu Sharkawy, an internal medicine and infectious diseases specialist with the University Health Network and an assistant professor of medicine at the University of Toronto, who recently received two doses of the Pfizer vaccine himself. Here’s what you need to know.
As vaccinations roll out across Canada, we have every reason to feel optimistic about their role in helping the pandemic coming to an end. That said, things still aren’t going to change overnight. While official word is that an individual’s full protection potential is reached two weeks after receiving their second dose, experts say that this is based on average trial participants. Some individuals, like those with underlying health conditions or weakened immune status, may actually need up to three months to reach that level of immunity, explains Sharkawy. This could very well mean your parents, grandparents or other high-risk family members need to wait much longer than just two weeks after their second dose to be protected.
Even once a vaccine’s full protection potential has been reached, some precautions, like masking or social distancing, will remain necessary as long as case numbers remain high. This isn’t just because of the relatively small chance the vaccine won’t work—it’s because even after being vaccinated, you can still potentially transmit the virus to others.
Sharkawy explains that while COVID vaccines are highly effective, they do not necessarily prevent transmission between individuals. This is because both approved COVID-19 vaccines we have so far provide effective immunity rather than sterilizing immunity: while the vaccine protects you from getting sick from COVID-19, it’s possible that you could still become asymptomatically infected and transmit the virus to others in your household or your community.
This means that if Grandma has received both doses of her vaccine and resumes her normal work and social life, she could carry COVID-19 to you and your kids. Or, if you’re a frontline worker who’s been vaccinated and you decide to visit your parents, you could potentially pass the virus to them (whether they’ve been vaccinated or not). Scientists believe that most COVID vaccines will, most likely, significantly reduce transmission (the research we have seen so far is promising), but we don't know for sure at this point. Fortunately, we can expect to learn more about this in the coming months.
It may be relatively safe for two fully vaccinated individuals to interact a few months from now, when they’ve both achieved full protective immunity and we know more about transmission risk after vaccination, Sharkawy says. But don’t plan on booking a cottage with family this summer or travelling for non-essential purposes, such as visiting long-distance family members. Sadly, he says we aren’t there yet.
Currently, there are already strict travel measures in place in some provinces, even if you're not leaving Canada. For example, Manitoba currently requires anyone entering the province to take two COVID tests and isolate for 14 days, including those who are just hopping over the border from Ontario or Saskatchewan.
If you travel outside of Canada, a negative PCR test is required before re-entering the country—and, depending on whether you’re travelling by plane or by car, you’ll have to quarantine in a designated hotel (the new hotel quarantine rules start on Feb. 22) or in your house upon return, with hefty fines for those who don’t comply.
As more Canadians are vaccinated, we can expect to see a reduction in case numbers, and that means gradually regaining some normalcy in our lives. It’s definitely something to be excited about. However, change is happening slowly, and we don’t know what’s going to happen with the new, more contagious variants in the meantime. Even with the promise of vaccines, we need to prepare ourselves for delayed gratification—particularly if you live somewhere with a high number of active cases.
Last summer, some provinces approved social bubbles or circles, including Ontario, where I live. We could have close contact with the 10 individuals in our bubble—unmasked indoor visits, shared meals and even hugging—while continuing to social distance from all others. It was amazing, and a lot of people are hoping for a repeat this summer. But here’s the thing: last July and August, there were less than 200 cases a day in Ontario for weeks at a time. In contrast, for the past few months, the province has recorded new case numbers in the thousands every single day. To get to a point where we can safely create social bubbles again, we need to get case numbers way down and keep them there for a while—ideally, for about three months. Only then will guidelines change to reflect this downward trend, Sharkawy says. He anticipates this happening around August, potentially, if the vaccine roll-out goes according to plan. So, another summer bubble in Ontario? Probably not. But fewer restrictions by Thanksgiving or the winter holidays? Totally possible, though we can’t know for sure what that will look like.
For now and in the coming months, Sharkawy recommends sticking to outdoor visits with social distancing, even if some or all parties are vaccinated, and always following your local public health guidelines.
Relatives who live in long-term care facilities or other congregate settings will continue to see restrictions in terms of family access, even if they’re vaccinated, as they’re at very high risk of complications from COVID.
For grandparents who live independently, their risk level depends on their lifestyle, work situation, and how well they practice social distancing in their daily lives. Are they getting together for coffee dates and indoor visits with friends, or working outside the home? If so, where are they working? (Sharkawy notes that public-facing jobs like cashiers are at higher risk than most office employees, for example.) Or, are they retired and dedicated to staying home? All of this impacts their health and safety—and yours.
If you’re considering an indoor visit with the grandparents despite recommendations against it, or plan on having a grandparent provide childcare over the summer months, remember that your own lifestyle impacts their risk level. If you go into a workplace every day or have kids in daycare, school, camp or extracurriculars, for example, the likelihood of transmission increases.
“At the end of the day, advanced age is still a very big risk factor. Care should be exercised in deciding if, or how, to interact with any elderly person during this time,” says Sharkawy. At this point, with the pandemic still very much an active event, it remains critical that we exercise caution to protect both ourselves and our senior loved ones, he explains.
There is a light at the end of the tunnel, though: Guidelines are expected to change as more of the population has immunity to the virus, and it's happening—slowly. Think of this year as a period of transition, with more normalcy on the horizon as immunizations happen.