What the CDC recommends for fully vaccinated, pregnant, and immune compromised persons

Like weather updates about tornados, hurricanes, and blizzards, the warnings and recommendations from the CDC about COVID-19 change to reflect current findings and predictions.

This information is current as of the date of original publication or update. It may have changed by the time you read this. I invite you to fact-check what you read here.

Please do not use this information for diagnosis or treatment purposes. Before making health decisions, discuss with your physician or other qualified healthcare provider.

When I wrote the first version of this post I did not anticipate a need to update it, but have now done so 4 times. Like weather updates about tornados, hurricanes, and blizzards, the warnings and recommendations from the CDC about COVID-19 change to reflect new data about the current status of the coronavirus and its activity among the population. Now I suspect this will not be the final post in this series.

The arrival of the Delta virus variant into the United State caused a new surge of infections, mostly among the unvaccinated. Those of us vaccinated can become infected with it, but likely will not become seriously ill, need hospitalization, or die.

Breaking news – Vaccination in pregnancy

August 11, 2021
  • COVID-19 vaccination is recommended for all people 12 years and older, including people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future.
  • Evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy has been growing. These data suggest that the benefits of receiving a COVID-19 vaccine outweigh any known or potential risks of vaccination during pregnancy.
  • There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in women or men.

Breaking news-COVID-19 Vaccines for Moderately to Severely Immunocompromised People

August 13, 2021

CDC now recommends that people whose immune systems are compromised moderately to severely should receive an additional dose of mRNA COVID-19 vaccine after the initial 2 doses. Widespread vaccination is a critical tool to help stop the pandemic. Read CDC’s statement.

CDC updates July 27, 2021

The CDC recommends fully vaccinated people wear a mask in public indoor settings , in areas of substantial or high transmission. (find transmission rates at this link.)

Fully vaccinated people might choose to wear a mask regardless of the level of transmission, particularly if they are immunocompromised or at increased risk for severe disease from COVID-19, or if they have someone in their household who is immunocompromised, at increased risk of severe disease or not fully vaccinated.

Fully vaccinated people who have come into close contact with someone with suspected or confirmed COVID-19 to be tested 3-5 days after exposure, and to wear a mask in public indoor settings for 14 days or until they receive a negative test result.

CDC recommends universal indoor masking for all teachers, staff, students, and visitors to schools, regardless of vaccination status.

electron microscope image of a 2019-nCoV isolate
Transmission electron microscopic image of an isolate from the first U.S. case of COVID-19, formerly known as 2019-nCoV. The spherical viral particles, colorized blue, contain cross-sections through the viral genome, seen as black dots. credit Hannah A Bullock; Azaibi Tamin, public domain
Here is what the CDC, Centers for Disease Control and Prevention, posted on their web site as of July 28, 2021.

Interim Public Health Recommendations for Fully Vaccinated People

For the purposes of this guidance, people are considered fully vaccinated for COVID-19

  • ≥2 weeks after they have received the second dose in a 2-dose series (Pfizer-BioNTech or Moderna), or We
  • ≥2 weeks after they have received a single-dose vaccine (Johnson and Johnson (J&J)/Janssen ).
Dr. Aletha inspecting her arm after a COVID-19 shot
Three days after my first vaccination the soreness in my arm was almost gone, and I had no redness or swelling. After the second shot, minimal soreness. No other side effects to report. I feel fortunate. I am now fully vaccinated.

Fully vaccinated people can:

  • Resume activities without wearing masks or physically distancing, except where required by federal, state, local, tribal, or territorial laws, rules and regulations, including local business and workplace guidance
  • Resume domestic travel and refrain from testing before or after travel or self-quarantine after travel
  • Refrain from testing before leaving the United States for international travel (unless required by the destination) and refrain from self-quarantine after arriving back in the United States
  • If you came into close contact with someone with COVID-19 get tested 3-5 days after the date of your exposure and wear a mask in public indoor settings for 14 days after exposure or until a negative test result.
  • Refrain from routine screening testing if feasible
  • Get tested if experiencing COVID-19 symptoms and isolate for 10 days if positive.
  • Follow CDC and health department travel requirements and recommendations

Travel

For now, masks are still required for everyone on public transportation, until those policies are updated. (June 10, 2021 update)

Healthcare facilities

For now, you will likely be required to wear a mask in hospitals, clinics, medical offices, nursing homes, and other facilities that provide direct healthcare.

Protocols for vaccinated and non-vaccinated healthcare workers are detailed on the CDC website.

Immune compromise

People who are immunocompromised should be counseled about the potential for reduced immune responses to COVID-19 vaccines and to follow current prevention measures (including wearing a maskstaying 6 feet apart from others they don’t live with, and avoiding crowds and poorly ventilated indoor spaces) regardless of their vaccination status to protect themselves against COVID-19 until advised otherwise by their healthcare provider.

It has been reported that the CDC may recommend a booster for these people soon.

a scientist in a lab working on covid antibodies
Centers for Disease Control and Prevention (CDC) scientist was preparing patients’ samples for SARS-CoV-2antibody testing. Serological testing is used to detect antibodies, which indicate past infection with the virus that causes COVID-19, and is important to the understanding of disease prevalence within a population. credit James Gathanay, public domain

About the Delta Variant: 

Vaccines are highly effective against severe illness, but the Delta variant causes more infections and spreads faster than earlier forms of the virus that causes COVID-19. Learn more about variants in the US.

Testing, testing, testing

Testing helps us identify cases, trace contacts, and prevent spread. With fewer cases, public health professionals can find contacts easier and sooner. Stopping spread will make the variant viruses less of a threat.

So please don’t stop seeking testing if you have symptoms; it is still important to know how many cases of COVID-19 there are. If we only know about the severe cases that required hospitalization, it will skew the statistics, and be less representative of the true extent of the pandemic.

Masks and Vaccines -“do unto others”

I’m not here to debate the use of masks. If you are not yet vaccinated, masks are an easy and safe way to protect yourself but aren’t anywhere close to vaccine effectiveness. Bottom line, get vaccinated; it’s available and easy to get. You probably won’t have to wait in line for an hour like I did. Just click on this link

VACCINES.GOV

Remember, this is a contagious infectious disease spread by direct person to person contact. It’s not just about you, we’re here for each other.

Information and misinformation

There has been much of both in the past year, some deliberate, some well intentioned, some valuable, some just plain wrong. Whenever possible, get your information directly from the source, not “a friend of a friend’s second cousin”. Here are some tips for finding reliable information

7 Resources for Responsible Social Media Sharing

The post emphasizes the importance of responsible social media usage by highlighting various resources and strategies to combat misinformation. It discusses how emotional responses can be manipulated by disinformation and urges readers to critically evaluate content before sharing. We all have a responsibility to research claims and ensure truthfulness online.

Final comments from the CDC

CDC will continue to evaluate and update public health recommendations for fully vaccinated people as more information, including on new variants, becomes available. Further information on evidence and considerations related to these recommendations is available in the  Science Brief.

CDC website

exploring the HEART of ending the pandemic

Please do your friends a favor by sharing this post on social media and even in real conversations.

Dr. Aletha

Dying with Ease- a book review

Dr. Spiess doesn’t suggest that confronted with terminal illness we refuse treatment and give up. He advocates thinking about and planning for the dying process long before we develop an illness that might be fatal.

This is at least the fouth book about death I have reviewed. I didn’t plan to, but it just happened. Maybe because of what Dr. Atul Gawande wrote in his book Being Mortal, another book I reviewed.

Death may be the enemy, but it is also the natural order of things.

Atul Gawande, M.D.

In this instance, I was approached by the publisher , FSB Associates, asking if I would review the book, and offered a complimentary copy. Otherwise, I was not compensated for my review. The book links in this post are affiliate links which may help support this blog financially.

Dying with Ease by Jeff Spiess, M.D.

A Compassionate Guide for Making Wiser End-of-Life Decisions
Dying with East-a book

In the introduction, author Dr. Jeff Spiess explains his purpose for writing this book.

my primary hope is for you, dear reader, to become more informed and at peace regarding your own dying.

Jeff Spiess, M.D.

Dr. Spiess doesn’t suggest that confronted with terminal illness we refuse treatment and give up. He advocates thinking about and planning for the dying process long before we develop an illness that might be fatal.

His book reviews the challenges of the dying process, and guides us in making choices that make it smoother and with ease.

Let’s review the titles of each chapter with a brief description of what each contains.

1. Dying in America

Here he proposes a definition for what is a “good death”; it’s one that matches the wishes of the dying person and their family.

2. I’m Going to Die? What Can I Do?

In this chapter he explains Advance Care Planning

  • Advanced Directives
  • Durable power of attorney for healthcare
  • Do Not Resuscitate-DNR
  • Physician Orders for Life Sustaining Treatment
  • Artificial Nutrition and Hydration

3. Hospice

In this chapter he reviews the history of hospice care care and explains the basics of palliative (rather than curative) care

4. Suffering

Most dying persons want to minimize suffering so Dr. Spiess lists ways to do so, some of which are controversial and even illegal in some states.

  • Palliative sedation
  • Voluntary stopping eating / drinking
  • medical aid in dying
  • voluntary euthanasia

5. It’s My Life, Isn’t It?

Here he discussed autonomy , bioethics, and the legal system using past high profile cases as illustrations, those being

  • Karen Ann Quinlan
  • Brittnany Maynard
  • Theresa Schiavo
"To every thing there is a season" Bible verse with fall color leaves
from Ecclesiastes 3

the time of peril, what St. John of the Cross called the “dark night of the soul,” … both tests the validity of one’s faith and initiates that essential process of incarnation

page 109

6. What’s God Got to Do With It?

Here he talks about “Religion, Spirituality, and the End of Life. He finds many people turn to religion when faced with death and sometimes that is not an altogether positive experience. However, he denies being anti-religion saying,

many find religious traditions to be sources of profound comfort and meaning. …it has been so for many friends, relatives, and patients, and also because it is true for me.

page 109

He finds it essential to differentiate religion as primarily a matter of intellectual assent to doctrines and beliefs, or whether the essense of a person’s faith has become understood and embodied in their being.

photo by DJ Thomas, Lightstock.com

7. What Does It Feel Like to Die?

In this chapter he invites the reader to do a guided exercise to encounter the inner experience of dying. Putting pen to paper you will answer a series of questions about your life. Then you review it as you finish reading the chapter. I did the exercise and found it enlightening and sobering.

8. Envisioning Your Own Death

Here he expands on the idea of Advanced Care Planning introduced in chapter 2. He adds such steps as

  • Know the rules (insurance coverage)
  • Disposition of your body
  • Disposition of “stuff”, making a will
woman sitting in a cemetery
photo from the Lightstock.com collection, an affiliate link

9. What’s It All About, Anyway?

Dr. Spiess concludes with a true story about a wife’s journey to finding meaning after her young husband’s unexpected death.

living well increases the likelihood of dying well

page 161

Conclusion

After the obligatory Acknowledgments this book has

  • Discussion Questions which seem most appropriate for personal reflection . There is one question based on each chapter.
  • Notes, which are chapter specific
  • An extensive Bibliography
  • An Index
  • Brief Author bio

Jeff Spiess, M.D.

Dr. Jeff Spiess

Dr. Spiess started in medicine as an oncologist, cancer specialist, then transitioned into palliative and end-of-life care as director of a hospice. His website, https://drjeffspiess.com/, offers a complete bio, audio interviews, his blog posts, social media links, and form to join his email list.

exploring the HEART of life and death

Dr. Aletha

cheesy-free faith-focused stock photos

Lightstock-quality photos and graphics site- here. 

(This is an affiliate link)