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How to Protect Vulnerable Family Members from COVID This Thanksgiving: Shots

The holidays are us.  Here's your toolkit on how to keep COVID out of your festivals and keep your most vulnerable family members safe this year.

Chanelle Nibbelink for NPR

The holidays are us.  Here's your toolkit on how to keep COVID out of your festivals and keep your most vulnerable family members safe this year.

Chanelle Nibbelink for NPR

Here’s something to be grateful for this year: It’s not Thanksgiving 2020. A year ago, with a vaccine still unapproved, the daily death toll spiked – rising to more than 2,000 a day in May. 12 — and many Americans have shied away and skipped holiday celebrations to reduce their risk.

This year, 80% of people 12 years of age and older received at least one vaccination, and about half of Americans are planning to gather in groups of 10 or more for the holiday, a recent survey found.

While many of us are getting ready to restart our holiday traditions, COVID cases are once again rapidly increasing – with nearly 95,000 new cases per day. Experts warn we still need to keep in mind minimizing COVID risks. Even if your family is fully vaccinated, remember that the most vulnerable members of your family, especially those over 80 or those who are immunocompromised, are still at high risk. seriously ill with COVID.

Nearly two years into this pandemic, we’ve learned a lot about how to reduce the risk of catching and spreading this virus, including the simple steps of wearing a mask and washing your hands. Now let’s not forget.

Here are some reminders on how to keep your family gatherings safe.

If you’re gathering with grandparents or other older adults, be aware: They’re still at risk

Fact Check: People over 80 are at high risk of dying from COVID, even if they’ve been vaccinated

Although vaccines offer strong protection against hospitalization and death, disruptive infections are a reality. Usually, coronavirus infection after vaccination leads to only mild illness, and sometimes people test positive but have no symptoms. However, older adults and those with compromised immune systems are at increased risk for severe breakouts of COVID.

While breakouts rarely lead to hospitalization or death, the chances for a group are higher. As NPR reported, CDC data from August show that fully immunized people age 80 and older are about 13 times more likely to die from COVID than the general vaccinated population (of all ages). That’s one reason why booster use is especially important for older adults.

“This is something that we have to be aware of when people are congregating across generations,” said physician and public health epidemiologist William Miller of Ohio State University. “Grandparents and grandmothers are relatively protected compared to if they were unvaccinated, but they are still at risk,” he said.

That’s why you should take precautions when traveling and in the week leading up to any celebrations where older friends and relatives will be present.

“I strongly encourage people to continue to wear masks in crowded, indoor places like grocery stores, even if it’s not mandatory,” Miller said. This will reduce the risk of exposure and transmission of the virus. And remember, TSA . mask requirements Still in effect through January 18, 2022, mask wearing is required in airports, on commercial airline flights, and on commuter bus and rail systems.

So the bottom line, even if all your holiday invitees are vaccinated, it’s still important to protect loved ones who are elderly or immunocompromised.

Get a booster shot if you qualify

Federal health agencies now recommend COVID vaccine booster for all adults, six months after the last shot – and they can be especially important for adults over 50 or any adult with underlying medical conditions or a high-risk job. Getting one before traveling and holiday gathering can boost your immunity against COVID.

The agency’s decision is based on emerging evidence that immunity can decline over time, and evidence that a booster dose can enhance protection, as the name suggests.

Some of the best recent real world data from the UK. Back in September, the UK government introduced a boosted scheme targeting people aged 50 and over.

White House medical adviser Dr Anthony Fauci said the new analysis indicated a significant increase in protection (against symptomatic infections) from the booster dose. “If you look at the third dose in people where the protection has dropped to about 63 percent, you’d increase it back to at least 94 percent, which is actually quite impressive,” he said. “That’s exactly the kind of thing you want boosters to do.”

Immunity begins to recover within a few days of booster vaccination, Fauci says, although you don’t reach peak protection for two to four weeks. He said before going to indoor holiday gatherings, especially in places where there is a high chance of virus transmission, “I recommend if you qualify for a boost, go get a booster now.” now.”

Quick check-ins can protect your guests. Here’s how to spend time with them

As a risk mitigation measure, you can ask your guests to take a COVID test before hosting a major holiday. A year ago, it was difficult to get real-time information from COVID testing due to delays in test results and lack of rapid testing options. There are now many over-the-counter rapid antigen tests, such as the Abbott BinaxNOW or the Orasure InteliSwab, available online and in pharmacies.

“Rapid antigen testing is an extra layer of protection for everyone,” Judy Guzman-Cottrill, a pediatric infectious disease specialist at Oregon Health and Science University.

“Antigen tests are a snapshot to see if viral proteins are present in the person’s nose that day,” explains Guzman-Cottrill. one day later a positive result the next day.

Emily Landon, an infectious disease physician at the University of Chicago, explains that tests are not 100% reliable if someone has just been exposed. “The test really doesn’t detect really low levels of the virus in your nose, and so it won’t detect a really early infection,” she said. So, she recommends taking the test on the morning of the rally, or as close to the start of the rally as possible.

Some families check before they travel and then check again when they arrive at their destination, depending on the risk profile of the people they are with. (Note: depending on which test you purchased, the instructions will vary. For example: BinaxNOW guide that everyone should be tested twice in three days with at least 24 hours between tests for the most accurate results)

William Miller also participates in the test strategy to be safe. “It’s a kind of mindset,” says Miller. It’s one way of signaling: Make the visit as safe as possible.

Think carefully about how to include unvaccinated family members

Deciding who to invite to a home is a matter of personal decision, but experts say at this point in the pandemic it’s pretty clear that a fully vaccinated group is the safest situation.

“I think it’s reasonable for people to ask their guests to be vaccinated, especially if young unvaccinated children are coming or people are less likely to have a strong immune response to vaccines,” says Guzman-Cottrill. , such as immunocompromised people. “Those are the people we still really need to make sure we stay as safe as possible because this pandemic isn’t over yet,” she added.

Asking for a vaccine can lead to some feelings of hurt or conflict, but Miller suggests framing the decision as a way to protect elderly loved ones. “I actually think it’s completely acceptable to say, ‘I’m sorry you weren’t vaccinated. You know, grandma is here, and your coming, that greatly increases the risk. sick,'” he said.

An alternative is to ask an unvaccinated guest for a lab-based PCR test 24 to 48 hours before the event (provided they can get their results back in a timely manner) or a test. COVID rapid antigen test just before they arrive. Additionally, Landon recommends that unvaccinated guests take additional precautions in the week leading up to the event, including wearing masks in public places and limiting contact with unvaccinated people. other vaccinations.

“We think with delta variation, most people will get sick a few days after exposure, but it could take up to a week, maybe a little longer,” explains Landon. prior to close, undisguised contact with a high-risk person,” she said.

Take precautions if your child has not been vaccinated or has only had one shot

Many children ages 5 to 11 have received the first of the two recommended doses, but will not be eligible for the second dose until after the Thanksgiving holiday. Guzman-Cottrill says immunity builds up gradually after vaccination, but it’s not known exactly how much protection a single dose of the COVID vaccine provides children,” said Guzman-Cottrill.

“I know many families who are in this uncomfortable limbo because their children won’t be fully vaccinated before Thanksgiving,” she said. With this state of limbo, “it’s really important to just keep in mind that this is not the time for those families to let their guard down,” she said. That’s no reason to cancel multi-generational gatherings, but it’s a reminder to take precautions.

So what precautions are recommended? It depends on the health and age of the relatives who will be attending “If you are a nimble 70-year-old woman with no medical problems and have had two doses of the vaccine plus a booster , I don’t think it’s these kids, Landon said.

But if the grandparent is over 80 and has health problems, the risk of a bad outcome is much higher.

An easy step to take if you are concerned about your unvaccinated children passing the virus on to grandparents is to wear a mask, not only when visiting, but a week before when in public, especially avoid crowded, indoor spaces, even if mask duty has no effect.

She said she wouldn’t recommend keeping kids out of school to avoid exposure, unless there’s an additional risk associated with your child’s school – such as an outbreak of cases or a shortage of face masks. Landon says: “If circumstances force you to miss school to protect a high-risk loved one, that might be a layer you want to add.

Another option: if you live in a mild climate, stay outdoors as much as possible for intergenerational social events and may choose not to sleep in the same house as grandparents.

Landon suggests: “Only come during the day for big events and stay at a hotel. Or let grandparents sleep in hotels, she added.

The bottom line: “You have to think about the risks of the individuals involved — about what happens if they get COVID,” says Landon. And it’s better to be cautious when you’re wrong.

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