What happens when adults are vaccinated but kids are not?
Pediatrician’s super simple tool parents can use for getting together with family & friends when not everyone has had the vaccine yet
by Steve Silvestro, MD @zendocsteve
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My mom’s been really excited lately.
We’ve only seen my parents in-person once since the pandemic began a full year ago. They live three hours away and we wanted to be COVID-safe, so we camped in their backyard for a weekend and spent two days hanging out entirely outdoors. My mom was dead-set on getting hugs from us and her grandkids, so we also brought masks and gloves—and I may have “liberated” a few medical gowns from work…
But now that she and my dad have gotten both doses of their COVID vaccine—as have my wife and I, plus my brother and sister-in-law—my mom is bursting at the seams with hopes of getting us all together and sharing some real hugs gown-free.
She’s not alone—grandparents and plenty of other loved ones around the world are feeling that same excitement.
Of course, there’s one small wrench in the plans, one tiny detail keeping the murky decision-making of these pandemic days alive—no one’s kids are vaccinated (and there are plenty of adults who haven’t received the vaccine yet, as well). So while the light at the end of the tunnel is within grasp, there are still a few sticky obstacles we have to navigate to help keep everyone as healthy as possible.
Below, I break down the CDC’s guidelines for how to handle situations where some people are vaccinated and some are not—namely, when there are kids involved—and I propose a super-simple and fun way your family can remember exactly what to do.
WHAT CAN FULLY VACCINATED PEOPLE DO?
Let’s start by talking about what people who are fully vaccinated against COVID can do when it comes to getting together.
First, it’s really important to recognize that “fully vaccinated” means that it’s been at least two weeks since the second dose of a two-dose COVID vaccine (Pfizer, Moderna), or at least two weeks since getting a single-dose vaccine (Johnson & Johnson). There aren’t any shortcuts here—while everyone’s body might respond differently, the general consensus is that it takes about two weeks after the last effective dose to comfortably assume that you have maximum immunity.
Once you’ve hit that “fully vaccinated” definition, the current CDC guidelines say that you can then:
- Hang out with other fully vaccinated people indoors, and without masks or social distancing
- Hang out with unvaccinated people indoors without masks or distancing IF those unvaccinated people are all from the same household AND neither they nor other people they live with are at risk for severe COVID disease if they catch it
As we’ll see in a moment, it’s satisfying these requirements for the unvaccinated people that is where things get a little sticky.
When it comes to figuring out who’s at risk for severe COVID, the CDC has a pretty extensive list here. But some of the more common conditions that put people at high risk include pregnancy, obesity, smoking, heart conditions, and immunocompromised states.
THE PEANUT BUTTER & JELLY METHOD FOR FAMILIES WITH KIDS
So what does this mean for families with kids or other unvaccinated people? Can they hug grandparents indoors and mask-free? What if cousins are over? Can you go on vacation together or spend a weekend with another family?
The sticking point is that when you mix unvaccinated people from different households, then everyone—including vaccinated people—still need to wear a mask, keep 6 feet of distance, and be in well-ventilated areas.
To help sort these situations out, you can think about peanut butter and jelly.
See, peanut butter is peanut butter. You can mix Jiff with Peter Pan and it’s no big deal. You could even throw some natural peanut butter into the mix and it’s all going to taste, well, like peanut butter.
But jelly? Mix different types of jelly—grape, strawberry, peach, apricot—and you have a pretty unpalatable glop of sickeningly sweet goop.
So, anyone who’s fully vaccinated—they’re peanut butter. Unvaccinated people are jelly. And when it comes to unvaccinated people, each household has its own flavor—your house is grape jelly, mine’s apricot, my brother’s house is strawberry.
Fully vaccinated people can mix and match all they want and it’s all just peanut butter. Pretty good. Fully vaccinated people can even hang out with one household’s unvaccinated people—peanut butter + one type of jelly works great.
But mixing vaccinated people with unvaccinated people from different households? That’s peanut butter + a few different types of jelly—not so tasty. That’s a situation in which everyone still needs to wear masks, keep distance, and be either outdoors or in an otherwise well-ventilated area.
THE PEANUT BUTTER & JELLY METHOD IN ACTION
To help clarify further, let’s use a few real-world examples. In each of these, we’re going to assume that no one’s at high risk for severe COVID (because that would require masks and distancing no matter what):
- Your family’s going to visit fully vaccinated grandparents. In this situation, the grandparents are peanut butter & your family is one flavor of jelly. Great combination! Whether you are vaccinated or not, since your family counts as one flavor, it’s okay to get together with the grandparents indoors and mask-free.
- Your family’s getting together with the grandparents, plus aunts, uncles, and cousins. The adults are all fully vaccinated, but your kids and the cousins aren’t. In this situation, you, the grandparents, and the aunts and uncles are all peanut butter—it’s okay for all the adults to mix. But since your kids and the cousins aren’t vaccinated and live in two different households, this situation mixes multiple flavors of jelly—not okay. So in this situation, you’ll need to wear masks, keep distance, and be outdoors or in a well-ventilated area.
- You and your partner want to go out to dinner at another couple’s house. They’re fully vaccinated, as are you. Your fully vaccinated mom is going to watch your unvaccinated kids. This is what plenty of parents are craving, right? Date night! There are a few combinations going on here, so let’s break it down. You, your partner, and your friends are all fully vaccinated—you’re all peanut butter—you’re good to go there mask-free. Even if they have unvaccinated kids in their home, those kids are one flavor of jelly—it’s okay for you to go over. As for what’s happening back at home, your mom is fully vaccinated (peanut butter) and your kids are unvaccinated (one flavor of jelly)—they’re good to mix mask-free, too. Hooray for the return of date night!
Thinking in terms of how many flavors of jelly are involved—that is, how many households the unvaccinated people belong to—is the key to figuring out whether COVID precautions are needed when getting together.
But what about school? If these kids are already mixing with other kids in school, doesn’t that mean it’s fine to get different households together? This is the question I’ve been asked a few times when talking about this. It’s true, gathering a dozen kids into a classroom means mixing unvaccinated people from different households—you’re mixing grape jelly, strawberry, apple, you name it. But remember, the Peanut Butter & Jelly Method and these new CDC guidelines are all about figuring out who can mix together without masks or social distancing. Kids who are going to school, at least for now, are wearing masks and sitting 3-6 feet apart. They’re essentially still following the Peanut Butter & Jelly rule.
EXTENDED TRIPS AND A LOOPHOLE WHEN ADULTS ARE VACCINATED BUT KIDS ARE NOT
These same guidelines apply to longer times spent together, as well.
If my family were to go and visit my fully vaccinated parents, the current thinking is that it would be okay to stay in their home for the weekend. But if we wanted to spend a week at the beach with friends and all of our kids are unvaccinated, we’d be mixing jellies and that’s not okay. It’s pretty hard to wear masks, keep distance, and make sure there’s good ventilation 24/7 for a week.
However, there is one way multi-jelly groups can still spend extended time together—pre-visit quarantine. Just like experts recommended last year for summer vacations or holiday gatherings, you can decrease the risk to unvaccinated kids and others by having them quarantine before getting together.
If you were to think about quarantining in order to mix unvaccinated people from multiple families, plan on making sure the unvaccinated people in each family are actually quarantining. That ideally means cutting out trips to stores, seeing other people in their “bubble” if they have one, etc.. With that in mind, they’ll then have to either:
- Quarantine for 14 days before meeting up, OR
- Quarantine for 7 days and then getting a COVID test—and continuing to quarantine until the test results come back if it’s not a rapid test
If the unvaccinated people can follow these rules, then that makes them…flavorless jelly? Okay, it’s a stretch—but following those quarantine guidelines can help to make it safer for your multi-household, multi-jelly families to mix.
CLOSER TO FINE
At some point, things will be easier. Some day, hopefully this year, enough kids and adults will be vaccinated that we can go back to doing things together without having to think about intricate rules. At some point, the food analogies will be gone.
But for now, you can use the Peanut Butter & Jelly Method to easily figure out exactly what your family needs to do to socialize safely when vaccinated and unvaccinated people mix. And maybe bring a glass of milk.