Upcoming holidays present an opportunity to help the unvaccinated

The holiday season is fast approaching. Families and friends are looking forward to festive meals and social events. The CDC recently issued guidance on how to hold holiday gatherings safely, with vaccination as the best strategy for all eligible participants. However, with over 30 percent of those 12 years of age and older still not fully vaccinated, are holiday gatherings reasonable or reckless?

To assess the COVID-19 risks during the upcoming holiday season, one only needs to compare the public health environment in late-2020 to what we are experiencing today.

Beginning in early October 2020, the deaths attributed to COVID-19 were beginning to climb, reaching a daily peak of over 4,000 deaths on Jan. 12, 2021. The nation plodded through the holiday season without widespread access to the remarkable vaccines that are now widely available. Effectively, everyone was vulnerable to infection and the deleterious risks that accompanied it.

Fast forward one year and the public health situation is dramatically different. 

Around 80 percent of the adult population has received at least one vaccine dose, with many now eligible for booster shots. For at-risk populations, like those 65 years and older, over 97 percent of them have received at least one vaccine dose. Those who are immunocompromised have been eligible for a third shot for several weeks. All the available vaccines have been game-changers to keep people out of hospitals and from dying, with remarkable low breakthrough infection rates that lead to such severe outcomes.

The surge of hospitalizations that began during late summer has significantly abated, with much of it centered in areas of the country with low immunity, either due to low vaccination rates or due to low prior infection rates. This creates an environment favorable for enjoying the holidays in a manner that most of us welcome.

Is there anecdotal evidence to support such planning?

Indeed, there is.

Fans have packed college and professional football stadiums, as well as hockey arenas, to full capacity. There have been no reports of large infection outbreaks attributed to such venues. Many of these venues are moving to requiring proof of vaccination, with safety protocols in place.

Most colleges and universities have returned to in-person education, without surges in hospitalization among their more vulnerable populations. Transportation Security Officers at airport checkpoints have seen a precipitous drop in new infections.

It is no coincidence that areas with high hospitalization rates are where population immunity is low.

So, what can people do to remain as safe as possible, while enjoying their holiday gatherings?

The best strategy first: vaccination for all vaccine-eligible attendees.

If everyone present is vaccinated, the likelihood of health issues ensuing after such events is far less than if some of the people who attend are unvaccinated. For those over 65 years old, getting a booster shot is advisable. Booster shots in general provide added protection to everyone.

If you want to celebrate the holidays with family or friends who remain unvaccinated, this provides a unique opportunity to reach out to such people and discuss their options. Such a personal touch may make a difference in helping to understand their hesitancy and move toward a solution that is beneficial to all.

If such people are unwilling to even discuss the issue, such a red flag should be heeded. They may not only resist getting vaccinated but also be resistant to safety precautions that involve testing and using face coverings. 

People who are vaccinated must assess all the risks and ask whether they wish to be exposed to vaccine-eligible people who have chosen not to be vaccinated and are unwilling to discuss viable safety options for all. Breakthrough infections after vaccination, while not common, are possible. 

For children 5 through 12 years of age, the FDA granted the Pfizer vaccine emergency use authorization — when the CDC recommends it, this will allow such young people to join the ranks of the vaccinated. Until then, testing prior to holiday gatherings is prudent, especially if vaccinated older or at-risk relatives and friends are present who are most vulnerable to breakthrough infections.

This holiday season can and should proceed with joyous celebrations. Those vaccinated should take the necessary precautions to hold their gatherings with the necessary precautions that keep the virus out of their events. Depending on circumstances, those vaccinated may ultimately choose to exclude unvaccinated adults from their holiday plans. If the unvaccinated remain obstinate, preferring not to protect themselves and most importantly, others, a risk sensible solution may be to allow them to celebrate the holidays amongst themselves.

Sheldon H. Jacobson, Ph.D., is a founder professor of Computer Science and the Carle Illinois College of Medicine at the University of Illinois at Urbana-Champaign. He applies his expertise in data-driven risk-based decision-making to evaluate and inform public health policy.