Since the start of the pandemic, Kit Breshears has been terrified of catching the coronavirus. Getting vaccinated did not magically change that.
For the past 13 months, Breshears, 44, of Buffalo, Minnesota, has not stepped foot inside a store or restaurant, not even to pick up a takeout meal. Any visits with family and friends have been over Zoom.
When he received his second Covid-19 shot earlier this month, he felt relief, he said — but with the pandemic still ongoing, he has found it impossible to turn off his anxiety.
“My fear is that enough people are not going to get vaccinated, or they’re not going to get vaccinated in a timely fashion, and we end up getting a horrible variant that puts us right back to where we are,” Breshears, a communications director at a local university, said. “I don’t want to be sitting in a movie theater with ‘patient zero’ of a variant that bucks the vaccine.”
With more than 93 million people, or more than a quarter of America, fully vaccinated, two camps have emerged: those making up for lost time in the form of house parties, happy hours and travel, and those who cannot shake the fear that they may still get the coronavirus.
Breshears is far from the only one in the latter category. A survey released last month by the American Psychological Association found that 48 percent of adults who have been vaccinated said they felt “uneasy” about returning to in-person interactions once the pandemic is over.
For the time being, some timidness is a good thing, public health experts say.
“We’re still involved in the disease containment phase of the pandemic,” said Tener Goodwin Veenema, a professor and visiting scholar at the Johns Hopkins Center for Health Security. Fully vaccinated individuals should feel confident in the protection they have received, she said, but should still wear their masks in public and avoid big groups of unmasked people.
Nonetheless, for healthy, fully vaccinated people, the fear of catching Covid-19 should not be paralyzing, said Vaile Wright, a clinical psychologist and the senior director of health care innovation at the American Psychological Association.
“With previous pandemics, like SARS and Ebola, we have seen agoraphobia,” she said, referring to the anxiety disorder in which people fear certain situations so much that they may not leave their homes. “At the end of the day, if you’re really, really struggling, then it’s time to seek out some professional help.”
"There is going to be this lingering sense of anxiety going forward, because uncertainty still remains.”
She said she anticipated that many people will continue to have anxiety as they await answers on the long-term robustness of the vaccines, as well as what life after the pandemic will look like, from returning to the workplace to getting children back to school full time.
“There has been this dialogue that if we can just get to the vaccine, then everything is going to be okay,” she said. “But there is going to be this lingering sense of anxiety going forward, because uncertainty still remains.”
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Just how worried should you be once you are vaccinated?
Studies indicate the vaccines offer strong protection against the coronavirus.
Pfizer-BioNTech's and Moderna’s shots were found to be about 90 percent effective against infection based on real-world data, according to a Centers for Disease Control and Prevention study published in March. While it is not yet known how long the protection lasts, immunity from those vaccines appears to last for at least six months.
Johnson & Johnson’s single-dose shot, meanwhile, was 66.3 percent effective overall in clinical trials at preventing illness and appeared to be 100 percent effective at preventing hospitalization and deaths from the virus. (The U.S. recently put that vaccine on a brief pause while it investigated reports of very rare blood clots linked to it. On Friday, the CDC and the Food and Drug Administration announced that the U.S. can resume administering the vaccine.)
There have been so-called breakthrough cases of fully vaccinated people catching Covid-19: Earlier this month, the CDC said it had received reports of about 5,800 infections among the nearly 77 million people in the U.S. who had gotten their vaccinations at that point.
Breakthrough cases are not unexpected, experts say.
“No vaccine is 100 percent effective. These vaccines are no exception to that,” said Dr. Adam Ratner, director of pediatric infectious diseases at NYU Langone Health. “For a lot of people, the protection they get may be that it’s protecting them against needing to go to the hospital, or severe disease, or death, even if they do end up getting a Covid infection.”
Among the breakthrough cases, only 7 percent required hospitalization, the CDC said, and 74 people died. The deaths represent less than 0.0001 percent of all fully vaccinated people.
Compared to a flu vaccine, which may only be about 40 percent effective depending on the year, those numbers are encouraging, Ratner said.
Still, they show that we need to get “population-level control of this virus,” he added.
Experts say this will be particularly important as variants continue to emerge and spread, although so far, the vaccines have performed well against them in trials. Last week, the New England Journal of Medicine documented two fully vaccinated people with breakthrough cases tied to variants; both had mild symptoms.
“It reinforces this road race between getting enough people vaccinated and achieving more immunity before the variants can continue to spread and mutate and continue to get stronger,” Goodwin Veenema said.
While more people are getting vaccinated each day, the pandemic is far from over. On average, there are still around 60,000 new daily cases of Covid-19 diagnosed across the country; the nation’s top infectious diseases doctor, Dr. Anthony Fauci, has consistently said states should not ease coronavirus restrictions until new cases fall to under 10,000 daily.
Peak protection from the vaccines comes two weeks after the second dose in two-dose vaccines and two weeks after the single Johnson & Johnson dose.
At that point, the CDC says, fully vaccinated people can attend small indoor gatherings, unmasked, with other fully vaccinated people, or even with unvaccinated people who are healthy and are not at risk for severe complications of Covid-19, such as young grandchildren.
What to do — and what not to do — if you are anxious
Not every person is ready to get back to pre-pandemic ways. Psychologists urge everyone to have patience, both with themselves and with others, as all of us adjust to the idea that being fully vaccinated means we can safely do some of the activities that we had to abruptly abandon when the pandemic hit.
“Recognize that the other person might just not be where you’re at yet, and that doesn’t make them wrong,” Wright said.
If you are feeling anxious about doing things that fall within safe CDC guidelines for fully vaccinated people, Wright suggests identifying small steps that you can take.
“There are people who haven’t gone to the grocery store in a year. Grocery stores are pretty safe if you’re wearing masks, so maybe that’s step one,” she said. “And then maybe move up to lunch outside with a friend who is also fully vaccinated.”
“The worst thing people can do is continue to avoid safe and relatively safe situations because that in essence reinforces to us that these are scary, unapproachable situations.”
Taking those steps, she said, is critical.
“The worst thing people can do is continue to avoid safe and relatively safe situations because that in essence reinforces to us that these are scary, unapproachable situations,” she said. “The more you continue to avoid it, the harder it’s going to be to overcome that.”
Breshears, the Minnesota man who received his second vaccination earlier this month, does not feel ready to resume going to the movies, an activity he used to do every weekend.
But knowing he has protection against the virus — and hearing of more people each day who do, too — is helping him work up the confidence to do other things. He is considering going into stores as opposed to relying on deliveries. Next month, he and his partner hope to have a movie night at their home with a few other fully vaccinated friends.
Breshears, who said he has suffered from anxiety since he was a teen, said he feels comfortable with the idea of being around a small group of people whose vaccination status he knows, and he is excited to see his friends.
But the upcoming movie night has increased his anxiety for a different reason: It will be a test of social skills that feel rusty.
“What are we going to talk about?” he said, laughing. “I’m so concerned that I’m not going to know how to act around people.”