I Got a Trial Covid-19 Vaccine. Do I Still Have to Wear a Mask?

Let’s review a few more factual considerations. Specific antibodies target specific segments (“epitopes”) of a protein. The major American vaccine candidates, which focus on the coronavirus’s spike protein, might not give you as rich a complement of antibodies as those produced by someone who had actually been infected with the virus; the virus is more than its spikes. And acquired immunity doesn’t just arise from the antibodies in our serum; it involves white blood cells, such as killer T cells, that have been, in effect, trained to deal with the threat. As my medical colleagues remind me, recovered Covid-19 patients might be expected to have levels of cellular immunity that some vaccines may not trigger. (A few vaccines, notably one for HPV, may produce a better immune response than natural infection does, but usually it’s the other way around.) Going by available data, one well-funded vaccine candidate seems to produce only a weak cellular response. It might still work wonderfully well, but results in the test tube are no substitute for results in the field. And what’s expected of a good vaccine is that it would reduce your odds of infection (albeit in ways that, once vaccination is widespread, could lead to herd immunity), not that it would eliminate them.

Even if your optimistic assumptions were borne out, though, you should still join others in wearing a mask in public places. After all, people aren’t going to know why you aren’t wearing one. They may infer that you’re antimask or fear that you might pose a threat to them. At the same time, you would be eroding an important social norm. Whatever your personal risk profile, wearing a mask signals your support for a practice that can save lives; it helps maintain a public realm in which all of us do our share to contain transmission. For the same reason, you should continue with social distancing in public places.

Don’t give up on hand hygiene, either. At least in theory, your hands could transfer the virus from a surface to someone else’s hands. So regular hand-washing remains a good idea. (With additional benefits as we come into the usual season for colds and flu.)

None of this is to say that — bearing in mind all the caveats — you shouldn’t engage in the permitted activities you mention, like dining out and travel. Diminished economic activity has bad effects on the welfare of many, which includes costs in health. Will these treats be a reward for the good deed of being a guinea pig? That isn’t how I would look at it. But doing so would be a positive contribution to the recovery.

I recognize that the choice to eat out is already a great privilege in this time of massive dislocation and lost livelihoods. My quandary concerns the conditions under which it is ethically appropriate to do so (of course, masked, outdoors and six feet apart from other diners). On the one hand, I recognize that those who work in restaurants (bar, front of house, line cooks, etc.) are likely working because they depend on these wages, i.e., they must. On the other hand, I recognize that they would likely prefer to work remotely, as those privileged enough to have the option can do, and I do not want to support this multitiered wage-class system. I also recognize that contributing to sustaining local business — owners as well as the employees who depend on wages to sustain themselves — is important right now. Eating out seems as problematic as eating in, since those who prepare the food are equally at risk. How would you think through the ethical course of action? Name Withheld

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