Homes Divided: Vaccinated Health Workers Chart a New Normal

They’ll be vaccinated but their families won’t, at least not yet. So for now all the precautions remain in place.

On the morning of Dec. 16, the threat of a Virginia snowstorm canceled school for 7-year-old Alain Bell. He instead spent the morning scribbling a scowling face in black marker onto his father’s newly vaccinated upper arm.

“It was his idea,” Alain said over Zoom, pointing to his father, Dr. Taison Bell, 37, a critical care physician at UVA Health in Charlottesville. “I feel good that he’s not going to get sick.”

Dr. Bell’s actual face was all smiles. Shortly after 2 p.m. on Dec. 15, he became the second person in his hospital to receive a dose of Pfizer’s new coronavirus vaccine. “I feel fine,” he said. “But my right arm, if you were to interview it, is probably not excited about what’s happened to it.”

His limb experienced a bit of swelling and soreness, nothing out of the ordinary for a vaccine. It was a sign that the injection was doing its job: instructing Dr. Bell’s cells to churn out a protein called spike, which will teach his immune system to recognize and thwart the new coronavirus, should he ever encounter it. His second dose, scheduled for early January, will clinch the process.

The shot introduced a microscopic shift that will have an outsize impact on his risk of getting Covid-19. But, Dr. Bell said, little else in his life will change until more of his community joins the vaccinated pool.

Dr. Bell remains a relative rarity among the people he sees both inside and outside of work. His wife, Kristen, and their children, Alain and Ruby, are unlikely to be vaccinated before the spring or summer. They, like many others, will soon live in a home divided by the splinter-thin prick of a needle — one person vaccinated, three not. They represent a liminal state that will persist for months nationwide, as the first people to be injected navigate a new coexistence with the vulnerable at home.

Although the new vaccines have been shown to be highly effective at preventing people from developing symptomatic cases of Covid-19, little data exists on how well they can stop the spread of the virus, raising the possibility that vaccinated people, despite being much safer individually, could still pose a threat to those they love.

For that reason, “we’re still going to be taking all the same precautions,” Ms. Bell said. “Our day-to-day isn’t going to change for months, as the vaccines continue to get rolled out.”

That isn’t always an easy decision. Laura Lombardo, 40, a respiratory therapist at UW Health University Hospital in Madison, Wis., received her first shot on the afternoon of Dec. 21. She never worried about how she would tolerate the injection itself, which she said had saddled her with a sore arm and a headache — mild side effects.

But Ms. Lombardo, who is trying to conceive a second child, said she felt uneasy about the lack of data on the vaccine’s effects on women who are pregnant or lactating. She decided to pause her fertility treatments a couple of months ago and most likely won’t resume them for some time after her second injection.

But after months of watching her patients, most of whom are children, battle the virus, Ms. Lombardo is sure the vaccine is worth it — “a light at the end of the tunnel.”

It will probably be many months before the rest of Ms. Lombardo’s family receives their own injections, and her 6-year-old daughter, Kaleena, is impatient for change. She feels “good” about her mother’s getting vaccinated. But virtual schooling and months of distancing have taken a toll; with fresh-fallen snow carpeting their neighborhood, she misses being able to play with her friends. Vaccination for them, as for so many others, will not arrive as a lightning-fast fix, but at a plodding slog that will stretch at least into the spring.

Even families with multiple health workers at the front of the vaccination line are not yet ready to mingle. Jeanel and Mike Little, nurse practitioners at UVA Health, will both be fully vaccinated by the end of January. But the timeline is far murkier for their 7-month-old daughter, Ruby. Children have been largely absent from vaccine trials, and the virus appears to affect the very young in unusual, and understudied, ways.

Jeanel and Mike Little, with their daughter, Ruby. Both are nurse practitioners at UVA Health, and they aren’t sure when Ruby will be able to get vaccinated. 
Eze Amos for The New York Times

“She has been the biggest variable for us,” Mr. Little said. He and Ms. Little will continue to be vigilant about their own hygiene, knowing that they might still be able to transmit the virus, he said. Ruby started day care only in December and has yet to establish regular, in-person contact with any of her grandparents. But for everyone’s sake, that will remain the case for now.

“Our families have not really met our baby,” Ms. Little said. “We won’t loosen those restrictions in the near future; we still need to isolate her as much as possible.”

Public health experts have estimated that a majority of Americans, perhaps 70 to 80 percent, will need to have some degree of immunity to the virus for its spread to sputter and slow. Reaching that threshold will take time, effort and patience as scientists tackle hurdles, from strained supply chains to the deep-seated distrust of vaccines that pervades some populations.

But even as vaccines find their way into more and more arms, scientists will continue to study their effects on the population at large, searching for signs of unexpected or rare side effects and monitoring whether the vaccine might curb the coronavirus’s ability to pass from person to person.

Dr. Bell, of UVA Health, is treading cautiously with the unknowns. Perhaps the biggest is transmission, and whether the vaccine will help tame it. He said he suspected that the vaccine would have at least some impact on contagiousness. Once he is fully vaccinated, Dr. Bell might consider making the occasional masked visit to the gym — a luxury he gave up months ago after finding his usual haunt overrun with people who had tossed their face coverings aside.

His wife, Kristen, said Dr. Bell’s vaccination had brought her hope and “a sense of relief — it’s nice to know he’ll have some protection.”

But on other matters, the Bells stand firm. Before the pandemic, their son, Alain, would often greet his father at the door with a friendly tackle. That stopped in the spring. Dr. Bell plans to maintain his routine of discarding his work clothes and showering before engaging with his children.

Alain, who intends on becoming a doctor himself, ideally in outer space, said he was impatient and excited for his own injection. “Most shots are fun,” he said.

But he has also begun to grapple with the pandemic’s true toll. He once asked if he or his father might die of Covid-19. Dr. Bell told his son, “I will try my best not to get infected.”

Dr. Krutika Kuppalli, 42, an infectious-disease physician at the Medical University of South Carolina, where she received her first dose of Pfizer’s vaccine on Dec. 15, said she was giving herself one post-vaccination allowance: a trip home to California to visit her parents and her sister, who is due to give birth at the end of January.

“There’s no way I was going to go if I wasn’t getting the vaccine,” she said.

Because of the unknowns around transmission, she will still quarantine upon arrival, wear a mask and keep her distance from her parents, who are older and have health conditions that raise their risk of severe Covid-19.

But Dr. Kuppalli, who lived with her parents in Palo Alto until August, has been living for four months in isolation in South Carolina, amid a pandemic that shuttered businesses all over town.

Leslie Ryann McKellar for The New York Times

“Since January, Covid is all I’ve eaten, slept and drank,” she said. “And I’m by myself. It’s been a difficult transition.”

Her mother, Veena, was at first anxious to hear about the shot. Now that the first dose is done, with no serious side effects, she is relieved and eager for her daughter’s arrival next month.

“We have always taken the precautions,” she said. “I don’t think there’s going to be any difference.”

Dr. Kuppalli and others expressed some discomfort at being first in line for the vaccine, while so many others in the United States and beyond line up for their own shot at safety. “I don’t think guilt is the right word,” she said. The system of tiers, recommended by government officials to prioritize those at highest risk, made scientific sense. But there was still immense privilege, she said, tucked into the tiny droplets of fluid that were pricked into her right arm this month.

After nearly a year on the front lines of the fight against the coronavirus, health workers are finally receiving a long-awaited coat of armor. It feels strange to wear it, they said, amid the many millions still left without their own chain mail.

Manevone Philavong, 46, who has worked in environmental services at the University of Pittsburgh Medical Center Passavant for 21 years, was among the first in the nation to be vaccinated on the morning of Dec. 14.

He long ago became accustomed to the risks posed by his line of work, which involves cleaning just about “every aspect of the hospital,” he said. When he arrives home from work, he enters through the garage and disrobes in the basement before heading inside, where he lives with his mother and father, who are in their 80s, and his pregnant 30-year-old niece.

Since the start of the pandemic, Mr. Philavong has tried to keep physical distance from his parents. They speak to each other from opposite sides of the living room. His father has had to work alone while tinkering with the family cars — a 2008 Jeep Grand Cherokee and a 2009 Ford F-150 — and tending the herbs and vegetables in the garden. This year, the family skipped their regular trip to Moraine State Park to fish for trout and bass.

When Mr. Philavong told his parents about his injection, they were thrilled. “They said, ‘Now you can spend more time with us,’” he said. “I said, ‘Not quite yet.’

The vaccine provides “a layer of hope,” Mr. Philavong said. “But I’m still going to use every precaution I can.”

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