Vaccines, variants and July Fourth: How to celebrate safely

Is it safe to fire up the barbecue and party like it’s 1999 — or maybe just 2019?

When President Joe Biden set the goal of 70% of all Americans getting  at least one vaccine shot by July Fourth, he dangled the nation’s birthday party as a reward.

"We need you to bring it home," Biden said May 4. "Get vaccinated. In two months, let’s celebrate our independence as a nation, and our independence of this virus. We can do this."

The U.S. won’t quite meet Biden’s target. The Centers for Disease Control and Prevention says 66.2% of adults have had at least one shot (the 70% goal was for adults, not the entire population) and 57.2% are fully vaccinated. For Americans of all ages, the fully vaccinated share stands at 46.4%.

The U.S. spent over a year living under the guidelines of social distancing and wearing masks. Is it safe for everyone to pull out all the stops for the Fourth?

The answer is, it depends.

Public health doctors say it depends on whether you’re vaccinated, and to some extent, where you live. In places where cases are rising, which is likely tied to the spread of new viral variants, more caution is advised.

"If your entire group is fully vaccinated, you can still gather unmasked without fear," said Dr. Megan Ranney, a Brown University physician. "I am looking forward to July Fourth get-togethers with my vaccinated friends this weekend."

The CDC says it’s safe for groups of vaccinated people to celebrate the way they normally would.

For the unvaccinated, the CDC has a chart that walks them through different situations. The not-so-subtle message is, in most situations, a mask is recommended for people who have not been vaccinated.

According to the CDC, an unvaccinated person can ditch the mask at a small outdoor party where everyone else is vaccinated. But take the same outdoor gathering, add other unvaccinated guests, and hold it in a place where cases are rising, and the CDC directive goes back to "Wear a mask."

The national trends for hospitalizations and cases are encouraging. The number of hospitalizations has been tumbling, from over 3,200 in mid-April to 383 in mid-June. 

The only troubling trend is that the fraction of people ages 18 to 49 has steadily grown. They now account for 42% of all those who go to the hospital because of COVID-19.

The younger end of the age range is also the group where vaccination rates lag.

Cases, nationally, are also headed down. The latest rolling 7-day average of new cases is about 4.4% less than the previous 7-day average.

But in a handful of states, such as Nevada, Wyoming and Arkansas, cases have ticked up slightly. While detailed genome testing data are incomplete, lower vaccination rates and the spread of variants are factors in these increases.

The so-called delta variant is nearly twice as infectious as the original coronavirus. 

"As infection rates and the percentage of positive test results start to increase, you can pretty much guarantee that it's because of the delta variant," Ranney said.

She suggested that if infections are rising where you live, you might want to only invite fully vaccinated people to any July Fourth gatherings. And if you don’t know who has or hasn’t taken that step, consider holding your party outside.

The CDC predicts the delta variant will soon account for 45% of infections in a large group of states that span from Missouri to Montana.

Dr. Monica Gandhi, professor of medicine at the University of California-San Francisco, said the U.S. has made huge strides with vaccinations. Many children remain unvaccinated, but Gandhi voiced less concern about the risks to them at a July Fourth get-together.

"Children are at low risk from infection, even though they are unvaccinated," Gandhi said. "But a smaller group of vaccinated adults and unvaccinated children is safest."