Covid Scotland: I've had both doses of the coronavirus vaccine — what now?

Coronavirus travel restrictions in Scotland have been eased and more people will be able to meet up outdoors, thanks to a reduction in prevalence of the virus as well as progress with the rollout of the vaccine.

However, it’s highly likely vaccination rates will play a key role in determining continued progress as restrictions ease.

And as confidence rebuilds, and Scotland emerges from lockdown, plenty of question marks still hang in the air.

And for the hundreds of thousands who have now recieved two doses of the vaccine, they may be wondering - what now?

We asked Dr Georgia Perona-Wright, who is a senior lecturer in Immunology at the University of Glasgow, to weigh in.

Can I still get Covid, after I’m vaccinated?

Yes, you can. The good news though is that it’s very much less likely that you will get covid if you’re vaccinated, compared to someone who isn’t.

Even better, in the unlikely event that you do catch Covid after being vaccinated, you are much less likely to get severe symptoms or be hospitalised than if you had not been vaccinated.

The clinical trials for the Pfizer vaccine reported a 95% efficacy, which means that the number of people who showed symptoms of covid during the time of the trial was 95% lower in the vaccinated group than in a comparison group who were not vaccinated.

Data collected since the trials, as the vaccines have begun to be used widely, has confirmed these numbers, so the vaccines are very effective on a population scale. On a individual scale, though, there is still a chance that you might be one of the very few people who is vaccinated and still gets infected; it is possible, just very much less likely than without a vaccine.

One extra point to add here is that the vaccines take time to work.

The vaccine is not a instant shot of protection; it is a way to train your immune system, so that your immune system will then protect you. It takes 2-3 weeks or so for the immune system to respond so, even if you are someone who has a superb immune response to the vaccine, you are still not protected until 2-3 weeks after the jag.

Some cases of people being infected with covid after the vaccination are because they were exposed to the virus during this 2-3 week window. Be especially cautious during this time.

Can I still infect other people?

Just as the vaccines make it much less likely that you’ll get infected, they also make it much less likely that you will be able to infect others – but in both cases the answer is that the chances are much reduced, but not zero.

We don’t fully understand why some people are fully protected and others are not; it might be that you have a slightly quirky immune system, or are immunosuppressed; it might be that you are exposed to an unusually high dose of the virus.

It might be something in your genes or environment that makes you a particularly good target for the virus.

When the first trials were conducted to test how well the vaccines work, the data that was collected measured the number of people who showed symptoms of disease. This number was reduced 95% in the Pfizer trial.

The trials did not attempt to measure whether vaccinated people could still be infectious. We have some really encouraging data now, collected after the trials from countries where vaccines have been used widely, showing that vaccination does also reduce transmission – meaning that vaccinated people are less likely to infect others than people who are not vaccinated.

This is what we expected and hoped for, and it’s really good to see. This is why being vaccinated not only protects ourselves, but also others.

Viruses cannot live for long periods on their own; they need a person to provide a home.

If you are successfully vaccinated, then your body is trained to refuse entry to the virus, denying it that home.

When only a few people are vaccinated, the virus can fairly easily find another person, another home to occupy. When very many people are vaccinated, finding a home becomes much more of a challenge, and the virus is condemned to a lonely death outside.

The idea of working together by using our immune systems to reduce the number of opportunities that the virus has to gain a foothold and spread is what’s called “herd immunity”.

Even the rare people in whom the vaccine didn’t work very well can be protected this way, as other people’s vaccinations mean that they too are less likely to encounter the virus.

Can I stop wearing a facemask when I’m vaccinated?

No. The importance of a face mask is that it is a barrier to stop you infecting other people.

We still need to be cautious to avoid infection, and to avoid infecting others, until the amount of virus circulating in our communities falls.

The Covid vaccines are one part of our toolkit for reducing the amount of virus circulating. They make it less likely you’ll get infected, less likely you’ll get sick, and less likely you’ll breathe out the virus and spread it to others.

But there is still a small chance that each of these steps can happen, and so facemasks, space and distance are all still needed just now.

The gradual easing of restrictions that is beginning just now is possible because we’ve successfully driven case numbers down, in part through the vaccination programme.

If we can keep this up, then we will get to a point when case numbers are low enough that restrictions will ease yet further, and facemasks might then become optional in more places.

Will immunity last?

We are optimistic that immunity will last – but not yet certain.

The first people to receive the Covid vaccines were only vaccinated 8 months ago, so we know that vaccines can generate immunity that lasts at least 8 months.

We know that the majority of people who have been infected with the SARS-CoV2 virus, that causes Covid, also have persistent immune cells and good antibody levels, even a year after infection.

There was a lot of fear that immunity would not last, and there are been some prominent cases where people have been shown to be infected twice – so in those particualr people, immunity was either not persistent or not ever good enough.

But for the majority of people, infection has led to persistent immunity, so far.

Another piece of encouraging news is that particular immune cells, essential for protection, were still detectable last year in people who were infected in 2003 with SARS, which was a severe infection caused by a similar coronavirus to the one that causes Covid.

So we are optimistic, but will only know for certain when more time has passed.

Another twist here, is whether immunity generated by having one of the current vaccines will be effective against any virus variants: lasting immunity might not be useful, if the virus mutates and can escape that immunity. But there are grounds for optimism here too…

Will I need a booster?

... There are two situations in which a booster might be useful.

The first one is if immunity doesn’t last long enough without a booster, and in that case a third jag is definitely a possible solution.

The second one is if the virus mutates or varies, and we need to update our vaccines to match the new variants. The coronavirus that causes Covid is one that is known to mutate – that’s a normal part of its biology.

The flu virus is another example of a virus that we know mutates, and that’s why flu vaccines are updated and given every year.

But the Covid vaccines have held up well so far: the vaccines currently being used in the UK were designed against the original version of the virus, but have done very well in reducing disease and blocking transmission of the B1.1.7 Kent variant, for example.

The immune response generated by the vaccines is strong, and even if it is two fold less effective against a new variant, there is a good chance the remaining immune response will still be enough to prevent severe disease and slow the spread of the virus.

Another piece of good news is the way that these new vaccines have been designed makes it a relatively simple process to update them, if new variants make that necessary.

If we do need boosters, that too should be achievable.

Will everything go back to normal once everyone has had both doses?

The gradual easing of restrictions that have begun now reflects the success of our collective ability to reduce the amount of virus circulating, and getting people fully vaccinated is a large part of this success.

I hope that this gradual process will continue as the vaccination programme is completed, and more normality will be achieved in each step.

That said, we are still a long way away from everyone having both doses, as we need vaccinations to be completed globally before any individual country can fully relax.

Within the UK, the vaccination programme is currently planned for all adults, but vaccines for teenagers and younger children are only in the stage of clinical trials.

Globally, some restrictions on international travel might need to persist until global vaccination rates increase, and those gobal vaccination rates depend on politics and cooperation between nations.

Another aspect to this question is what normal really means.

The pandemic hit us hard and for people who’ve been bereaved, who have persistent symptoms or Long Covid, or whose jobs and livelihoods have been affected, normal won’t ever be as it was.

And as communities, there are also changes both good and bad.

Will hand sanitiser provision in supermarkets continue? Will working from home always be more possible? Will high streets rejuvenate? There are opportunities for change here, if we want to grasp them; but there may also need to be time to heal and recover.