In addition to the big, juicy turkey on the table, there’s also an elephant lurking in the room this Thanksgiving: the vaccination status of your guests.
It’s a tricky thing to talk about. Do you ask your aunt if she received the COVID vaccine after she RSVPs? What if she says no? Do you endure another scaled-back celebration, like last year? Or should you serve up a bunch of precautions?
According to a Marist Poll published in September, most Americans (nearly 80%) say they have gotten or will get a COVID vaccine, but nearly 20% still say they do not intend to be vaccinated.
That doesn’t sit well with some of the people who have already rolled up their sleeves. A recent Harris Poll found that half of the more than 1,400 vaccinated respondents were either “extremely” or “considerably” hesitant to spend the holidays with unvaccinated family members or friends.
For some, the risk of celebrating with unvaccinated friends and relatives just isn’t worth it. But if you’re open to gathering with a mixed vaccination status group, there are ways to do it cautiously, experts say.
“Be not afraid, but be reasonable,” said Dr. Juan C. Salazar, a pediatric infectious diseases specialist and physician-in-chief of Connecticut Children’s in Hartford, Connecticut. You can still get together, he said, but each family will need to ask one crucial question: “What is the likelihood that we will get very sick from COVID-19?”
If you’re uncertain of how to proceed (or whether you ought to gather at all) we asked several experts for ideas on how to make Thanksgiving safer for everyone.
Make it a shared problem to be solved.Start by calling your unvaccinated family members and soliciting their ideas on how to gather safely, said Daniel L. Shapiro, an associate professor of psychology at Harvard Medical School and the author of “Negotiating the Nonnegotiable: How to Resolve Your Most Emotionally Charged Conflicts.”
Ask: “What’s your advice on how we can make sure everyone feels safe and comfortable when we get together?” he suggested. Then come up with some ideas. Perhaps you suggest that there should be mandatory testing right before dinner, or that you should gather outside, near a patio heater.
“Try not to judge any ideas right away,” Shapiro advised. “Some ideas will be better than others, and by brainstorming together as a family, everyone can take more ownership over the chosen idea. A warning, though: If you go this route, make sure you stick to joint brainstorming and don’t slip into political debate.”
Use rapid testing to reduce risk.According to the Centers for Disease Control and Prevention, taking a coronavirus test before a holiday celebration can reduce the risk of spreading the virus, particularly when people from multiple households and different parts of the country mix.
Rapid antigen tests, which can indicate within minutes whether someone is contagious with COVID-19, are the best options, said Dr. Michael J. Mina, an epidemiologist at the Harvard T.H. Chan School of Public Health and a co-author of a recent New York Times editorial about the usefulness of home testing.
“Everyone knows if they come to my house, they are going to be tested,” he said.
Mina, who is hosting Thanksgiving dinner this year (and also has a newborn), will offer rapid antigen home tests to each of his guests, regardless of their vaccination status — and his family will use them as well. Any guests who are positive will need to leave.
Taking the test just before entering someone’s home is ideal, because the results only reflect whether you have a lot of virus in your nose at that very moment, he added.
If your family members balk at the idea, remind them that an infected person can easily spread the virus to other people, even if they don’t have symptoms. And while the vaccine is very good at protecting against severe illness and death, the latest data suggest that immunity against infection may be slowly waning for vaccinated people.
“If a rapid test says you’re positive, then that is a very reliable indication that you are infected and infectious,” said Eleanor Murray, an epidemiologist at the Boston University School of Public Health. “You should not be around other people.”
Rapid tests are sometimes in short supply, but can be found at retailers like Amazon, Walmart, Kroger, CVS or Walgreens, both online and in stores. Many of them are pricey, often costing around $24 for two tests.
Keep an open mind when talking to relatives about the vaccine.People may decide not to get vaccinated for a variety of reasons, so try not to make assumptions about their rationale, the experts said. Instead, ask questions and listen.
If they have a fear of needles (something called trypanophobia, which can occur in adults and children), perhaps you might ask if you can accompany them to the vaccination site and hold their hand. Or if they say they haven’t been vaccinated because they haven’t had time to schedule an appointment, you might ask if you can assist them in doing that. “That one-on-one conversation approach really does help,” Murray said.
The Pfizer-BioNTech and Moderna vaccines require two shots spaced three or four weeks apart, and full protection comes two weeks after the second dose. If your relatives want one of these vaccines and haven’t yet received a first dose, they’re out of time to get fully vaccinated before Thanksgiving. But there is plenty of time to do it before Christmas — and they can get one shot now, which will provide some protection before Thanksgiving, Murray said.
Alternatively, there’s still time to get fully vaccinated with the one-shot Johnson & Johnson vaccine, but it is not as widely available as the mRNA vaccines, nor is it considered as protective as a two-dose regimen.
Think about masks, ventilation and the size of your party.Your family may not have the money to spend on pricey rapid tests. But there are other things you can do to stay protected.
Regardless of whether your guests are vaccinated, one of the safest places to gather is outdoors. If you are attending an indoor gathering, open the windows and — if you have the extra cash — consider buying a HEPA air purifier to reduce the amount of airborne virus, Mina said.
The CDC recommends that everyone, including children 2 years old and up, wear a mask if any guests are at increased risk of serious disease, have a weakened immune system or are unvaccinated.
If you’re the one hosting Thanksgiving and you have unvaccinated family members, consider limiting your gathering to no more than 10 people and two households, Salazar suggested. “This is not yet the year where 30 people can gather in one household,” he added.
But if everyone in attendance is fully vaccinated and nobody has viral symptoms or any risk factors for serious disease, he advised that gatherings could potentially go up to three family groups or 15 people.
“Nothing is foolproof,” he added, including the vaccine.