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When is it a HIPAA violation to disclose proof of vaccination? More COVID-19 questions answered.

When is it a HIPAA violation to disclose proof of vaccination? How can you still catch COVID-19 if you’re vaccinated? And what measures can you take to stay healthy until this latest surge is behind us? These are some of the questions that we’ve put to health and science experts. This resource will be updated as more questions arrive, so check back often. Have your own pandemic question? Send it to the Tribune here. Get the latest Chicago COVID-19 information and updates from the Chicago Tribune on our COVID-19 Facebook page.

When is it a HIPAA violation to disclose proof of vaccination?

According to the U.S. Department of Health and Human Services, those mandated to follow the Health Insurance Portability and Accountability Act (HIPAA) include health plans and most health care providers.

This may be something many misunderstand. According to Andy Reeder, associate vice president and privacy officer at Rush University Medical Center, people may confuse HIPAA with an individual’s desire to assert personal privacy. HIPAA constrains what health care staff can or cannot disclose about someone in their care, but does not typically apply, he explained, in the case of private individuals or businesses requesting information in the interest of public health. For example, asking someone’s vaccine status is not a HIPAA violation. But a doctor sharing a patient’s vaccination status without the patient’s permission is a violation.

What is the risk for breakthrough infections?

According to Dr. Robert Murphy, executive director of the Institute for Global Health at Northwestern University Feinberg School of Medicine, “The vaccine is about 90% effective against the delta variant, so one person in 10 who gets vaccinated and is exposed to SARS-CoV-2 will have a breakthrough infection.”

“Anybody is at risk for it, not just the immune-compromised,” Murphy said. “It’s athletes. It’s totally healthy people. Certainly, the immune-compromised are at a higher risk because they can’t mount a strong enough immunologic response to the vaccine. Older people may also have a weaker response to the vaccine.”

Still, Murphy has some encouraging news for those who are fully vaccinated.

“The end game is most people who get breakthrough infections either have very mild symptoms or no symptoms. They rarely end up in the hospital, and they don’t die,” Murphy said, adding: “The big question is how infectious are they? That’s what we are trying to find out.”

Murphy is among a group of doctors at Northwestern and other universities who are investigating the infectiousness of vaccinated students who got COVID-19, with the results of their study expected in the coming months.

Is the delta variant causing more breakthrough infections?

Mercedes Carnethon, vice chair of preventive medicine at Feinberg, said doctors are seeing breakthrough infections, adding that “while we know that no vaccine is 100% effective, it feels frightening.”

Experts remain unsure why the “rate of infections — both new and breakthrough — appear to be picking up,” she said.

“One concern is the delta variant is evading the vaccines. Another concern is any virus that causes a high viral load would break through vaccine protection — and there is evidence that the delta variant does cause higher viral loads earlier in the course of infection,” Carnethon said.

“We will never get away from these concerns because the virus will continue to mutate itself into new variants so long as it circulates in the population, and the biggest space it has to circulate is among the unvaccinated,” she said.

Should vaccinated people wear masks?

Even prior to Illinois Gov. J.B. Pritzker’s mask mandate for Illinois schools in early August, Dr. Benjamin Singer, assistant professor of medicine in pulmonary and critical care at Feinberg, said, “vaccinated people may still choose to wear masks if they or someone in their household contact is at particularly high risk.”

“In places with low vaccination rates and high community transmission, I think it makes clear sense to add back masking when you are indoors as an additional layer of protection from a more contagious variant,” Singer said.

Should your behavior change if you are an older adult?

“All vulnerable individuals, either due to age or pre-existing conditions, should take precautions because if they are infected or re-infected it may not be a mild illness,” Carnethon said. “The highest rates of mortality consistently have been older adults, which is traditionally defined as 65 and older.”

“However, the risks for severe illness go up with each decade of life, and there is no age cutoff where the risk of illness is significantly lower,” she said. “There are 40-year-olds with the health profiles that we know are associated with severe illness—obesity, diabetes, uncontrolled hypertension, cancer or pre-existing heart disease. Those individuals, regardless of their age, are just as vulnerable as older adults and should also take precautions.”

— Karen Ann Cullotta

It’s now being recommended that pregnant individuals be vaccinated against COVID-19. What changed?

The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, organizations that represent specialists in obstetric care, recommend that all pregnant individuals be vaccinated against COVID-19.

The move is a turnabout from earlier in the year, when data was not there pertaining to pregnant women, vaccinations and clinical trials.

Northwestern Medicine’s Chief of Obstetrics Dr. Emily Miller, a member of the Society for Maternal-Fetal Medicine’s COVID-19 Task Force, helped write the new language from “should not be excluded” to “recommend vaccination.” Miller said that the change is in light of coronavirus cases rising.

“The original data that showed us that the vaccines were safe and effective excluded pregnant people,” Miller said. “So, the national organizations had to temper their recommendation since they had no data on pregnancy — the recommendation was to individualize that decision making based on that person’s risk as far as SARS-COV2 acquisition. We would individualize and not withhold the vaccine, but we didn’t feel like we could initially recommend it just because we had no data. Now we have data that the vaccine works in pregnant people, reduces their risk of COVID-19, and we don’t see any signals that there’s an increased risk of adverse pregnancy outcomes. And so now that we have these data we can say the benefits of the vaccine outweigh the risks.”

Pregnant individuals who have decided to wait until after delivery to be vaccinated may be inadvertently exposing themselves to an increased risk of severe illness or death. Those who have recently delivered and were not vaccinated during pregnancy are also strongly encouraged to get vaccinated as soon as possible.

Miller hopes the recommendation from the professional societies emphasize how important vaccinations are and will help sway some people who have yet to be vaccinated. According to the Centers for Disease Control and Prevention, almost 140,000 pregnant people have been vaccinated.

“I know that it’s stressful, and people want to be safe but I think we have to recognize that it’s not safe to be unvaccinated in a pandemic,” she said. “I think people are forgetting that not getting the vaccine means you’re at risk of infection. Particularly now when we’re entering what is it? Our fourth or 2000th wave?”

Dr. Carmen Adams, obstetrician and gynecologist at Cook County Health, received her first COVID-19 vaccine shot when 37 weeks pregnant. She received her second shot about two weeks before she gave birth to her first child. She said the science behind the vaccines led her to her lightbulb moment to take the vaccine.

“The only vaccines that we don’t give to pregnant women are live vaccines and knowing that made it safe,” Adams said. “I did not want to have a COVID infection close to delivery, with delivery (I was still seeing patients in the hospital basically until I delivered) and I didn’t want to take a chance getting an infection and getting severely sick or having to be separated or isolated from my baby after delivery.”

Adams feels better as a provider to say that practitioner societies are recommending taking the vaccine. And in turn, she thinks her patients will feel more comfortable receiving it.

“I like to tell my patients you should get it to protect yourself so that you don’t get sick, but I also think there’s really good data out there that’s showing that there’s antibodies created from pregnant women that go to the placenta and to the baby that are likely going to protect the baby for several months,” she said. “I like to emphasize that not only can we protect ourselves but likely protect our babies as well and I think that that is encouraging too.”

Chicago public health Commissioner Dr. Allison Arwady said in an August 3rd press conference that the Delta variant is more contagious, but there’s no clear data that the variant is making people sicker or putting them in the hospital more than other variants.

“The thing that is extremely clear is that the vaccines are working really well,” she said. “And where people are fully vaccinated, I’ve not seen anything that has made me change my behavior at this point except putting my mask on inside while we get through this surge. All we can say is here is the data we have now, here’s the recommendation, and stay up with the science of it.”

With the new surge of COVID-19 infections, the Food and Drug Administration has accelerated its timetable to fully approve Pfizer-BioNTech’s coronavirus vaccine, aiming to complete the process by the start of next month, according to reports.

— Darcel Rockett

Can COVID-19 push someone into diabetes?

According to Dr. Sirimon Reutrakul,associate professor in the endocrinology, diabetes and metabolism division at UI College of Medicine, there are some suspicions in the medical community that there’s some association between diabetes and COVID-19. Research is going on to see if there is causation.

There are a number of studies looking at whether some people can develop diabetes after an acute COVID-19 infection. (Two National Institutes of Health-supported studies in the journal Cell Metabolism, center on SARS-CoV-2 targeting and impairing the body’s insulin-producing cells aka beta cells.)

Reutrakul said she’s seen people come in with COVID-19 with new onset diabetes, though not many.

“I think this is why people are trying to do these studies,” Reutrakul said. “I don’t know if you could prevent yourself from getting diabetes if you’ve become infected with COVID-19 that’s a bit extreme. But I think some of the symptoms of COVID-19 and some symptoms of diabetes may overlap (fatigue and weight loss), so that’s one thing to think about.”

Until there’s something definitive, she said people should keep their eye on the science.

Her suggestion: “If you have a fever, sore throat, a runny nose, those are not symptoms of diabetes. If you have COVID-19 and have significant weight loss, drinking/urination a lot, those may be indicating that you might have something else on top of COVID,” so go get checked.

— Darcel Rockett

Illinois has a new mask mandate. Where does it apply?

Gov. J.B. Pritzker issued a new mask mandate for preschool through high school students and staff statewide, effective immediately. Universal masking also will be required in long-term care facilities statewide.

The requirement will apply to all indoor athletic activities in schools, Pritzker said. Masks won’t be required for outdoor sports and activities.

The move comes as a new school year approaches and a fourth coronavirus spike is occurring in the state. Chicago Public Schools, the state’s largest district, had already made the decision to require masks, but other districts have made them optional in the face of vocal opposition from some parents.

“Far too few school districts have chosen to follow the federal Centers for Disease Control and Prevention prescription for keeping students and staff safe,” Pritzker said in issuing the new requirement, which applies to public and private schools, and day care centers. “Given the CDC’s strong recommendation, I had hoped that a state mask requirement in schools wouldn’t be necessary, but it is.”

A vaccine mandate for employees in state prisons, veterans homes and other congregate settings has also been put in effect. The Centers for Disease Control and Prevention changed its masking guideline recommendations on July 27 saying even vaccinated people should return to wearing masks indoors in parts of the U.S. where the delta variant of the coronavirus is fueling infection surges. With the change, local retailers are scrambling to get face masks back on shelves. Here’s a list of recommended masks.

— Dan Petrella, Lisa Schencker, and Madeline Buckley

What do we need to know about the variants, like delta or lambda?

First, many called it simply the coronavirus, then COVID or COVID-19. Now, we are keeping track of descriptors like alpha, beta and gamma, the variants of COVID-19. The World Health Organization created this naming system to make them easier to publicly discuss.

The Illinois Department of Public Health lists COVID-19 variants of concern. As of their most recent data, updated July 26, the original alpha still accounts for the majority of cases, with 6,973 of the total 10,886 cases. Next up is the gamma variant, with 2,641 cases, followed by 636 cases of the delta variant.

Viruses are constantly changing through mutation, which results in new variants, something scientists expect to monitor.

Read our guide to each COVID-19 variant and what to know.

— Alison Bowen

Should we wear masks inside?

The Centers for Disease Control and Prevention recommended July 27 that even vaccinated people wear masks indoors in parts of the country where U.S. cases are increasing.

Previously, the CDC had eased mask guidelines, saying fully vaccinated people did not need to cover faces.

— Alison Bowen

How many minutes is considered exposure to someone with COVID-19?

The Centers for Disease Control and Prevention considers a close contact someone who has been within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period.

But given that researchers are concerned the delta variant might be more transmissible, Dr. Stephen Schrantz, an infectious disease pediatrician at University of Chicago Medicine, said delta’s increased contagiousness “should give the CDC some reason to reexamine its definition of ‘an exposure.'” He added, “I will not be surprised if the CDC does amend its recommendations regarding the duration of contact as more data accumulates.”

— Alison Bowen

When students head back to school next month, should they still wear masks?

According to the American Academy of Pediatrics’ latest guidance for opening schools for the start of the 2021-22 school year, the nation’s pediatricians recommend that everyone older than age 2 wear masks, regardless of vaccination status.

In the AAP’s updated guidance July 19, officials said they are recommending “universal masking because a significant portion of the student population is not yet eligible for vaccines, and masking is proven to reduce transmission of the virus and to protect those who are not vaccinated.” Officials said research has shown that “opening schools generally does not significantly increase community transmission with masking and other safety measures in place.”

Chicago Public Schools had yet to announce its masking policy as of July 21, with just over five weeks until students return to full in-person instruction.

Above all, the AAP is urging all who are eligible to be vaccinated to protect against COVID-19, and is recommending a “layered approach” to ensure schools are safe for all students, teachers and staff. According to Dr. Sara Bode, chairperson-elect of the group’s Council on School Health Executive Committee: “This is why it’s important to use every tool in our tool kit to safeguard children from COVID-19. Universal masking is one of those tools, and has been proven effective in protecting people against other respiratory diseases, as well. It’s also the most effective strategy to create consistent messages and expectations among students without the added burden of needing to monitor everyone’s vaccination status.”

The AAP is also calling for making in-person learning a priority, and advising schools to be prepared to address students’ mental health needs.

What other steps should schools take to keep kids safe?

The AAP underscores the Centers for Disease Control and Prevention’s recommendations for building ventilation, testing, quarantining, cleaning and disinfection into the updated guidance.

“We need to prioritize getting children back into schools alongside their friends and their teachers — and we all play a role in making sure it happens safely,” said Dr. Sonja O’Leary, chairwoman of the AAP Council on School Health.

“The pandemic has taken a heartbreaking toll on children, and it’s not just their education that has suffered but their mental, emotional and physical health. Combining layers of protection that include vaccinations, masking and clean hands hygiene will make in-person learning safe and possible for everyone,” O’Leary said.

— Karen Ann Cullotta

Enduring symptoms of COVID-19 after diagnosis? Illinois is looking to help those long haulers. Which states were added back to Chicago’s emergency travel advisory? These are some of the many questions readers have sent us that we’ve put to health and science experts. This resource will be updated as more questions arrive, so check back often. Have your own pandemic question? Send it to the Tribune here. Get the latest Chicago COVID-19 information and updates from Chicago Tribune reporters and editors on our COVID-19 Facebook page.

Suffering from lingering COVID-19 symptoms after dealing with coronavirus? Illinois looking to help long haulers.

Long COVID-19 is a range of symptoms that can last weeks or months after first being infected with COVID-19 or can appear weeks after infection, according to the Centers for Disease Control and Prevention. Symptoms of long COVID-19 vary greatly — some of the most common symptoms include fatigue, difficulty breathing, difficulty concentrating, body or muscle aches, problems with taste or smell, trouble sleeping, feeling anxious or depressed, dizziness and weakness — and the risk of becoming a long-hauler increases with the severity of illness after infection.

It can happen to anyone who has had COVID-19.

Estimates suggest 10% to 30% of people who get COVID-19 will develop long COVID-19, according to Dr. Jerry Krishnan, University of Illinois Chicago associate vice chancellor for population health sciences and professor of medicine and public health.

“The CDC estimates that about 33 million Americans tested positive for COVID-19, which means 3 to 10 million Americans likely have or have had long COVID,” Krishnan said.

National and local initiatives are being formed to understand and treat patients with the condition.

In December, Congress provided $1.15 billion in funding over four years to the National Institutes of Health to support research into the prolonged health consequences of long COVID-19. The initiative called RECOVER, or Researching COVID to Enhance Recovery, is designed to learn whether differences in long COVID-19 risk are due to different virus variants, host response (ability to fight the virus infection and to heal after the infection is cleared) and the social determinants of health.

UIC has been selected to lead an Illinois-based team for the U.S. RECOVER consortium. Krishnan is a part of the team spearheading the efforts to bring health centers, community-based organizations and faith-based organizations in Chicago, Peoria, Rockford and Urbana together to form a network of state resources for a directory that can be available to people with long COVID-19.

There is no test for long COVID-19, Krishnan said. Serology tests used to look for antibodies in the blood are the best gauge for diagnosis, he said. Finding a doctor who knows about testing and best practices from current data is necessary to prevent confusion with other health conditions, he said.

“We’re going to have to rethink where to care for these individuals,” Krishnan said. “The other piece is we got to be careful because we don’t know yet what to do for these individuals.”

To join the RECOVER study without a doctor referral, reach out to PASCProject@uic.edu.

— Darcel Rockett

Which states were added back to Chicago’s emergency travel advisory?

Missouri and Arkansas are the only two states where unvaccinated travelers returning to Chicago will be asked to abide by quarantine or COVID-19 test requirements, according to the Chicago Department of Public Health. The list is updated every two weeks and travel guidance on new states goes into effect on July 16.

Missouri and Arkansas were added this week because they met the threshold of at least 15 daily cases per 100,000 residents. Once a state breaches that ceiling, travelers returning from there to Chicago are advised to be fully vaccinated, quarantine for 10 days or test negative for COVID-19 no more than 72 hours before arrival.

Since the start of June, no states had been on the city’s COVID-19 travel restriction list thanks to vaccinations. But as the more contagious delta variant began spreading and states hit a wall with vaccine outreach, positive tests began creeping up again. That variant has become the dominant strain in the country.

— Alice Yin

What do we need to know about the delta variant?

Local health officials say nearly 10,000 cases of the various COVID-19 variants reported in Illinois as of June 27 are not yet cause for alarm.

Chicago public health Commissioner Dr. Allison Arwady said residents shouldn’t be concerned with the World Health Organization’s recommendation that fully vaccinated people should wear masks indoors because of the highly contagious delta variant.

Gov. J.B. Pritzker said June 28 that the delta variant already is a “growing presence in Illinois,” and officials expect it to be the dominant strain statewide by fall.

Dr. Emily Landon, chief health care epidemiologist at the University of Chicago, said the delta variant is “even more contagious than the alpha variant,” but vaccination efforts throughout the state should keep the spread limited.

“Fully vaccinated people really don’t need to be concerned,” Landon said. “All of the vaccines that are available in the U.S. work well with the delta variant but don’t work as well as protecting you from the original COVID. But, we’re talking about 95 and 90%, which is not significant enough to make me want to change how people are behaving.

“Where you see fewer vaccinated individuals, you’re more likely to have an outbreak. When you have COVID spreading in your community, everybody is at higher risk, including the people that are vaccinated. Certain communities, certain parts of the country are more likely to be protected because they have more people who are vaccinated.

“Unvaccinated children are still unvaccinated. Even if the rest of the family is all vaccinated, if you take unvaccinated kids to a COVID hot spot, they could get it and bring it back to your community and spread it.”

Read more here.

— Shanzeh Ahmad and Alice Yin

Will extended mask-wearing affect our susceptibility to germs?

Dr. Sindhura Bandi, an allergy and immunology specialist and associate professor of medicine and pediatrics with Rush University Medical Center, said that social distancing and masking will not weaken the immune system.

“By adulthood, we have come into contact with many types of viruses and bacteria,” she said. “Our immune system has created memory to these pathogens, so that when we come into contact with them we can make antibodies to fight off the disease.”

Vaccines are important for novel pathogens, like COVID-19, she noted.

— Alison Bowen

What types of childhood illnesses are cropping up this summer?

Dr. Rosibell Arcia-Diaz, a pediatrician with Cook County Health, said June 22 that this month doctors have seen a few kids with rashes, and many children with runny noses who have contracted viruses, including the rhinovirus, a cold that is common during the summer months.

While RSV — respiratory syncytial virus — lingered a little longer than usual this year, Arcia-Diaz said that with school out for the summer, pediatricians have not seen a lot of strep throat, which she said is easily transmitted by students in classrooms.

Still, Arcia-Diaz warned that parents who have not taken their children to see their pediatrician since COVID-19 arrived nearly 16 months ago should ensure this summer that their family is up to date on wellness checks and immunizations.

And for children age 12 and older, parents can check with their pediatrician to see if the COVID-19 vaccine is available.

“We’re definitely encouraging parents to be proactive, and to schedule their children’s appointments early on this summer, so the kids will be caught up on their immunizations before the start of the new school year,” Arcia-Diaz said.

Why is mask shaming still happening now that Illinois has reopened?

The Centers for Disease Control and Prevention no longer recommends that fully vaccinated people wear a mask in many situations, but masks are required on buses, planes and trains, and in hospitals, prisons, homeless shelters and businesses that require them. It’s recommended that unvaccinated people continue to wear masks in many public settings.

But seeing a mask on strangers may trigger some people to offer a negative opinion, leading to a round of mask shaming.

Laurie Zoloth, a bioethicist at the University of Chicago who has advised federal health agencies and considered many of the complicated moral questions raised by the pandemic, says the move is one of the political differences playing out in the public arena.

As she describes it: “There was a moment for every one of us when we realized that we were being overcome by an extraordinarily powerful force (the pandemic) that we couldn’t control. People reacted to it in two very different ways. Some people wore a mask, saying I take this seriously, I’m in reality and I’m cautious. For others, the mask served to remind them of a painful truth they would rather deny. For those people, seeing someone wearing a mask is very destabilizing, because here’s someone wearing the visible sign of catastrophe, and they don’t want to be reminded of that tragic reality. One way to do that is to politicize it and to mock it and to make the person wearing the mask feel like they have it wrong. Then they reassert their vision of reality. That’s what’s behind the politicalization (of masks).”

Zoloth says folks shouldn’t be shamed for wearing masks or not feeling like the pandemic is completely over.

“You could be wearing a mask because you have an autoimmune disease, or because you’re not fully vaccinated, or because you live with someone whose health is considered fragile, or you just had surgery or any number of health conditions that really are not anyone else’s business,” she said. “Understand that putting one on is not an admission of defeat or signal that you’re neurotic. It’s just a sign that you understand how profound this pandemic was and how it still represents a threat. We should be really humble and understand how much further we have to go.”

— Darcel Rockett

How prevalent is the Delta variant in Illinois?

The Illinois Department of Public Health has identified 64 cases of the variant, a COVID-19 strain first found in India that federal health officials have labeled a “variant of concern.”

The state’s health department has identified more than 9,400 variant cases of the virus in Illinois, more than 6,300 of which are the Alpha variant, first found in the United Kingdom. The next biggest slice comes from the Gamma variant, first identified in travelers from Brazil, with more than 2,400 cases.

Though identified cases of the Delta variant make up the smallest number of variants in Illinois so far, the Centers for Disease Control and Prevention has estimated that it may account for about 10% of emerging COVID-19 infections in the United States.

Speaking to NPR on June 17, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, urged people to get vaccinated to help combat the spread of the Delta variant.

“If you are vaccinated, you’re going to be protected, which is another very good reason to encourage people strongly to get vaccinated,” Fauci told NPR’s “Morning Edition.” “If you are not vaccinated, you are at risk of getting infected with the virus that now spreads more rapidly and gives more serious disease.”

— Madeline Buckley and Dan Petrella

Should people who have already been fully vaccinated with Moderna or Pfizer, also get a J&J shot? Will this improve protection?

“There is no evidence that extra doses of vaccine are necessary at this time,” said Dr. John Segreti medical director of infection control and prevention at Rush University. “The response seems robust, durable and real-life surveys have confirmed high level of efficacy seen in the trials.”

He added that no matter which vaccine, the only way a vaccinated person can add to their protection is by helping get others vaccinated.

— Alison Bowen

When we get a booster shot, will it have the same level of side effects?

We don’t yet know if booster doses, which augment vaccine effectiveness, will be needed, noted Dr. John Segreti of Rush University. He added that there are several booster studies underway that should inform us of the possible side effects.

— Alison Bowen

I donate whole blood every 8 weeks. Should I be concerned about donating blood after the vaccination process? Will losing blood affect my immune response?

According to a statement from the American Red Cross, there is no deferral time for eligible blood donors who are vaccinated. Donating blood after receiving a vaccine does not reduce protection from the virus, the American Red Cross said. Similar to other vaccines such as measles, mumps or influenza, the COVID-19 vaccine generates an immune response to help protect from illness; this is not affected by giving blood.

— Alison Bowen

What are the guidelines for phase 5 in Chicago and Illinois?

Here is a guide for what to expect.

When does phase five start? Friday, June 11.

Where will masks still be required? Masks will still be required for everyone, even vaccinated people, on public transit, at the airport, and in schools, hospitals and other congregate settings. The state is now adjusting guidelines for outdoor mask wearing at schools, dropping the requirement in most situations.

What should people who aren’t vaccinated do? The state recommends unvaccinated people should wear masks — and stay socially distanced — in crowded places inside and outside.

With the recent easing of COVID-19 restrictions coinciding with seasonal gatherings like graduation parties, how can we safely mingle in social settings with friends and family members who are not vaccinated?

Dr. Robert Murphy, executive director of the Institute for Global Health at Northwestern University Feinberg School of Medicine, said vaccinated people who don’t have immunodeficiency (meaning no active cancers, no organ transplants, no one on immunosuppressive therapy) “are very safe from getting symptomatic COVID-19, hospitalization and death. A relatively small number may get infected but for the most part, without symptoms. They essentially have no restrictions and no longer have to use masks except in hospitals, medical facilities, long term care residences.”

Murphy noted that local or state regulations “may be more strict, for now anyway.”

He also pointed out that unvaccinated people “will continue to become infected, about 15% will get very ill and may end up in the hospital, and 1-2% will die from COVID-19. This is where the epidemic is going now.”

Many local stores have signs saying masks are optional but recommended for those who aren’t vaccinated. But should those of us who are vaccinated still wear a mask indoors, at least for the short term?

Murphy’s response was no. “I follow the science,” he said. “Masks are no longer needed for fully vaccinated persons in most situations indoors or outdoors.”

For families who are planning summer vacations, but have kids under 12 who are still too young for the vaccine, is there a safe way to travel that would mitigate risk for the unvaccinated?

“Not really,” Murphy said. “Vaccines are now approved at 12 years and older. Younger children, if they do get infected, typically have very mild disease if otherwise healthy. They will be at risk for infection like everyone else who is not vaccinated. They just handle the infection better.”

— Karen Ann Cullotta

Swollen lymph nodes have been mistaken for cancer after Pfizer and Moderna vaccination shots. Does J&J have the same possibility, even though it approaches the coronavirus in an entirely different way?

Dr. Deepa Sheth, a radiologist and breast imaging specialist at the University of Chicago Medicine, says all the recent research journal articles focus on the Pfizer and Moderna vaccines, so there isn’t any data yet on the Johnson & Johnson shot

“But the prior guidelines and recommendations should theoretically remain the same since this vaccine also boosts your immune response,” she said. “Getting a COVID-19 vaccine might result in swollen lymph nodes under the arm in which the injection was given. These swollen lymph nodes under the arm might show up on a mammogram done to screen for breast cancer.”

Women are encouraged to wait four to six weeks from the date of their last COVID-19 vaccine before undergoing a routine screening mammogram. But if one has any breast-related complaints (i.e. skin changes, nipple discharge, breast mass, breast pain, underarm swelling), Sheth said don’t delay coming going in for a mammogram.

— Darcel Rockett

Where do I need to wear a mask under the new Illinois and Chicago guidelines?

The Centers for Disease Control and Prevention revised its guidance on where people need to wear masks, saying that those who are two weeks past their vaccines can mostly return to pre-pandemic activities without masks.

Following those recommendations, Gov. J.B. Pritzker announced new guidelines that put Illinois in line with the new federal guidance. In Chicago, which has at times maintained separate rules from the state throughout COVID-19, public health Commissioner Dr. Allison Arwady said Tuesday that fully vaccinated people can go maskless in most settings, but some businesses will be strongly advised to maintain mask requirements.

According to that guidance, people who are fully vaccinated should still wear masks in health care settings or while riding trains, buses, planes or other forms of public transportation, as well as including at airports, bus stations or train stations.

— Alison Bowen

Should pregnant women feel safe taking a COVID-19 vaccine?

According to the Centers for Disease Control and Prevention, the answer is yes.

Agency Director Rochelle WalenskyCQ announced the recommendation during an update on the pandemic at a White House briefing Friday, April 23. She noted that a CDC study published this week found no safety concerns with Moderna and Pfizer vaccinations given during the third trimester of pregnancy.

The new study is based on reports from pregnant women who got shots soon after the vaccines became available. The researchers called for more data, including from vaccination earlier in pregnancy.

Pregnant women were excluded from COVID-19 vaccination studies, although there is limited safety data on some who became pregnant after enrolling.

“We know that this is a deeply personal decision, and I encourage people to talk to their doctors or primary care providers to determine what is best for them and for their baby,” Walensky said.

— Associated Press