Within every family, there’s almost always a touchy subject best avoided during the holidays — politics, perhaps, or an ongoing issue that can’t seem to stay buried.
This year, however, there’s one question many people will likely need to ask one another if they plan to visit in person during the holidays: Have you been vaccinated?
For some, this may be a sensitive subject and cause friction between loved ones who do not share the same views about how to best protect themselves and others during the COVID-19 pandemic.
We spoke with health experts about the best way to approach the subject with family and friends, what to do if they respond negatively, and how to evaluate your risk if you decide to spend the holidays with loved ones who aren’t vaccinated.
Holiday gatherings often bring people from multiple households together, where they spend long periods of time indoors eating, drinking, and talking in close quarters.
Hannah Newman, MPH, CIC, director of epidemiology at Lenox Hill Hospital in New York, says that vaccination is the key to assuring the health and safety of all while resuming more normal pre-pandemic activities.
“Getting vaccinated is a safe and effective way to protect ourselves and each other. Not only does it prevent severe disease, hospitalization, and death, but it also stops the chain of transmission, especially to those who are at risk for more severe disease and/or who are not yet eligible for vaccination,” she said.
Vaccination is potentially a hot-button topic. But it doesn’t have to be.
Victoria Albina, NP, MPH, a holistic nurse practitioner and life coach, says that if you go into the conversation labeling it or expecting it to be a difficult one, it more likely will be. That approach can also create additional anxiety for you.
“There are so many decisions we make for our health every day that don’t feel hard because we’re not telling ourselves that they are hard. It’s not hard for me to choose to put on my seat belt in a car, or take a vitamin, or avoid foods I am allergic to. We have the option to choose our thoughts around any situation,” she said.
The advantage of asking about vaccination in advance, Albina added, is being able to gather enough information and having enough time to sit with it to make decisions and set boundaries in a thoughtful way.
“Asking in advance gives you a chance to have more time to be thoughtful and eloquent in your response, and also gives more time to reflect on how you feel and stay aligned with actual wants and needs,” she said.
“It’s easier to do that when your emotions and nervous system are regulated, since many of us may not have the skills we need to stay regulated when faced with social pressure on the spot,” Albina added.
From a medical standpoint, Newman says it’s a good idea to hold discussions about expectations and behavior early, so everyone is on the same page about safety measures by the time the holidays are here.
“It’s important to note that vaccinated individuals do not reach their maximum protection until 2 weeks after the final dose. In the two-shot mRNA series, that means 5 weeks for Pfizer and 6 weeks for Moderna since there is a waiting period between doses,” she said.
“Therefore, it’s better to have these conversations now, so those choosing to be vaccinated will have maximal protection before it’s time to gather,” Newman said.
He says it’s important to show your friends and family that you understand how they feel, and to remember you don’t necessarily have to agree with the other person to validate their experience.
“If your goal is to maintain the relationship with your friends and family, despite how difficult the subject matter of the conversation may be, be gentle in your approach. This means no attacks, threats, judgments or sneering. Be as respectful as you possibly can,” he said.
Albina also suggests being clear on your “why” before you have the conversation. This way, you can try to stay in an emotionally neutral place.
“We can’t control other people’s choices. Talk only about what you will do to take care of yourself, and don’t make it about them in any way. Keep your focus and the focus of the conversation on what you will or won’t do.
“Open, honest communication is resentment prevention. When we take time and put effort into our relationships to ask for what we want and need, then everyone in the situation gets to make the most self-loving choice based on knowing the facts.
“When we let conflict avoidance and people pleasing get in the way of asking for what we need, we set ourselves up for more potential conflict,” Albina said.
If you decide not to attend a holiday gathering because unvaccinated people will be there, you may get a less than positive reaction.
However, experts say it’s important to remain calm and refrain from reacting emotionally.
“It’s OK to feel sad, but you don’t have to choose to borrow their thoughts, words, judgments or feelings. We can choose our own thoughts and feelings, just as everyone is choosing theirs,” Albina said.
“If someone rejects us for taking care of ourselves or can’t respect our decision to take care of ourselves the way we see fit during a global pandemic, it may be time to consider whether that is someone you want in your life anyway,” she said.
Lewis notes it’s important to practice acceptance of the situation as it is — which, to be clear, does not mean you agree with the other person.
“Negative or invalidating responses from loved ones can be difficult to manage. They can even be painful at times when important facts in your life are ignored or denied,” Lewis said.
“Practicing acceptance means you choose to live in reality and continue with your daily activities without spending extra time thinking or talking about the negative responses,” he said.
To evaluate your COVID-19 risk at a holiday gathering, Newman says you should consider several things, including the vaccination status of others attending, local transmission rates, the ventilation of the space in which the gathering will be held, and whether masks will be worn.
“The best thing you can do to protect yourself is to get fully vaccinated,” she said. “Vaccination not only prevents severe outcomes, but stops the chain of transmission to others around you who may be more vulnerable.”
After getting vaccinated, Newman says each additional preventive measure you take is a layer of protection, and each has an additive effect.
The more layers you can put in place, the more confidence you can place in your safety.
“Think of it as a shield and armor. If COVID-19 are the arrows, it’s good to have a shield (vaccination), but it’s even better to have a shield and armor,” she said.
“If there are different households gathering, the safer option is to try to stay outdoors rather than indoors. If gathering indoors, we should be looking at ways to optimize ventilation,” Newman said.
Ultimately, Albina says if you’re vaccinated and are comfortable with your personal precautions, you may decide attending a holiday gathering with others who are unvaccinated is a risk you’re willing to take.
“Ask yourself what your risk tolerance is,” Albina said. “If you are expecting to see a family member or friend who lives across the globe and you may not get to see them again for a few years, or if there’s an elder family member who may not be with you for much longer, you may decide it’s worth the risk, and choose to stay masked.”
If you decide not to participate in a family gathering due to COVID-19 concerns, Albina says it’s important to give yourself space to feel the emotions you’ll have following your decision.
You may feel sad. Albina points out that’s OK, but to remember it’s your job to take care of you and your health. You’re not doing anything wrong by deciding not to attend.
“Prioritize being kind, which to me means being honest, direct, and loving,” Albina said.
She suggests reminding family members that it’s a hard decision for you, that you love them, and you’re sorry if they don’t understand your choice.
You may also want to offer to call or video chat with others at the gathering while it’s happening.
She also said making alternative plans with others is something you shouldn’t feel guilty about, and that you should give yourself permission to celebrate the holidays in a way in which you feel safe.
“Many people don’t spend holidays with their family of origin and lean on their chosen family. If you have friends who are vaccinated and agreed to be COVID careful together, lean on that community,” Albina said.