Last year, the predominant public health advice before Thanksgiving and other holiday gatherings was simple: don’t go, but if you must, be really, really careful. This year, now that all American adults, along with children over age 5, are eligible to receive at least one of an arsenal of highly effective vaccines, many infectious disease experts cautiously acknowledge that the risks of gathering are generally lower.

Still, you would be hard-pressed to find a COVID-19 expert willing to declare Thanksgiving 2021 fully “safe.” The reality, they say, is that there is going to be some amount of risk of spreading the virus; families who are considering gathering will need to decide how much risk they’re willing to accept, both in terms of their own health and those they’ll be spending time with.
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Consider Who’s Most At Risk

As you’re deciding what precautions to take, or whether to travel at all, keep in mind the people you’re trying to protect. The most important goal is to keep safe those who are at risk of severe disease or dying from COVID-19, says Denis Nash, professor of epidemiology at the City University of New York and co-founder of the CHASING COVID Cohort Study, a research project designed to understand the virus’ spread. Even if they’re vaccinated, people who are older or have pre-existing conditions are still at higher risk of ending up in the hospital or dying of the coronavirus.

Of course, not being vaccinated puts people at much higher risk of severe COVID-19. Unvaccinated adults are about 12 times more likely to end up in the hospital than vaccinated people, according to the U.S. Centers for Disease Control and Prevention.

It’s also worth considering the safety of children who are too young to be vaccinated or are only partially vaccinated. Although it’s true that kids are at lower risk of severe COVID-19 than older people, that would be cold comfort if your child ends up in the hospital. “There are no guarantees,” says Shruti Mehta, a professor of epidemiology at Johns Hopkins Bloomberg School of Public Health. “The problem is that statistics don’t tell [parents] what’s going to happen to their child.” In addition, unvaccinated children can still be carriers of the virus even if they don’t suffer related symptoms, which means they can unknowingly pass it on to those who are at higher risk of severe disease, like grandparents.

Once you’ve identified who’s at greatest risk, the next step is to consider how you can protect those people. For instance, if you have a young, unvaccinated child, the “safest scenario,” says Mehta, is if they’re surrounded only by people who are vaccinated. She emphasizes that when someone you’re gathering with is unvaccinated, it’s especially important to layer on other protective measures, such as reducing other social activities and masking around the time of the visit.

For her part, Mehta has been thinking about how to keep her elderly father safe over the holidays. She says that she’ll make sure he’s had a booster and throughout the season gatherings, will only come in contact with vaccinated, masked people. “That’s the best that we can do,” she says.

Know Who’s Vaccinatedor Had a Booster

It isn’t foolproof, but the best thing you and your loved ones can do to protect yourselves from COVID-19 is to get vaccinated. Fortunately, more people are eligible for vaccination than ever before: children as young as 5 can now receive the Pfizer-BioNTech vaccine.

Before you agree to attend the Thanksgiving feast, speak to the other guests about whether or not they and their families are vaccinated. “It’s always important to have conversations well in advance with everyone involved about the plan to gather safely,” says Nash.

You and your loved ones may be able to further strengthen your immunity by receiving a booster shot. Boosters are currently recommended for people at high risk for severe COVID-19—including those over age 65 and who have certain health conditions, or are at increased risk because of where they live or work. They’re also recommended for anyone who initially received the J&J shot. However, the Food and Drug Administration is expected to expand eligibility for booster shots soon, and more adults could be eligible for shots as soon as Friday.

Think About Where You’re Going … and Where You’re Coming From

The spread of COVID-19 isn’t just about our own behavior—it’s also about what’s going on in our communities. That’s why you should keep an eye on how quickly the virus is spreading in your local community, as well as in the community you’re traveling to.

Dr. Jill Foster, a professor of pediatrics at the University of Minnesota, says that if the parent of an unvaccinated child asked her if they should travel, “I think the first thing to ask is where they’re going,” she says. “The number of infections is very low in New York; I would feel very safe taking an unvaccinated child to New York. I’m now in Minnesota, which has some of the highest [daily case] rates in the entire country right now. And so I wouldn’t bring an unvaccinated child to Minnesota.”

What Else Are You Doing to Reduce Risk (Besides Getting Vaccinated)?

Beyond getting vaccinated, infectious disease experts say it’s important to keep up the now-familiar pandemic safety measures: social distancing, masking, washing your hands and considering eating outside.

There’s promising evidence from last Thanksgiving that efforts to slow transmission can make a difference. In research published by Scientific Reports in August, Mehta and colleagues from Johns Hopkins found that people who traveled for Thanksgiving were only more likely to test positive for COVID-19 if they’d also participated in lots of other activities that put them in contact with people in the weeks before and after the holiday.

One big lesson for this year, says Mehta, is not only to think about the holiday itself, but all the other gatherings we’re taking part in around that time. “I think it’s this idea that if you’re going to do one thing, you can’t do all of the others,” says Mehta. “If you’re going to travel, just limit the other pieces. Don’t go to a restaurant every day the week before you travel.”

Consider Waiting Until Next Year

If you ultimately decide that the risks posed by gathering for the holidays are too great, your best option might be staying home. That’s especially true for those who are unvaccinated, and even more so if they’re at higher risk for COVID-19, or expect to be in contact with someone who is at high risk in the near future. In those cases, “really think twice,” says Mehta.

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