How to Manage COVID-19 Anxiety After You’re Vaccinated

You and your fully vaccinated friend plan a long-overdue happy hour. But as the date nears, concern and dread grow. 

The COVID-19 vaccines are proving to be highly effective at preventing hospitalization and death, and the Centers for Disease Control and Prevention (CDC) says that if you are fully vaccinated, it is safe to go maskless in most places. So why do you feel anxious about this safe social interaction?

Dr. Kristen Lindgren, a psychologist and co-director of the Trauma Recovery Innovations research program at the Psychiatry Clinic at UW Medical Center – Roosevelt, explains why you might feel fearful about these situations, even once you’ve gotten your COVID-19 vaccine — and how to deal with this re-entry anxiety.

What causes re-entry anxiety? 

Since March 2020, COVID-19 has drastically changed the way we live and what we perceive as unsafe.

“What we’ve learned is that being around people is dangerous, and that not wearing masks is dangerous,” says Lindgren. “We’ve learned this in a time where there was threat and danger.”

The threat of COVID-19 causes fear-based learning — a specific type of learning not easily forgotten.

“Fear-based learning is particularly sticky,” says Lindgren. “We know that the learning people acquire in the context of fear is more robust. It lasts longer and it doesn’t take much for those things to become a habit.”

Lindgren says that the reason behind this has to do with our survival instincts. In response to something that puts our health at risk — such as becoming infected with COVID-19 — we rely on our ability to quickly learn how to survive and then automatically commit these skills to memory (often without even realizing it).

So, when you learned that staying 6 feet away from someone and wearing a mask can help protect you from COVID-19, it really stuck.

The flip side? It also means that being in close proximity with others without a mask goes against what you learned and can make you feel unsafe — even if you’ve been vaccinated.

Retrain your brain

Shaking off a traumatic event like COVID-19 isn’t an easy task — especially as variants emerge, the virus continues to spread and public health experts share conflicting opinions about the CDC’s guidance for fully vaccinated people to go maskless in most situations.  

“When the threat shifts, it means we’re going to have to double down and learn that it isn’t as dangerous now,” Lindgren says. “A big part of it is unlearning, and that unlearning takes work.”

So how do you “unlearn”?

The first step is to recognize when your body feels fearful or anxious in a situation that is no longer a threat.

For instance, let’s say you decide to meet up with that fully vaccinated friend for happy hour at an outdoor bar. It may be the first time you’ve removed your mask around someone outside your household in over a year — and it’s a situation that your brain has recognized as “unsafe” since the start of the pandemic.

“That anxiety signal might be going off, and we have to learn not to give it the weight we used to,” says Lindgren. “Acknowledge that fear. Say to yourself, ‘It makes total sense, and I need to learn and experience directly that it’s not as risky.’”

By acknowledging that those feelings of fear are normal but do not reflect the actual risk of the situation, you can retrain your brain to give those feelings less weight. With practice, that anxiety signal will diminish.

Take small, thoughtful steps

As you retrain how your brain responds to fear, consider the environment you want to immerse yourself in.

For instance, if removing your mask at a dinner party with fully vaccinated friends sounds overwhelming, start with something that feels safer and more approachable, such as picnicking in a park with a friend. 

Lindgren says another way to re-introduce yourself to social activities is by starting with a short period of time and gradually increasing the length of time as you get more comfortable.

“Choose something that you have been excited to try and that you’ve missed, and have that learning happen then,” says Lindgren.

If you’re invited to a dinner party and you don’t feel ready for it (or just lost interest in doing that sort of social activity), Lindgren offers some advice on what to say.

“You can say, ‘I’m not ready for this quite yet or my taste has changed, and that isn’t my jam anymore — but I’d love to do this instead,’” she says.

By suggesting an alternative way to socialize with a friend — whether it be going on a walk, grabbing takeout and eating at a nearby park, or hanging out in someone’s backyard — you can find a more comfortable way to engage with the people you’ve missed.

When to seek help

If you do decline an activity, it’s important to ask yourself why you said no. Is it because you’re fearful and want to avoid the situation, or because you’re actually just not interested?

“If you genuinely don’t want to anymore, that’s OK. You get to be a different person than you were before,” says Lindgren.

But if you or a loved one constantly avoids in-person interactions and chooses to stay socially isolated (a phenomenon sometimes referred to as “cave syndrome”), Lindgren says that could be an indication to reach out to a professional for help.

“When fear responses get activated, what we want to do is avoid because it brings anxiety down in the short term but it creates long-term problems,” says Lindgren. “We want to be careful not to avoid.”

Other things to look out for include trouble sleeping, feeling worried all the time, or an increase in sadness, anger or irritation.

These are symptoms associated with post-traumatic stress disorder (PTSD) — which can develop after a traumatic event, such as a pandemic. Symptoms of PTSD may look like other mental health conditions, so talk to your doctor for diagnosis and treatment.

“Some people may struggle more with re-entry, and there are ways we can help those who are having a harder time than others,” says Lindgren.

Give yourself and others grace

As you take steps to re-enter into your pre-pandemic ways of life, it might feel clunky and uncomfortable at times. Lindgren assures that this is normal — and to give yourself and others grace.

“Be compassionate with yourself,” she says. “What we’re experiencing is a very natural response. It doesn’t mean you’re bad or broken or will always feel this way.”

On top of feeling anxious or fearful, these initial social interactions might feel uncomfortable because your socializing skills are rusty. 

“This is happening at a time when people haven’t had much social interaction in a while,” says Lindgren. “It’s a double whammy.”

That’s a lot stacked against us all. But know that the more you practice getting back out there, the easier these social interactions will get (and the more fun you’ll have!).

“You may find that the first time was harder, or easier or helpful. Afterwards, ask yourself, ‘What do I need to do to make this easier or more enjoyable?’” says Lindgren.

Use each experience as a feedback loop that informs your next social activity. 

“It’s going to take some time and practice,” says Lindgren. 
 
Together, and at our own pace, we will navigate this new normal — one picnic, backyard hangout or outdoor happy hour at a time.  

The info in this article is accurate as of the publishing date. While Right as Rain strives to keep our stories as current as possible, the COVID-19 pandemic continues to evolve. It’s possible some things have changed since publication. We encourage you to stay informed by checking out your local health department resources, like Public Health Seattle King County or Washington State Department of Health.