The CDC Is Recommending That Vaccinated People Wear Masks Indoors Again

·8 min read
  • CDC officials have reversed some of their previous mandates releasing vaccinated individuals from wearing face masks in public.

  • Students, in particular, are now being advised to wear masks at all times while attending school, regardless of their age or vaccination status.

  • In cities and areas where COVID-19 transmission is high, masks are being recommended to all adults in the hopes of stopping the spread of the disease.

  • While skipping masks post-vaccination in socially distanced spaces has been shown to be low-risk, vaccinated individuals may want to consider masking up again as mounting proof suggests that variants are likely lead to breakthrough infections.

Federal health agents at the Centers for Disease Control and Prevention have once again overhauled their COVID-19 mask guidelines, advising fully vaccinated individuals to once again wear masks while in public indoor spaces. These recommendations are tailored to regions of the country where COVID-19 infection rates are spiking — an increase of about 170% in total over the last two weeks alone, per CNN — but aren't resulting in public mandates for mask compliance just yet.

CDC officials have also released strict new recommendations for school children in particular. Coming a few weeks after new suggestions were released by pediatric experts on the crucial need for masks in schools, the CDC has updated its guidelines to suggest that all students, from kindergarten through 12th grade, wear masks while in school — even if they've been vaccinated.

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These new CDC guidelines are a near-total reversal from when the agency walked back public mask mandates for vaccinated individuals in May. Currently, vaccination rates in the United States are approaching a 50% of all those eligible, per data curated by NPR. The agency never reversed its guidelines for unvaccinated individuals, who must continue to wear masks in crowded outdoor spaces and in all indoor settings.

The latest recommendations have largely come about due to a variant of SARS-CoV-2 that's been named the "Delta" variation by experts at the World Health Organization. The highly contagious variation of the disease is to blame for more than 80% of new COVID-19 cases in the U.S., especially in areas where vaccine rates are low, according to Newsweek.

The CDC's latest guidelines for masks

As highlighted, the CDC's new guidelines for public use of face masks are particularly targeted to "substantial or high transmission" of SARS-CoV-2, as explained by CDC Director Rochelle Walensky. How much of the U.S. would these new recommendations apply to, then? Upwards of half of all U.S. counties, per data sourced by the CDC, as these places are considered "high transmission" areas currently. In these areas, adults (regardless of vaccination status) are being advised to wear masks in all public spaces to avoid risk of infection — or the risk of spreading COVID-19 unknowingly to unvaccinated family and friends.

As far as the new advice for students and those in educational settings, much of the recommendations from all fields within the medical community have to do with the fact that all children likely won't be vaccinated well until after the school year begins, in some cases as soon as next month. COVID-19 can easily spread among unvaccinated children, who may potentially bring the disease back home with them at the end of the school day.

The agency's reversal may have to do with burgeoning data suggesting that even vaccinated individuals can be at risk for infection or reinfection. The vaccines in use now were approved in an emergency capacity by the Food and Drug Administration for their ability to prevent severe COVID-19 infection and symptoms in individuals, but the vaccines haven't been studied as thoroughly for their ability to slow disease spread to others entirely.

"Since their approval, vaccines have shown that they decrease the risk of asymptomatic COVID-19 infection substantially, but no vaccine is 100% effective," says Sherrill Brown, M.D., the medical director of infection prevention at California-based AltaMed Health Services. "There's still a small chance that even after we are vaccinated, we can become infected and show little to no signs of disease, and then go on to pass SARS-CoV-2 to others that are under-or unvaccinated."

Should we still wear a face mask?

The risk of someone getting COVID-19 after receiving a full vaccination is indeed low, but breakthrough cases aren't unheard of — there are just under 6,000 breakthrough COVID-19 cases that resulted in hospitalization, according to the CDC. There is a chance that vaccinated individuals may contract COVID-19 without knowing it. LaTasha Seliby Perkins, M.D., a professor and family physician within Georgetown University's MedStar Hospital system, explains that while you likely won't feel sick or have any serious symptoms, you can just as easily pass it onto family, friends or the public around you, especially if they're unvaccinated. It's advised to continue wearing a face mask in these spaces to help protect others around you.

Vaccinated individuals have earned immunity against SARS-CoV-2, but there's also concern that new virulent strains may impact immunity. "As the virus continues to affect communities, it also continues to mutate," Dr. Perkins explains, "and while we have a level of immunity, it's still important to be mindful once you get the vaccine."

CDC officials have previously highlighted evidence that shows that the risk of COVID-19 transmission outdoors is low. But spending extended periods of time indoors, especially in crowded spaces, is entirely different; it can pose minimal risk to vaccinated individuals but serious, elevated risk to unvaccinated people.

"When in interior spaces, airflow can be much more stagnant or recycled, and large concentrations of SARS-CoV-2 can remain in the air for longer periods of time, easily entering the airways of unmasked individuals," Dr. Brown adds. "Since no vaccine is 100% effective at preventing infection, this larger concentration of virus in the air makes it more likely that even some vaccinated individuals could become infected."

To be clear, the CDC's updated guidelines for vaccinated individuals do not apply to some interior spaces, especially in transit. Vaccinated individuals must wear masks on planes, trains, buses and shared transportation — and in crowded public places where essential services are offered, including hospitals.

Take note: Unvaccinated or under-vaccinated Americans can only skip a mask when they're hanging out in a small group in a non-crowded outdoor space, or exercising alone. Guidelines still maintain that these individuals must wear masks in all indoor settings outside of the home.

Should we still be social distancing?

Like masks, keeping hand hygiene in check and, more importantly, maintaining as much social distance as possible are essential in lowering the risk of COVID-19 transmission — even for vaccinated individuals. If it's at all possible, you should remain socially distant when meeting with friends, especially indoors. "Outdoors is always safer than indoors, distance will always be safer than being close, mask-wearing will always be safer than not wearing a mask," Dr. Brown says.

Being socially distant outdoors in an uncrowded space could be a compromise for those who wish to skip masks altogether. "Outdoors, the protection of mask-wearing is negligible, especially when physical distancing is in play," she adds.

Inside, socially distancing is paramount as limited ventilation increases the risk that infectious aerosols and droplets end up in your airways. Talking, shouting, itching a nose or sneezing, clearing throats; all of these activities push airborne aerosols to spread indoors, Dr. Perkins explains. "Indoors, there's a concern for how air is being recycled; every building is different, and there's no way to standardize airflow," she says. "That's why we still have to take extra precautions indoors, because the route of spread is airborne."

I'm vaccinated and following guidelines. Why should I have to care about risk?

It's understandable if you may be feeling mask fatigue: After all, it's been more than a year, and you've hopefully had a chance to get vaccinated by now. Taking the time to still adhere to best safety practices against COVID-19 — wearing a mask, maintaining as much social distance as possible and keeping hands and surfaces clean — can save you from potentially spreading the disease to others around you, including vulnerable unvaccinated individuals or children.

Dr. Brown cites recent evidence that suggests that mild COVID-19 infections may later prompt prolonged symptoms and side effects for six months or longer. "These symptoms can include fatigue, memory complaints and pulmonary complaints," says Dr. Brown, adding that a slew of other issues have been tied to what's now known as long-haul symptoms. "We don't know for sure if people that have asymptomatic or mild infections after vaccination may still have these long-term side effects after infection."

Avoiding infection at all costs is going to pay off for your holistic health in the future, and taking care to exercise caution in certain areas will also benefit your community in the end.

"Like getting a vaccine, wearing a mask is a choice and a selfless act, so we appreciate when you wear it for others, such as kids who can't be vaccinated," Dr. Perkins adds. "There are lots of situations where you don't need to wear a mask, but it's always good to stop and ask yourself of the benefits of doing so."

As more information about the coronavirus pandemic develops, some of the information in this story may have changed since it was last updated. For the most up-to-date information on COVID-19, please visit online resources provided by the CDC, WHO, and your local public health department.


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