3 Reasons Why the CDC Changed Its Mask Guidelines for Vaccinated People (Again)
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Even if you are fully vaccinated against COVID-19, the Centers for Disease Control and Prevention (CDC) now advises that you wear a mask indoors in public when you are in an area of “substantial or high transmission.” Universal masking is also recommended for people in schools, regardless of vaccination status and local COVID-19 rates.
That’s a huge departure from the announcement the CDC made on May 13, which gave fully vaccinated people the green light to no longer wear a face mask indoors or practice social distancing, “except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance.”
The nation is shocked—again. While the updated guidelines highlight changes for vaccinated people, “this is an issue predominantly among the unvaccinated,” Anthony Fauci, M.D., director of the U.S. National Institute of Allergy and Infectious Diseases, told CNN on July 25.
CDC Director Rochelle Walensky, M.D., echoed that thought during a news briefing on July 27. The Delta variant—now the dominant strain of COVID-19 in the U.S.—“is showing every day its willingness to outsmart us,” she said.
Per the new guidance, Americans should wear a mask in areas where there are more than 50 new infections per 100,000 residents over the past seven days, or more than an 8% positivity rate over a week. Based on the data, people in nearly two-thirds of counties in the country should wear a mask indoors in public spaces, The New York Times reports. (You can view your county on this hand map provided by the CDC.)
People who are vaccinated but do not live in high-transmission areas should still consider wearing a mask in public if they or someone in their house is at high risk for severe COVID-19 illness, such as a person who is immunocompromised or a child who is not yet able to be vaccinated.
Dr. Walensky explained the reasons behind the masking update during a media briefing, and it boils down to these three factors:
Fully vaccinated people may be able to transmit COVID-19 to others.
When fully vaccinated people become infected with COVID-19, a rare occurrence known as a breakthrough infection, they can carry small amounts of the coronavirus. Remember: The vaccines are not 100% effective in preventing an infection; their job is to prevent serious illness and hospitalization.
“The vast majority of breakthrough cases are really minor,” says William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine. “People are getting what feels like a bad cold or are just having a day in bed.”
“It is not the vaccinated, even those with high viral load breakthrough infections, that constitute anywhere near the majority of transmission events,” says infectious disease expert Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security.
However, more data is still needed to determine how the Delta variant—which is now responsible for 83% of COVID-19 infections in the U.S. and is stressing local healthcare systems—impacts vaccine effectiveness.
Fully vaccinated people who become infected with the virus may have mild symptoms or no symptoms at all—but they still have the ability to transmit the virus to others. Until experts know more, it is the safest bet to mask up indoors.
Vaccination rates aren’t what officials hoped they would be.
Back in early summer, President Joe Biden announced a big goal: He hoped that 70% of American adults would have at least one dose of the COVID-19 vaccine by July 4th. That goal didn’t happen, and the numbers are still falling short.
According to CDC data at the time of publication, 69.1% of U.S. adults have received at least one dose of the COVID-19 vaccine and 60.1% are fully vaccinated. Just 57.6% of those who are eligible to be vaccinated (people aged 12 and up) are fully vaccinated.
Dr. Fauci recently said on CNN that this is a huge concern, and urged people to sign up for their immunization. “There’s a really, really good reason to get vaccinated, and that is to save your life—to prevent you from being hospitalized, to prevent you from dying,” he said. “Because the one thing that clearly works very well with this vaccine is that, even with the Delta variant, it prevents you—even if you do get infected—from landing in the hospital.”
As the virus evolves, so will the response to it.
As SARS-CoV-2 continues to mutate, public health recommendations will also continue to change. “The big concern is that the next variant that might emerge—just potentially a few mutations away—could evade our vaccine,” Dr. Walensky said.
This is a tough thing for people to accept, says Dr. Schaffner, especially after more than a year of lockdowns and confusing messaging.
“No one has a crystal ball,” says Richard Watkins, M.D., an infectious disease physician and a professor of internal medicine at the Northeast Ohio Medical University. “The situation is rapidly evolving, so there has to be some flexibility with what [public health experts] recommend.”
Bottom line: To end the pandemic (and mask mandates), more people need to get vaccinated.
“COVID is not a disease that can be eradicated or limited and we will always have cases,” Dr. Adalja says. “The goal was to make it a manageable respiratory illness, and it is in many places where enough high-risk individuals have been vaccinated.”
From his perspective, areas with the highest level of COVID-19 cases and the lowest level of vaccination rates—largely the Southern U.S.—are comprised of people who have already pushed back on wearing masks.
And because there is no way to force an individual to mask up, ending the pandemic lies with immunization: “The solution is the vaccine,” Dr. Adalja says.
This article is accurate as of press time. However, as the COVID-19 pandemic rapidly evolves and the scientific community’s understanding of the novel coronavirus develops, some of the information may have changed since it was last updated. While we aim to keep all of our stories up to date, please visit online resources provided by the CDC, WHO, and your local public health department to stay informed on the latest news. Always talk to your doctor for professional medical advice.
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