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Nearly three-quarters of eligible Americans have received at least one dose of the COVID-19 vaccines—but cases are rising again, driven largely by unvaccinated people and the highly transmissible Delta variant. One big question remains: Do you have to wear a face mask after you are fully vaccinated? The answer, per the experts, is clear: Yes, at least in certain situations.
Getting vaccinated is one of the most important actions you can take in reducing your risk of serious COVID-19 complications, on top of helping to keep your loved ones and community safe. But according to the Centers for Disease Control and Prevention (CDC), the available vaccines aren’t 100% effective against new and highly contagious variants, especially in high-risk situations.
Although most outdoor activities remain low-risk without wearing a mask, the rise of novel coronavirus variants is prompting officials to take a stronger stance on masking. “To maximize protection from the Delta variant and prevent possibly spreading it to others, wear a mask indoors in public if you are in an area of substantial or high transmission,” even after being vaccinated, the CDC announced in its updated masking guidance on July 27.
Here’s why wearing a face mask will still be crucial as vaccinations continue this year, according to doctors.
The Delta variant means masking is important.
Delta, a strain of SARS-CoV-2 that was first identified in India, has been labeled a “variant of concern” by the CDC because of its increased transmission rate and the fact that the COVID-19 vaccines and monoclonal antibody treatment could be less effective against it. When the CDC first loosened its masking guidance in May, saying that vaccinated people virtually never had to wear masks, Delta represented just 1% of COVID-19 cases in the United States, CNN reported; now, it's responsible for 83% of all cases.
Vaccinated people still have a public health job to do. By wearing a mask after vaccination, you’ll cut down your chances of accidentally spreading the highly transmissible Delta variant to those who are still unvaccinated (including those who cannot safely receive a dose).
To be clear, the vaccines are still highly effective against severe COVID-19 causing hospitalization and death, even factoring in the Delta variant; more than 97% of people hospitalized with the novel coronavirus are unvaccinated, CDC director Rochelle Walensky, M.D., told reporters on July 16, after Delta had become the dominant form of SARS-CoV-2 in the United States.
Although breakthrough cases—when fully vaccinated people contract COVID-19, with or without symptoms—have generated headlines, they’re still extremely rare and usually lead to mild illness. In fact, NBC News found evidence of over 125,000 breakthrough cases, which sounds concerning—but 165 million people have been fully vaccinated so far, meaning these cases represent less than 0.1% of vaccinated people.
The updated masking guidance is heavily influenced by Delta’s unique contagiousness. Although the vast majority of spread is among the unvaccinated, even vaccinated people might pass Delta along: “With prior variants, when people had these rare breakthrough infections, we didn’t see the capacity of them to spread the virus to others,” Walensky recently told CNN. “But with the Delta variant, we now see … if you happen to have one of those breakthrough infections, you can actually now pass it to somebody else.”
Asymptomatic breakthrough infections are not as concerning as COVID-19 in people who are unvaccinated, both from the standpoints of personal safety and disease transmission, explains Joseph Khabbaza, M.D., a critical care specialist and pulmonary care expert at Cleveland Clinic.
Vaccinated people are up to 78% less likely to spread COVID-19 to household members than unvaccinated people, per a small preprint study—but results were recorded before Delta became so prevalent. Another preprint study performed during Delta’s rise found that although people with breakthrough COVID-19 infections had similar viral loads to unvaccinated infected people (suggesting both types were equally infectious), their symptoms were less severe and their viral loads (and, therefore, their contagiousness) decreased much more quickly than their unvaccinated counterparts.
Still, given the high transmissibility of Delta and the lack of conclusive data on how much the vaccines reduce transmission, there’s a chance you could be playing a role in the variant’s spread without realizing it, especially “within households and some higher-risk settings,” Dr. Khabbaza says. A CDC investigation of a COVID-19 outbreak in Provincetown, MA, for example, found that three-quarters of cases (largely related to the Delta variant) were among vaccinated people—although there have been no deaths and very few hospitalizations among the 900 cases linked to it.
The vaccines don’t entirely rule out the possibility of you picking up a breakthrough infection or passing it to others, though they make it much less likely that you will, Dr. Khabbaza explains. Wearing a mask indoors, especially in high-risk settings, decreases that chance even further.
In most places, it’s still up to you to decide whether or not you’ll wear a mask indoors—but with Delta only becoming more prevalent, it’s not a bad idea to mask up when you’ll be hanging out inside public places. “If you could possibly be infectious to others, it’s prudent for people to wear masks [when required] so they don’t serve as a vector,” says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York.
Like other vaccines, the COVID-19 vaccines don’t provide 100% protection, even though they are effective.
While data released from Pfizer, Moderna, and Johnson & Johnson—the three vaccines which have received FDA authorization in the U.S.—show that the available options are incredibly effective, they don’t provide 100% protection from COVID-19 infections. Although they’re rare, breakthrough cases mean that masking in high-risk situations is still crucial.
Protection from the vaccine doesn’t happen instantly, either. In general, you can expect to reach the ideal level of immunity five to six weeks after your first dose, provided you receive all necessary injections.
But even with the slim chance of mild illness, “the vaccine will make COVID-19 infections less severe” should you get sick, says Richard Watkins, M.D., infectious disease physician and professor of internal medicine at the Northeast Ohio Medical University. On top of that, researchers have learned that wearing a mask can reduce the amount of SARS-CoV-2 you’re exposed to, which in turn can make potential COVID-19 infections less severe.
“The more things you do that are meant to prevent the spread of COVID-19, the more successful they’ll be,” Dr. Khabbaza explains. So get vaccinated, first and foremost, then keep taking the actions that we know will keep us more protected from infection: masking, social distancing, hand-washing, staying outdoors, opening windows, and the like.
Bottom line: Masking can help reduce the spread of new, highly contagious variants.
The CDC’s updated guidance isn’t a requirement, and whether or not you wear a mask comes down to local rules and personal risk comfort. But Delta poses a major threat to unvaccinated people, and masking could stave off more infections as we approach cold and flu season. It also might help keep you from contracting a breakthrough infection.
Dr. Russo expects masks to become very popular over the winter, when cold and flu season ramps up, since face coverings can help block respiratory viruses that cause the common cold and flu, too. “Many people may want to wear masks then,” he says, because “we still don’t know for sure whether we’ll be able to fully eliminate COVID-19.”
At the end of the day, masks won't end this pandemic—vaccines will. “I haven’t seen people regret getting vaccinated; I’ve only heard remorse, regret, and guilt amongst the family of the people who have not chosen to seek immunity the easy way,” Dr. Khabbaza says. “We know how well they work, but to see it in real time, just in the ICUs I work at—we are very lucky that we have these vaccines.”
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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