When You’ve Been Fully Vaccinated

If you are fully vaccinated against COVID-19, you may stop wearing a mask and social distancing in most settings, including at crowded indoor and outdoor events, according to new guidance issued by the U.S. Centers for Disease Control and Prevention (CDC). 

It is a big step toward a return to pre-pandemic life, and one that may take some getting used to for weary Americans who have been covering their faces and living with restrictions for more than a year.

“We have all longed for this moment,” CDC Director Rochelle Walensky, M.D, said at a press briefing. “If you are fully vaccinated, you can start doing the things that you had stopped doing because of the pandemic.”

You are considered fully vaccinated two weeks after the one-dose Johnson & Johnson shot, or two weeks after the second dose of either the Pfizer-BioNTech or the Moderna vaccine.

For now, the CDC says there are still some scenarios when fully vaccinated people should wear a mask: in hospitals, medical offices and nursing homes; at correctional facilities and homeless shelters; and when traveling by plane, bus, train or other public transportation. Walensky said Thursday that the agency may soon revisit some of those guidelines as well.

Vaccinated people should also obey state and local mask ordinances and wear a face covering if required by businesses and workplaces, the CDC says.

If you have a weak immune system, talk to your doctor about whether it’s safe to drop your mask.

An incentive to get vaccinated

William Schaffner, M.D., an infectious disease specialist and professor of preventive medicine at the Vanderbilt University School of Medicine, calls the new guidelines “an important step forward.”

He notes the CDC had faced criticism, including from some health officials, for being too cautious. The new guidelines, he says, “will make many, many people happy, and perhaps encourage some people to get vaccinated.”

About 119 million Americans, or more than a third of the population, are fully vaccinated against COVID-19. Nearly 72 percent of adults 65 and older are fully vaccinated. But the number of vaccinations administered per day has slowed in recent weeks.

Vivek Cherian, an internal medicine physician with the University of Maryland Medical System, describes the previous CDC guidance, which called for fully vaccinated people to wear masks in public indoor spaces, as “wishy-washy.”

“Now it’s a lot more streamlined,” he says. “If you’re vaccinated, you’re good to go. You don’t need to wear a mask.”

On the honor system

If you are unvaccinated, if you’ve received only one dose of a two-dose vaccine, or if it hasn’t been two weeks since your last vaccine dose, you should continue to mask up and practice social distancing, the CDC guidance says.

At the news conference, Walensky said the science for unvaccinated people is clear: “You remain at risk of mild or severe illness, death or spreading the disease to others. You should still mask and you should get vaccinated right away.”

Of course, when you’re out and about, there will be no easy way to distinguish between those who are vaccinated and those who are unvaccinated. Critics say there’s nothing to stop those who haven’t gotten their shot(s) from also going without a mask.

In a news conference Thursday, an unmasked President Joe Biden called the new guidelines “a great milestone,” and when asked how masking among unvaccinated Americans would be enforced, he said he believes they “care about the safety of their neighbors."

“We’re not going to go out and arrest people,” he said. “If you haven’t been vaccinated, wear your mask for your own protection and the protection of the people who also have not been vaccinated yet.”

It’s unlikely that businesses or organizers of large sporting events and concerts will step up and start requiring proof of vaccination, Cherian says. “Essentially it will come down to an honor system,” he says.

Some may continue to wear masks

Partly because of that uncertainty, some experts say older adults with underlying conditions that put them at higher risk from COVID-19 may want to continue wearing a mask, particularly if they attend a large indoor gathering or crowded event.

“Each person has to decide how careful they are going to be,” Schaffner says.

The CDC has reported a very small number of breakthrough COVID-19 cases in those who are fully vaccinated. COVID-19 is usually mild in vaccinated people, with symptoms more like a cold than a serious illness.

If you develop symptoms even though you’re fully vaccinated, you should don a mask and get tested right away, Walensky says.

Schaffner says he and his wife will likely continue to wear masks for a while. “We’re down in Tennessee, where the proportion of the population that is unvaccinated is still very, very high,” he says. “We both have some gray hair, and we both have some minor medical conditions.... That makes us careful and wary.”

Epidemiologist Ali Mokdad, a professor of health metrics sciences at the Institute for Health Metrics and Evaluation at the University of Washington, says he, too, will keep wearing his mask indoors when he is around others who may be unvaccinated.

“I will wear my mask indoors until we reach herd immunity and cases are very low,” he says.

Studies show the vaccines are highly effective

While some may still choose to wear a mask going forward, Walensky noted that the fully vaccinated are protected even around those who are unvaccinated, citing real-world studies that show the COVID-19 vaccines work to prevent not just symptoms, but infection as well.

One large study of vaccinated U.S. health care workers found that the vaccines are 90 percent effective at blocking infection and 94 percent effective at preventing hospitalization. Another found that adults 65 and older who are fully vaccinated were 94 percent less likely to be hospitalized with COVID-19 than people of the same age who were not vaccinated.

Other research shows that the vaccines are effective against the coronavirus variants circulating in the U.S., Walensky noted.

The rapid vaccine rollout has pushed the number of daily coronavirus cases and deaths in the U.S. to their lowest levels since mid-September. The U.S. is averaging about 600 COVID-19 deaths a day, CDC data shows, down from a high of more than 4,000 on some days in January.

Don’t put your mask away just yet

Walensky says it’s possible the agency’s mask guidance could change again if cases start to rise. Cherian says he expects it will take a while for some people to become comfortable without a mask, because mask-wearing has become such a social norm. “Social norms tend to lag behind science and data,” he says.

Dan Zeiler

dan@zeiler.com

708.597.5900 x134 

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