CDC: Fully vaccinated people can go maskless most places

CALIFORNIA: Zoe Meroney, right, purchases clothing from Christopher Castaneda, manager at Designer Sample Store on the Third Street Promenade in Santa Monica, Calif., on May 4, 2021. Al Seib/Los Angeles Times

Federal officials on Thursday announced a sweeping relaxation of face mask guidelines, including allowing fully vaccinated people to safely stop wearing masks in most places – either outdoors or indoors.

"Anyone who is fully vaccinated can participate in indoor and outdoor activities, large or small, without wearing a mask or physical distancing," Dr. Rochelle Walensky, the director of the U.S. Centers for Disease Control and Prevention, told reporters. "If you are fully vaccinated, you can start doing the things you have stopped doing because of the pandemic."

Unvaccinated people or partially vaccinated people are still asked to wear masks in almost all indoor settings and most outdoor settings when interacting with people from outside of their household who may not be vaccinated. (Members of a single household of unvaccinated people can be maskless indoors if everyone else is vaccinated, and be maskless at a small outdoor gathering with other unvaccinated people.)

A person is considered fully vaccinated once two weeks have passed since the final dose.

Calling it an "exciting and powerful moment," Walensky said the decision was made based on numerous reports and literature that have demonstrated the safety and efficacy of COVID-19 vaccines.

"We have all longed for this moment when can get back to some sense of normalcy," she said.

Masks will still be required for everyone traveling on public transportation, including buses, trains, airports and stations.

'A great day for America'

President Joe Biden welcomed the CDC's announcement as a milestone for the nation, and a credit to the U.S. vaccination campaign. Across the U.S., 46% of the population has received at least one dose of vaccine.

"Today is a great day for America," Biden said. "It's been made possible by the extraordinary success we've had in vaccinating so many Americans so quickly."

Biden urged those without full vaccination to keep masking up.

"Please protect yourself until you get to the finish line, because as great as this announcement is today, we don't want to let up. ... The safest thing for the country is for everyone to get vaccinated."

The announcement comes as scientists have reported a stunning array of positive developments in just the last several weeks.

Just two months ago, there were worries the U.S. was heading to a fourth wave, but a robust vaccination campaign seems to have decisively helped turn the tide. While the U.S. was once criticized for a slow vaccine rollout, the U.S. now has the fourth fastest per capita vaccine rollout for its population, behind only Israel, the United Kingdom and Bahrain, according to University of California, San Francisco infectious diseases specialist Dr. Monica Gandhi.

The average number of new coronavirus cases nationwide, over a weekly period, has fallen to 36,800 a day – an impressive 23% decrease from the previous seven-day period, and a 50% drop from the peak of the fourth wave recorded a month ago, driven by a spike in the pandemic in Michigan. Hospitalizations and COVID-19 deaths are down, with reported fatalities having dropped 12% from the previous weekly period.

California managed to escape the fourth wave, with scientists crediting the state's relative embrace of vaccines, and for L.A. County, lingering immunity among survivors of the devastating fall-and-winter surge. California is reporting its lowest COVID-19 hospitalization numbers since the first few weeks of the pandemic.

Vaccine supply problems in the U.S. have eased, and it is easier than ever to get a shot. On Thursday, vaccine appointments became available for everyone age 12 and older.

Additionally, data has continued to emerge that has bolstered increasing confidence among scientists that the vaccines we have work effectively against variants – whether they be the variants first identified in the United Kingdom, South Africa, Brazil, California, New York and India – causing fears to fade among some experts that some variants would render some vaccines ineffective.

Even in rare events where a coronavirus of any type breaks through the immunity of a fully vaccinated person, the resulting infection is most likely to be short in duration and provide less risk of transmission to others, Walensky said. (There have been some reports of coronavirus breaking through the immunity of fully vaccinated people among medical personnel in India; but overall data still points to the vaccines being effective there.)

In addition, evidence is mounting that not only do vaccines protect against people getting sick, but they also protect against asymptomatic infection, too. A recent study from Israel found 97% vaccine effectiveness against symptomatic infection and 86% effectiveness against asymptomatic infection in more than 5,000 health care workers, Walensky said. In the U.S., vaccines were 90% effective against any infection in nearly 4,000 health care workers.

The announcement comes amid mounting public pressure nationwide to ease masking guidelines.

The Biden administration and the CDC in recent weeks also faced pressure to ease guidelines to make the benefits of vaccination abundantly clear, emphasizing the extent to which those who are inoculated can return to an almost-normal life.

The science also remains clear around unvaccinated people, who "remain at risk of mild or severe illness, of death or of spreading the disease to others," Walensky said. Unvaccinated people should still wear masks and get vaccinated right away.

Those who develop symptoms should also put their masks back on and get tested right away, officials said.

Some experts welcomed the CDC's new guidance.

"I am very excited that we have reached this momentous time when those who are fully vaccinated can now get back to virtually pre-pandemic activities without concern of of disease themselves," said UCLA medical epidemiologist Dr. Robert Kim-Farley. "However, they still need to realize that if they are around unvaccinated people that may be vulnerable – the elderly, those with medical conditions – they still need to practice caution in that setting."

Walensky noted that people with compromised immune systems should speak to their doctors before giving up their masks.

"If things get worse, there is always a chance we may need to make a change to these recommendations," Walensky said, "but we know that the more people are vaccinated, the less cases we will have and the less chance of a new spike or additional variant emerging."

Gandhi, the UC San Francisco infectious diseases expert, has been among experts who have urged the CDC to move faster to lift mask guidelines, and was surprised at how fast they moved Thursday. She welcomed the move and said the science backs up the loosened mask guidance.

Gandhi said lifting mask guidance for fully vaccinated people will provide an incentive to people who may have put off getting the shot so far.

"People need incentives now," Gandhi said. "I think this is going to help people who are on the fence to get vaccinated go and get vaccinated.

"These are wildly effective vaccines. They block transmission. And once you have a vaccine, the more weaker tools of mitigation which are masks, distancing and ventilation, go away. Because vaccines are the solution," Gandhi said.

Walensky said the agency also will be updating all of its guidance – including for travel – but that decisions about businesses, schools and other settings where it may be hard to determine who is or is not vaccinated will likely be determined at a local level.

"The country is very heterogeneous; it is not uniform," she said. "I would encourage counties and localities to look at how much vaccine they have, how many people have been vaccinated, look at how many cases are in their area, and to make those decision with that information in mind."

The debate around face masks came just days after the CDC updated its COVID-19 science brief to emphasize the virus's airborne transmissibility. Transmission occurs in three main ways, the agency affirmed. They are the inhalation of aerosol particles; deposition of virus droplets onto mucous membranes such as the mouth, nose and eyes; and touching mucous membranes with "soiled hands contaminated with the virus."

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