On July 27, 2021, the Centers for Disease Control and Prevention (CDC) updated the Interim Public Health Recommendations for Fully Vaccinated People given new evidence on the Delta (B.1.617.2) variant rapidly circulating in the United States.
CDC Director Rochelle Walensky said Tuesday that “the Delta variant behaves uniquely differently” compared with other versions of the virus and that vaccinated people “may be contagious and spread the virus to others.”
Although the CDC isn’t recommending that everyone mask up again, there are only a few places where fully vaccinated people are safe indoors without them. Experts say masks can prevent carriers from spreading the disease, even if they have no symptoms or do not know they can transmit the deadly illness.
The agency’s new guidance is limited to places where COVID-19 transmission is deemed “substantial” or “high,” meaning there are either more than 50 cases per 100,000 people in the area, over a seven-day period, or the COVID-19 test positivity rate is higher than 5%.
CNN’s Dr. Sanjay Gupta explained that the CDC’s updated guidance recommends that even fully vaccinated people should wear masks indoors in areas with “substantial” and “high” transmission of Covid-19.
In summary, CDC recommends that unvaccinated and fully vaccinated people wear a mask in public indoor settings in areas of substantial or high transmission, and they released a map showing counties where people should wear masks indoors in public. The affected areas cover almost the entire country.
The federal public health agency also recommends universal indoor masking for all teachers, staff, students, and visitors to schools, regardless of vaccination status.
New data released today suggests that a third dose of the Pfizer/BioNTech Covid-19 vaccine can “strongly” boost protection against the Delta variant — beyond the protection afforded by the standard two doses.
The following recommendations apply to non-healthcare settings. For related information for healthcare settings, visit Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination.
Fully vaccinated people can:
- Participate in many of the activities that they did before the pandemic; for some of these activities, they may choose to wear a mask.
- Resume domestic travel and refrain from testing before or after travel and from self-quarantine after travel
- Refrain from testing before leaving the United States for international travel (unless required by the destination) and refrain from self-quarantine after arriving back in the United States
- Refrain from testing following a known exposure, if asymptomatic, with some exceptions for specific settings
- Refrain from quarantine following a known exposure if asymptomatic
- Refrain from routine screening testing if feasible
Infections happen in only a small proportion of people who are fully vaccinated, even with the Delta variant. However, preliminary evidence suggests that fully vaccinated people who do become infected with the Delta variant can spread the virus to others. To reduce their risk of becoming infected with the Delta variant and potentially spreading it to others: CDC recommends that fully vaccinated people:
- Wear a mask in public indoor settings if they are in an area of substantial or high transmission,
- Fully vaccinated people might choose to mask regardless of the level of transmission, particularly if they or someone in their household is immunocompromised or at increased risk for severe disease, or if someone in their household is unvaccinated. People who are at increased risk for severe disease include older adults and those who have certain medical conditions, such as diabetes, overweight or obesity, and heart conditions.
- Get tested if experiencing COVID-19 symptoms.
- Get tested 3-5 days following a known exposure to someone with suspected or confirmed COVID-19 and wear a mask in public indoor settings for 14 days after exposure or until a negative test result.
- Isolate if they have tested positive for COVID-19 in the prior 10 days or are experiencing COVID-19 symptoms.
- Follow any applicable federal, state, local, tribal, or territorial laws, rules, and regulations.
People who are immunocompromised should be counseled about the potential for reduced immune responses to COVID-19 vaccines and to follow current prevention measures (including wearing a mask, staying 6 feet apart from others they don’t live with, and avoiding crowds and poorly ventilated indoor spaces) regardless of their vaccination status to protect themselves against COVID-19 until advised otherwise by their healthcare provider.
The data posted by Pfizer, for discussion in a company earnings call, suggest that antibody levels against the Delta variant in people ages 18 to 55 who receive a third dose of vaccine are greater than five-fold than following a second dose. Among people ages 65 to 85, the Pfizer data suggest that antibody levels against the Delta variant after receiving a third dose of vaccine are greater than 11-fold than following a second dose.
The data have not yet been peer-reviewed or published, but it shows that antibody levels are much higher after a third dose than a second dose against the original coronavirus variant and the Beta variant, first identified in South Africa.
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