Should I Mask? These Are the CDC's Guidelines for Vaccinated and Unvaccinated People
Back in May, the Centers for Disease Control and Prevention (CDC) released guidelines stating that vaccinated people don't need to wear masks, indoors or outdoors, in any situation. But with the spread of the highly transmissible Delta variant, recommendations are shifting yet again.
"In recent days I have seen new scientific data from recent outbreak investigations showing that the Delta variant behaves uniquely differently from past strains of the virus that cause COVID-19," said Dr. Rochelle Walensky, CDC Director, in a media briefing on July 27. "This new science is worrisome and unfortunately warrants an update to our recommendations."
Essentially, COVID-19 vaccines have been shown to prevent severe illness and death from the Delta variant. But new research suggests that vaccinated people might be able to spread the virus, and increasing numbers of breakthrough infections have also been reported (although they remain rare).
Keep reading to learn the latest mask rules and recommendations for vaccinated and unvaccinated people.
Masks are Sometimes Recommended for Vaccinated People
You're considered fully vaccinated two weeks after the final dose of the COVID-19 vaccine, whether it's Pfizer, Moderna, or Johnson & Johnson. All of the vaccines have proven so effective against COVID-19 that the CDC changed its guidelines on May 13, announcing that fully vaccinated individuals no longer need to wear masks or physically distance in any setting, outdoors or indoors, except when required by law.
However, the CDC updated its guidelines again on July 27, thanks to the highly transmissible Delta variant. The organization now recommends that vaccinated individuals mask "indoors in public if you are in an area of substantial or high transmission." (You can check on the CDC website). Individuals might also choose to mask "if you have a weakened immune system or if, because of your age or an underlying medical condition, you are at increased risk for severe disease, or if someone in your household has a weakened immune system, is at increased risk for severe disease, or is unvaccinated."
What's more, vaccinated people must continue wearing masks on public transportation (planes, trains, buses, etc.), in U.S. transportation hubs, and in health care settings. The CDC says that students, teachers, and school staff should wear masks in grades K through 12—regardless of vaccination status or community transmission.
If you have a confirmed or suspected COVID-19 case, wear a mask whenever you interact with someone—even members of your household. For example, you should wear it "when you are sharing a room, in a vehicle, visiting the doctor, or going to the grocery store," says Aimee Ferraro, Ph.D., senior core faculty member for Walden University's Master of Public Health program.
"Vaccinated individuals continue to represent a very small amount of transmission occurring around the country. We continue to estimate that the risk of a breakthrough infection with symptom upon exposure to the Delta variant is reduced by seven-fold. The reduction of 20-fold for hospitalizations, and deaths," said Walensky during the CDC briefing.
Mask Guidelines for Unvaccinated People
Per the CDC guidelines, unvaccinated people should still follow all social distancing and mask protocols. Masks not only protect those around you from COVID-19 infection, they can actually help to protect you.
"Masks are most likely to reduce the spread of COVID-19 when they are widely used by people in public settings," according to the CDC. "The spread of COVID-19 can be reduced when masks are used along with other preventive measures, including social distancing, frequent hand washing, and cleaning and disinfecting frequently touched surfaces."
The American Academy of Pediatrics (AAP) stresses that this mask guidance applies to anyone over age 2. Younger babies should never wear masks because of suffocation risks; they can't let you know if they're struggling to breathe.
Mask Mandates at State and Local Levels
Despite mask recommendations by the CDC, state and local governments can decide for themselves whether to change their guidelines. Vaccinated and unvaccinated individuals should always follow the mandates issued by their lawmakers.
Should I Wear Masks in Stores?
Should you wear a mask in your local salon or coffee shop? What about big-box retailers like Target or Walmart? As it turns out, business are free to make their own rules, but they must adhere to local and state guidelines. All people, whether vaccinated or unvaccinated, should follow rules set forth by restaurants, salons, stores, etc. It's always smart to have your mask on hand, so if you're ever confronted with a mask mandate, you'll be prepared. (Need some help remembering a mask? Consider buying a handy face mask chain so you always have your mask on your body.)
Should My Child Wear a Mask to School?
The CDC recommends that schools return to in-person learning this fall. However, the organization urges that schools should still require "universal indoor masking for all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status." Other layered prevention strategies like social distancing should also be implemented.
Children under age 12 can't receive the COVID-19 vaccine yet. And while it's true that kids generally have mild symptoms, severe illness and death have been reported on rare occasions. Kids can also contract COVID-19 at school and spread it to other high-risk individuals.
That said, while the CDC recommends obligatory masks in academic settings, school boards can make the decision themselves (as long as the state doesn't have an indoor mask mandate).
How to Wear a Face Mask Properly
Face masks work by containing droplets that might be contaminated with COVID-19, which can be released when an infected person coughs, sneezes, talks, or breaths. Masks also protect against "airborne particles" that stick around after coughing, sneezing, talking, or exhaling.
Wearing face masks improperly may actually increase your risk of the coronavirus, according to U.S. Surgeon General Jerome Adams. That's because infected particles could seep through the edges if you adjust the mask or take it off improperly. Here is the proper way to use one.
1. Choose a paper or cloth mask (and double mask, if you want extra protection). "Currently the N95 mask is in short supply, as it acts to prevent inhalation and exhalation of virus on particles of dust. A simple surgical mask or cloth mask is fine for most," says Michael Hall, M.D., a CDC vaccine provider who worked through the 2009 flu pandemic, providing H1N1 vaccines to his Miami patients. Only use a N95 respirator mask if advised by your health care provider.
The CDC says you can increase the effectiveness by double masking (layering a cloth mask over a surgical mask) or knotting and tucking the ear loops of a surgical mask. Both of these situations give masks a better fit. Double masking is recommended in high-risk situations, like if an unvaccinated individual visits a crowded grocery store.
2. Wash your hands. According to Dr. Ferraro, you should wash your hands with soap and water for at least 20 seconds. You can also use hand sanitizer with at least 60 percent alcohol in a pinch.
3. Put on the mask. "Cover your mouth and nose with the mask and pull the straps over the back of your head," says Dr. Ferraro. "Make sure there are no gaps between your face and the mask."
4. Don't fidget with it. When wearing the mask, you should avoid touching your face and the mask, or else you risk letting infected particles get inside.
5. Replace when needed. Replace the mask when it gets damp and do not reuse single-use masks. "To remove the mask, take it off from behind, discard it immediately in a closed trash can, and clean your hands with soap and water or an alcohol-based hand sanitizer," says Dr. Ferraro. You can also wash cloth masks, if they're made for reuse.
If you don't have a face mask on hand, you can make your own with a scarf, handkerchief, bandana, or other fabric. "Some studies have shown that any barrier that limits the spread of respiratory droplets from coughs and sneezes can be helpful," says Dr. Ferraro.
The Bottom Line
Per CDC guidelines, vaccinated individuals should wear masks indoors in areas "of substantial or high transmission. Unvaccinated people should still wear masks in public settings where social distancing might be difficult.