CDC Tightens Masking Rules for Fully Vaccinated in COVID-19 Hot Spots

New CDC guidelines say that vaccinated individuals should begin wearing masks again when indoors in public settings in parts of the US with substantial to high transmission.

Health care experts have been saying recently that in response to the Delta variant that’s causing yet another wave of COVID-19, that the Centers for Disease Control and Prevention (CDC) will have to update the agency’s recommendations regarding masking. The CDC must have been listening.

CDC Director Rochelle Walensky, MD, today announced that the agency is updating its recommendations, stating that vaccinated individuals should begin wearing masks again when indoors in public settings in parts of the US with substantial to high transmission.

Additionally, the CDC reversed its recommendations on masking in K-12 schools, stating that all teachers, staff, students and visitors should wear a mask indoors regardless of vaccination status.

"In recent days I have seen new scientific data from recent outbreak investigations showing that that Delta variant behaves uniquely differently from past strains of the virus that cause Covid-19," Walensky said. "This new science is worrisome and unfortunately warrants an update to our recommendations."

Over the previous 7 days, cases of COVID-19 are up 65% across the country, nearly 3 times as high as 2 weeks ago. New cases are currently averaging at around 43,700 a day.

The CDC's announcement today may come as a surprise to many. As recently as last week, a spokesperson for the CDC said that the agency had no plans to change its guidance unless there was a significant change in the science.

One of the experts who challenged the CDC’s guidelines is Kevin Kavanagh, MD, a member of the ICT®’s Editorial Advisory Board who just last week in an opinion piece implored the agency to take a different approach to COVID-19.

“We need to have a paradigm shift in the way we view this virus, planning and implementing strategies to allow us to live with an endemic pathogen,” Kavanagh wrote. And in a Q&A posted to ICT®’s website this morning with a headline—“Everybody Needs to be Vaccinated and Wear a Mask”—that may prove to be prescient, Kavanagh said that he’s “convinced this virus is about one or two iterations away from completely avoiding the vaccine. And remember, we have the lambda variant and the kappa variant which are sitting out there in the wings, waiting for immunity to drop and possibly cause another wave.”

But, as Kavanagh said, it’s the Delta variant that’s really changed the nature of the battle against COVID-19. The CDC relaxed masking guidelines for the fully vaccinated based on data taken from previous iterations of the coronavirus. Kavanagh said that his biggest concern is that “everybody’s in the mindset that this pandemic is over with. We don’t need to do anything else. And if you’re vaccinated, you have a get-out-of-jail card, and you can go on with your life as if it was normal. And with this Delta variant, nothing could be further from the truth. I feel it is imperative that everyone, even those vaccinated, start wearing masks and start following public health strategies, which were followed over the surge of the winter holidays. I can’t stress that more.”

Celine Gounder, MD, an infectious disease specialist at Bellevue Hospital Center in New York, tells the New York Times that “I think that’s great” about the CDC’s expected move.

In May, when the CDC announced that fully vaccinated individuals no longer needed to wear masks, they pointed to 2 studies touting the efficacy of the Pfizer and Moderna COVID-19 mRNA vaccines.