Fully Vaccinated People Can Go Mask-Free in Most Cases, CDC Says

In a surprising step toward normalcy, the federal health agency now states that individuals who are fully inoculated against COVID-19 can go without masks inside restaurants, bars, gyms, movie theaters, and more.

Individuals who are fully vaccinated against COVID-19 no longer need to wear masks indoors or outdoors or physically distance in most situations, according to updated guidance released by the Centers for Disease Control and Prevention (CDC) on Thursday.

“If you are fully vaccinated, you can start doing the things you had stopped doing because of the pandemic,” said the CDC director, Rochelle Walensky, MD, MPH, in a media briefing. “We have all longed for this moment when we can get back to some sense of normalcy. Based on the continuing downward trajectory of cases, the scientific data on the performance of our vaccine, and our understanding of how the virus is spread, that moment has come for those who are fully vaccinated.”

The CDC highlighted a wide range of everyday scenarios in which face coverings are now not necessary for the completely inoculated, who can now visit a barber or hair salon, go to the movies, eat in a restaurant, drink in a bar, exercise in a gym (even in a high-intensity workout class), shop, sing in a chorus, and attend a full-capacity church service — all without wearing a mask or remaining six feet apart from others.

People who haven’t been vaccinated remain at risk of getting sick from COVID-19 and infecting other unvaccinated individuals, which is why they need to remain vigilant about wearing masks and social distancing.

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A Few Exceptions Where Masks Are Still Needed
The federal health agency did underscore that vaccinated people may still need to wear masks in accordance with certain federal, state, local, tribal, or territorial regulations, and they may be subject to masking requests upheld by local businesses and workplaces. Face coverings are still recommended at prisons, homeless shelters, hospitals, and nursing homes.

Teresa Murray Amato, MD, the director of emergency medicine at Long Island Jewish Medical Center in Forest Hills, New York, views exceptions in healthcare settings as a necessary precaution.

“There are patients who are at a higher risk of getting COVID even if vaccinated,” says Dr. Amato. “We know that immunocompromised patients may not make a robust immune response to the vaccine.”

In addition, people who are vaccinated will still be required to wear a mask on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States, and in U.S. transportation hubs such as airports and train stations. Amato notes that more transmissible variants are circulating in the United States, and universal masking of travelers could help curb their spread.

Science Behind the Decision
The CDC’s decision to ease rules is based on several studies showing that all three available COVID-19 vaccines are highly effective at protecting people from infection. The Moderna shot was shown to be 94.1 percent effective in preventing COVID-19 among clinical trial participants. Johnson & Johnson trials suggested that the company’s Janssen vaccine was 85 percent effective in preventing severe disease. Research from Pfizer-BioNTech demonstrated that its inoculation had more than 90 percent efficacy up to six months after the second dose.

A study out of Israel indicated that the COVID-19 vaccines may be even more protective in real life than in clinical trials. The investigation, published in the Journal of the American Medical Association (JAMA) on May 6, found that the Pfizer-BioNTech vaccine was 97 percent effective against symptomatic infection and 86 percent effective against asymptomatic infection. While further research is needed, the JAMA study suggested that the vaccine may not just prevent the inoculated from getting ill but also stop them from infecting others.

Based on research thus far, Amato says, “The chance of transmission from a fully vaccinated unmasked individual to an unvaccinated unmasked individual should be extremely low.”

RELATED: What You Need to Know About COVID-19 Vaccines

‘A Great Milestone,’ Says President Biden
In an address in the White House Rose Garden following the CDC announcement, a mask-less President Joe Biden praised the CDC’s new decision, calling it “a great milestone.”

“If you’re fully vaccinated and can take your mask off, you’ve earned the right to do something that Americans are known for all around the world: greeting others with a smile,” said Biden. “Better days are ahead, I promise you.”

The president stressed that the lifting of restrictions is due to the success of the nation’s vaccination program. The latest figures from the CDC’s COVID Data Tracker indicate that almost 60 percent of adults over the age of 18 have now received at least one dose of a coronavirus vaccine. Biden has set a goal of getting at least 70 percent of U.S. adults partially inoculated by July.

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Greater numbers of people are expected to get immunized as the U.S. Food and Drug Administration (FDA) earlier this week authorized use of the Pfizer-BioNTech COVID-19 vaccine for 12- to 15-year-olds.

Incentive to Get the Jab
Public health authorities hope that the new freedoms that come with full immunization will motivate more people to get vaccinated. An analysis in Time magazine showed that the vaccination rate of 2 million shots per day has recently dropped to under a million.

“We hope the lifting of restrictions brings more people in to get vaccinated,” says William Schaffner, MD, a professor of infectious diseases at Vanderbilt University in Nashville, Tennessee. “What we hope doesn’t happen is that people who are unvaccinated take off their masks and mingle with the vaccinated people, because you can’t tell who’s vaccinated and who’s not. We hope that’s kept to a minimum.”

Dr. Schaffner expects many vaccinated people won’t give up the mask habit overnight.

“It’s going to be a gradual adjustment,” he says. “Some people will prefer to have the vaccination plus masks, and we shouldn’t disparage them for that. They’re just being very careful on their own behalf and on behalf of their families.”

RELATED: Vaccinated Against COVID-19 but Still Anxious? You're Not Alone

Getting Closer to a Pandemic Endpoint
In looking at the overall course of the pandemic, Schaffner sees this move by the CDC as a sign that the pandemic could be heading toward an endpoint.

“The science is now strong enough to open things up a bit and permit vaccinated people to take this next large step toward the new normal,” he says.