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CDC Issues New Interim Public Health Recommendations
for Fully Vaccinated Individuals
Published: July 28, 2021 at
09:00 a.m.
By: Press Release from Centers for Disease Control
(July 27, 2021)
Interim Public Health Recommendations for Fully
Vaccinated People
Updated July 27, 2021
Summary of Recent
Changes
Updates as of
July 27, 2021
- Updated information for fully vaccinated
people given new evidence on the B.1.617.2 (Delta) variant currently
circulating in the United States.
- Added a recommendation for fully vaccinated
people to wear a mask in public indoor settings in areas of substantial
or high transmission.
- Added information that fully vaccinated
people might choose to wear a mask regardless of the level of
transmission, particularly if they are immunocompromised or at increased
risk for severe disease from COVID-19, or if they have
someone in their household who is immunocompromised, at increased risk
of severe disease or not fully vaccinated.
- Added a recommendation for fully vaccinated
people who have a known exposure to someone with suspected or
confirmed COVID-19 to be tested 3-5 days after exposure, and to wear a
mask in public indoor settings for 14 days or until they receive a
negative test result.
- CDC recommends universal indoor masking for
all teachers, staff, students, and visitors to schools, regardless of
vaccination status
Key Points
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.
Overview
Currently
authorized vaccines in the United States are highly effective at protecting
vaccinated people against symptomatic and severe COVID-19. Fully vaccinated
people are less likely to become infected and, if infected, to develop
symptoms of COVID-19. They are at substantially reduced risk of severe
illness and death from COVID-19 compared with unvaccinated people.
Infections in
fully vaccinated people (breakthrough infections) happen in only a small
proportion of people who are fully vaccinated, even with the Delta variant.
Moreover, when these infections occur among vaccinated people, they tend to
be mild. However, preliminary
evidence suggests that fully vaccinated people who do become
infected with the Delta variant can be infectious and can spread the virus
to others.
For the purposes
of this guidance, people are considered fully vaccinated for COVID-19
≥2 weeks after they have received the second dose in a 2-dose series
(Pfizer-BioNTech or Moderna), or ≥2 weeks after they have received a
single-dose vaccine (Johnson & Johnson [J&J]/Janssen)†.
There is currently no post-vaccination time limit on fully vaccinated
status. People are considered not fully vaccinated if they have not
completed a two-dose vaccination series or have not received a single-dose
vaccine, regardless of age, including children under the age of 12.
Data suggest
immune response to COVID-19 vaccination might be reduced in some immunocompromised
people including, but not limited to, people receiving chemotherapy for
cancer, people with hematologic cancers such as chronic lymphocytic
leukemia, people receiving stem cells or organ transplants, people
receiving hemodialysis, and people using certain medications that might
blunt the immune response to vaccination (e.g., mycophenolate,
rituximab, azathioprine, anti-CD20 monoclonal antibodies, Bruton tyrosine
kinase inhibitors).
People who are
immunocompromised should be counseled about the potential for reduced
immune responses to COVID-19 vaccines and the need to continue 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) to protect themselves
against COVID-19 until advised otherwise by their healthcare
provider. Close contacts of immunocompromised people should also be
encouraged to be vaccinated against COVID-19 to help protect these people.
This guidance
provides recommendations for fully vaccinated people, including:
- How fully vaccinated people can safely resume
many activities while protecting others
- How fully vaccinated people should approach
domestic and international travel
- How fully vaccinated people should approach
isolation, quarantine, and testing
CDC will continue
to evaluate and update public health recommendations for fully vaccinated
people as more information, including on Delta and other new variants,
becomes available. Further information on evidence and considerations
related to these recommendations is available in the Science
Brief.
Guiding
Principles for Fully Vaccinated People
- Outdoor activities pose minimal risk to fully
vaccinated people.
- Most indoor activities pose low risk to fully
vaccinated people, especially in areas with low or moderate
transmission.
- Infections happen in only a small proportion
of people who are fully vaccinated, even with the Delta variant.
- Fully vaccinated people who become infected
with the Delta variant can transmit it 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.
- Get tested if experiencing COVID-19
symptoms.
- Isolate if they have tested positive for
COVID-19 in the prior 10 days or are experiencing COVID-19
symptoms.
- Get tested 3-5 days after exposure to someone
with suspected or confirmed COVID-19 and wear a mask in public indoor
settings for 14 days after exposure or until they receive a negative
test result.
- Continue to follow any applicable federal,
state, local, tribal, or territorial laws, rules, and regulations.
Recommendations
for Indoor Settings
Risk of
SARS-CoV-2 infection, severe disease, and death is reduced for fully
vaccinated people. Though they happen in only a small proportion of people
who are fully vaccinated, some infections do occur among fully vaccinated
people. Fully vaccinated people who do become infected with the Delta
variant can transmit it to others. Therefore, fully vaccinated people can
further reduce their risk of becoming infected with the Delta variant and
transmitting it to others by wearing a mask in public indoor settings
in areas
of substantial or high community transmission. Wearing a mask in public
is most important for people who are immunocompromised. 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
at increased risk for severe disease includes older adults and
those who have certain medical conditions, such as diabetes, overweight or
obesity, and heart conditions. Members of the household who are
unvaccinated include any adults who have not completed vaccination, who
cannot be vaccinated, and those who are not eligible for vaccines,
including children less than 12 years of age. Fully vaccinated people
should also continue to wear a mask where required by federal, state,
local, tribal, or territorial laws, rules, and regulations, including local
business and workplace guidance, and in correctional
facilities and homeless shelters. Prevention
measures are still recommended for unvaccinated people.
CDC recommends
universal indoor masking for all teachers, staff, students, and visitors to
schools, regardless of vaccination status. Children should return to
full-time in-person learning in the fall with proper prevention strategies
in place.
Recommendations
for Outdoor Settings
Current data
suggest the risk of transmission of SARS-CoV-2 in outdoor settings is minimal.
In general, fully vaccinated people do not need to wear a mask outdoors.
Fully vaccinated people might choose to wear a mask in crowded outdoor
settings if they or someone in their household is immunocompromised.
Travel
Fully vaccinated
travelers are less likely to get and spread SARS-CoV-2 and can now travel
at low risk to themselves within the United States. International travelers
need to pay close attention to the situation
at their international destinations before traveling due to the
spread of new variants and because the burden of COVID-19 varies globally.
Wearing
a mask over your nose and mouth is required on planes, buses,
trains, and other forms of public transportation traveling into, within, or
out of the United States and while indoors at U.S. transportation hubs such
as airports and stations. Travelers are not required to wear a mask in
outdoor areas of a conveyance (like on open deck areas of a ferry or the
uncovered top deck of a bus).
Domestic travel
(within the United States or to a U.S. territory)
- Fully vaccinated travelers do not need to get
a SARS-CoV-2 viral test before or after domestic travel, unless
testing is required by local, state, or territorial health
authorities.
- Fully vaccinated travelers do not need to
self-quarantine following domestic travel.
- For more information, see Domestic
Travel During COVID-19.
International
travel
- Fully vaccinated travelers do not need to get
tested before leaving the United States unless required by their
destination.
- Fully vaccinated air travelers coming to the
United States from abroad, including U.S. citizens, are still required to
have a negative SARS-CoV-2 viral test result or documentation of
recovery from COVID-19 before they board a flight to the United
States.
- International travelers arriving in the
United States are still recommended to get a SARS-CoV-2 viral test 3-5
days after travel regardless of vaccination status.
- Fully vaccinated travelers do not need to
self-quarantine in the United States following international travel.
- For more information, see International
Travel During COVID-19.
Recommendations
for Isolation, Quarantine and Testing
The following
recommendations apply to non-healthcare settings. Guidance for residents
and staff of healthcare settings can be found in the Updated
Healthcare Infection
Prevention Control Recommendations in Response to COVID-19 Vaccination.
Fully vaccinated
people with COVID-19 symptoms
Although the risk
that fully vaccinated people could become infected with COVID-19 is low,
any fully vaccinated person who experiences symptoms
consistent with COVID-19 should isolate
themselves from others, be clinically evaluated for COVID-19, and
tested for SARS-CoV-2 if indicated. The symptomatic fully vaccinated person
should inform their healthcare provider of their vaccination status at the
time of presentation to care.
Fully vaccinated
people with no COVID-like symptoms following an exposure to someone with
suspected or confirmed COVID-19
Fully vaccinated
people should be 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 or until they receive a negative test result, and isolate if
they test positive. Fully vaccinated people who live in a household with
someone who is immunosuppressed, at increased risk of severe disease, or
unvaccinated (including children <12 years of age) could also consider
masking at home for 14 days following a known exposure or until they
receive a negative test result. Most fully vaccinated people with no
COVID-like symptoms do not need to quarantine, be
restricted from work, or be tested following an exposure to
someone with suspected or confirmed COVID-19 if they wear a mask in public
indoor settings for 14 days after exposure or if they receive a negative
test result from a test taken 3-5 days after exposure. They should isolate
if they test positive.
Fully vaccinated
people should monitor for symptoms
of COVID-19 for 14 days following an exposure.
Fully vaccinated
people with no COVID-19-like symptoms and no known exposure to someone with
suspected or confirmed COVID-19.
It is recommended
that fully vaccinated people with no COVID-19-like symptoms and no known
exposure should be exempted from routine screening testing programs, if
feasible.
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