CDC mask recommendations changed as more people in the U.S. are fully vaccinated; masks are effective at reducing virus transmission and are especially important when the majority of the population is unvaccinated
The CDC’s mask guidelines changed throughout the pandemic as researchers collected more information about both the virus SARS-CoV-2 and the effectiveness of vaccines. The CDC’s recent guidelines, which stated that vaccinated individuals can forgo masks in any setting, were informed by newly discovered scientific evidence related to vaccine effectiveness and as the number of fully vaccinated individuals in the U.S. increased.
Lacks Context: Director of the U.S. National Institute of Allergy and Infectious Diseases Anthony Fauci pushed back on Senator Rand Paul's characterization of mask-wearing by vaccinated individuals as “theater” on 18 March 2021. At the time, COVID-19 cases in the U.S. were increasing and fewer individuals were fully vaccinated. But, the new mask guidelines were put in place after the COVID-19 situation in the U.S. had improved; more than 127 million individuals are now fully vaccinated and growing data suggests that the vaccines substantially reduce the chance of transmitting the virus.
Misleading: Mask recommendations changed due to new evidence of the vaccines’ effectiveness at preventing symptomatic COVID-19 and potentially decreasing the likelihood of transmitting the virus. By not mentioning the data that has accumulated since 18 March 2021, the Post Millennial article gave readers the inaccurate and misleading impression that there hasn’t been any progress or change in the COVID-19 situation over the past two months
On 13 May 2021, the U.S. Centers for Disease Control and Prevention (CDC) updated their interim public health recommendations for fully vaccinated individuals. Among the changes was the recommendation that “fully vaccinated people no longer need to wear a mask or physically distance in any setting”. This recommendation is only for vaccinated individuals; according to CDC Director Rochelle Walensky: “If you are not vaccinated, you are not safe. Please go get vaccinated or continue to wear your mask.”
The new guidelines have a number of caveats. One was that businesses and workplaces may still require masks, and that masks are still subject to federal, state, local, tribal and territorial rules. For instance, the state of New Jersey lifted its mask requirement for outdoor public spaces for vaccinated residents, but maintained the indoor mask mandate. Additionally, the requirement for masks on buses, trains, planes and other forms of public transportation, remains.
The recent update caused a good deal of confusion, and on 18 May 2021 Anthony Fauci, U.S. President Joe Biden’s chief medical advisor and the director of the National Institute of allergy and Infectious Disease, went on Good Morning America to clear up some of that confusion. While answering a question put by George Stephanopoulos about how the new guidelines changed his mask wearing practices, Fauci said that “before the CDC made the recommendation change, I didn’t want to look like I was giving mixed signals.” Fauci explained that he kept wearing the mask even though, as “a fully vaccinated person, the chances of my getting infected in an indoor setting is extremely low.”
That same day, The Post Millennial, a Canadian information site with a history of mixing factual and false reporting, published an article claiming that, in that interview, Fauci admitted to continuing to “wear a mask indoors for appearance’s sake, not based on the science surrounding the protection of the vaccine.”
The author of the article, Hannah Nightingale referred to a U.S. Senate hearing on 18 March 2021 where Fauci pushed back on Senator Rand Paul’s statement that mask-wearing by vaccinated individuals was “just theater”. Nightingale concluded that “as it turns out, Fauci believes that masking post-vaccination is all about the optics, the theatre of it, and not the science at all.”
In her article, Nightingale didn’t include the date of the Senate hearing, instead claiming that it happened “recently”. Furthermore, she included a truncated clip of Fauci’s Good Morning America interview that left out Fauci’s explanation about “the science that has evolved over the last few weeks” that led the CDC to make these new recommendations. That science relates to growing evidence about the effectiveness of the vaccines in protecting people against symptomatic COVID-19, and that vaccinated individuals are less likely to transmit SARS-CoV-2 to others.
The date of the hearing, 18 March 2021, is important because the state of the COVID-19 pandemic in the U.S. was markedly different then in May 2021. The first CDC guidelines on mask-wearing for vaccinated individuals were released on 8 March 2021 when 60 million Americans had received at least one dose of the COVID-19 vaccine and 31.5 million (nearly 10% of the U.S. population) were fully vaccinated. At the time, the CDC said that small groups of vaccinated individuals could gather indoors and without physical distancing, but should continue to wear masks and maintain social distance in public areas like gyms.
Since then, the number of fully vaccinated individuals in the U.S. reached over 127 million (more than 38% of the U.S. population) on 21 May 2021. In a survey of 723 epidemiologists conducted by The New York Times between April 28 and May 10, 59% said that vaccination rates were the most important statistic in determining when the country can resume pre-pandemic activities.
Moreover, according to the CDC, preliminary evidence suggests that the COVID-19 vaccines authorized in the US “will likely be effective against emerging variants,” while other research findings suggest that the risk of transmission “is likely to be substantially reduced in vaccinated people.” At the 18 March 2021 Senate hearing, the concern that COVID-19 variants could override protective immunity was one of the reasons Fauci gave for continued mask wearing.
Importantly, when Paul said that mask-wearing by vaccinated individuals was theater, the U.S. was experiencing a surge in COVID-19 cases and hospitalizations; there were more than 450,000 new COVID-19 cases on the week of 22 March according to Reuters, the third straight week in a row of increasing infections. As of 19 May 2021, “all 50 U.S. states have now shown decreases in the number of infections,” Fauci told Axios during a virtual event.
Before the 13 May 2021 CDC guideline update, the previous update was from 27 April 2021, about two weeks earlier. This update was more cautious, easing mask guidelines for vaccinated Americans only when outdoors or in small gatherings. Masks in busy outdoor venues, like sports stadiums, as well as indoors, were still necessary according to the CDC.
Fauci told Good Morning America’s Stephanopoulos that he kept wearing a mask for a period when he knew that “the chances of [him] getting infected in an indoor setting” were extremely low given that he is vaccinated. While the CDC analyzed new data and re-assessed their guidelines, Fauci complied with the CDC’s then-current guidelines, so as not to send contradictory messages and to set an example for others who may not have been vaccinated, even as he was aware of the most recent data on vaccine effectiveness.
The CDC’s mask guidelines have changed throughout the pandemic in keeping with the emergence of new knowledge about SARS-CoV-2 and the effectiveness of the COVID-19 vaccines. The Post Millennial article misleads readers by not explaining that real-world data showing that the vaccines protect individuals, potentially lower the risk of transmission, and provide at least partial immunity to COVID-19 variants, has been accumulating throughout 2021. This leaves readers thinking that scientific developments around COVID-19 and the vaccines didn’t change between the time of the 18 March Senate hearing and the 18 May Good Morning America interview. Further, the article failed to provide context on the landscape of the COVID-19 pandemic in the U.S. at the time of Paul’s “theater” comment about vaccinated individuals wearing masks, when the country was experiencing a rise in case numbers and significantly lower vaccination numbers.
Scientific evidence has demonstrated that masks, by preventing the dissemination of liquid particles carrying SARS-CoV-2, reduce the spread of COVID-19. Furthermore, the combination of mask-wearing with other public health interventions, such as physical distancing, increases the odds of controlling the spread of SARS-CoV-2 . As Joseph G. Allen, the director of the Healthy Buildings program at Harvard, told the New York Times in October 2020: when you wear masks “you protect yourself, you protect others”
- 1 – Rader et al. (2021) Mask-wearing and control of SARS-CoV-2 transmission in the USA: a cross-sectional study. The Lancet.