How Immunocompromised People Are Navigating New CDC Mask Guidance

Updated mask guidance the Centers for Disease Control and Prevention (CDC) saying fully vaccinated people can resume regular activities without a mask or social distancing was a welcome change for some. But, due to a lack of clear instruction, many immunocompromised people who have been vaccinated were left wondering what they could safely do.

In guidance for people who have been vaccinated, the CDC instructs that "if you have a condition or are taking medications that weaken your immune system, you may NOT be fully protected even if you are fully vaccinated." For some people living with a weakened immune system, the new mask guidelines may not apply.

"We are still only at 38% fully vaccinated, so people need to use a cautious and [use a] common sense approach depending on your own health situation," Purvi Parikh, MD, an immunologist and allergist with the Allergy & Asthma Network, tells Verywell. "Also be cautious when around large groups of people whose vaccination status is unknown."

Are Immunocompromised People Protected by the Vaccine?

Since the beginning of the COVID-19 pandemic, states and health organizations defined immunocompromised differently. Sometimes it refers to people taking immunosuppressive medication, those living with conditions that affect the immune system, or a combination of both.

"We should be thinking about any disease conditions and everything that is essentially immune weakening," Sri Banerjee, MD, PhD, MPH, an epidemiologist and faculty member for Walden University’s PhD in Public Health program, tells Verywell. "Is the data out there for precisely how much they can be considered immunized once they get a vaccination? The answer is no."

Researchers have looked into how effective the COVID-19 vaccine is for people on certain medications or with different health conditions. For example, a study awaiting peer review found that 34% of people with Crohn's disease on the drug Infliximab were protected after one dose of the Pfizer vaccine. In comparison, a study from the CDC found that the Pfizer and Moderna vaccines were around 80% effective in preventing illness that would require hospitalization among a general population.

Both Banerjee and Parikh recommend that people who have weakened immune systems continue to wear masks around people that they do not know, even if they are considered to be fully vaccinated.

Should Everyone Keep Wearing Masks?

Banerjee argues that it could be helpful for people without underlying health issues to continue masking to protect those around them. "Maybe you're vaccinated already, but you still can spread the virus to the person that's immunocompromised next to you," he says. "So, if you're wearing a mask that's still that barrier, then you're protecting the other person from the potential transmission."

Some studies suggest the vaccines can prevent transmission of the virus. But people who are fully vaccinated against COVID-19 may still be able to transmit it to unvaccinated people and immunocompromised people. Research shows that wearing face masks is the most effective method in preventing the spread of COVID-19.

Masks can also be helpful in preventing the spread of other illnesses. "The masks help protect against flu and all other respiratory viruses all of which can be deadly in immune-compromised people," Parikh says.

How Immunocompromised People Are Approaching It

Ellen Gurung, an MPH student at George Mason University in Virginia who lives with lupus, tells Verywell that she plans on continuing to wear a mask despite the new CDC guidelines. Gurung received both doses of the Pfizer vaccine, but her mother, who has asthma, is not fully vaccinated yet.

"This is just yet another example of how disabled or chronically ill people are forgotten about," she says. "There's so much focus on the impact of the pandemic on able-bodied people, the economy, and businesses, and there's just very little focus on you know people who are at the most risk health-wise."

Azmia Magane, MSW, a Florida resident, and writer who also lives with lupus, tells Verywell that she "will be continuing to practice social distancing as well as masking at the instructions of my physicians." Magane also worries that these guidelines are operating with an honor code, without acknowledging that there are anti-vaccine or vaccine-hesitant people who may also forego masks.

"I don't feel comfortable going out and living life normally yet, but also there's just a lot of unknown surrounding transmission," Gurung says. "I don't want to be responsible for accidentally putting someone at risk because I was too hasty to not wear a mask. Wearing a mask is easy."

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