CDC Urges Vaccinated People to Resume Wearing Masks in COVID-19 Hotspots

The Centers for Disease Control and Prevention (CDC) on Tuesday revised its masking guidance and recommended that fully vaccinated people in high-transmission areas should resume wearing face masks in public indoor settings.

Those who live in a county where the COVID-19 case rate falls within "substantial" or "high" range on the CDC's data tracker should wear a mask even if they are vaccinated. Counties that have more than 50 cases per 100,000 people or above 8% positivity rate over the last seven days are considered COVID-19 hotspots. These areas will show up on the CDC color-coded map as red or orange.

The new guidance follows a surge of COVID-19 cases in areas with low vaccination rates and some reports of breakthrough infections with the highly contagious Delta variant among fully vaccinated people.

In a teleconference, CDC Director Rochelle Walensky, MD, MPH told reporters that the CDC updated its mask guidance because of new evidence on the Delta variant suggested that vaccinated people who are infected with COVID-19 may carry virus levels similar to those who are unvaccinated.

While the CDC recommended masking in high-risk areas, Walensky reiterated that the best way to be protected against COVID-19 is to be vaccinated.

Additionally, the agency urged universal masking in schools regardless of vaccination status, echoing the latest guidance from the American Academy of Pediatrics.

When the CDC lifted the mask mandate in May, Walensky said the decision was based on two pieces of science: low rates of infection and low rates of transmission among vaccinated individuals.

But the Delta variant now accounts for 83% of all infections in the United States, the CDC said on Tuesday. Although the risk of severe illness and hospitalization from COVID-19 remains low among vaccinated individuals, they can still "get Delta in a breakthrough infection and may be contagious," according to the CDC.

“The CDC should have never changed their guidance in the first place," Leana Wen, MD, MPH, an adjunct associate professor of emergency medicine at the George Washington University School of Medicine, tells Verywell. "Many of us warned at the time that the honor code was not going to work and that the unvaccinated would start behaving as if they were vaccinated, leading to the surges we are now seeing.”

Wen added, however, that she is glad the CDC “is following the evolving science.” 

Amesh Adalja, MD, MPH, senior scholar at the Johns Hopkins Center for Health Security, tells Verywell that the solution is "getting vaccines into arms" rather than masks.

“The vaccines are holding up quite well," he says, noting that current data shows little severe disease, hospitalizations, and death among those who are vaccinated.

Adalja says what’s critically needed are one-on-one conversations with people still not vaccinated, often with primary care physicians, to allay fears and give support about the safety and need for vaccinations. 

Before the new CDC guidelines, some local governments, including Los Angeles County, have already reinstated indoor mask mandates.

Several authorities went further to mandate COVID-19 vaccinations among their employees. The Department of Veterans Affairs yesterday became the first federal agency to require COVID-19 vaccinations among its frontline healthcare workers. All New York City government employees are required to be vaccinated or undergo weekly testing.

"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, adding most of the breakthrough cases did not result in severe disease, hospitalization or death.  

Following today’s CDC announcement, President Joe Biden announced that he will wear a mask when he travels to parts of the U.S. with high rates of COVID-19 cases.

"Although most U.S. adults are vaccinated, too many are not," he said in a statement. "While we have seen an increase in vaccinations in recent days, we still need to do better."

During the conference today, Walensky acknowledged the fatigue and wariness many Americans are feeling because of the pandemic. What the U.S. really needs to do to drive down transmission, Walensky said, “is to get more and more people vaccinated, and in the meantime use masks.” 

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.