Health experts say people should consider their own health and the level of risk they’re willing to accept before going without a mask.
Federal health officials gave fully vaccinated people clearance to ditch their face masks in most situations. But after more than a year of following COVID-19 preventive measures, many feel hesitant about returning to their normal lives.
In guidance updated last week, the Centers for Disease Control and Prevention said people fully vaccinated against COVID-19 no longer have to wear face masks or social distance at gatherings of any size. The move came after increasing real-world evidence that vaccines were extremely protective against the virus.
While health experts say the science is solid, there are still certain factors vaccinated people need to account for before returning to normal. Here’s what three health experts said vaccinated people need to know about the new guidance.
Consider your own health before ditching your mask
All three health experts said that people fully vaccinated should consider their health before going without a face mask.
“What they don’t know, and what we still are learning a lot about, is people who are immunocompromised,” said Dr. Diana Cervantes, an assistant professor of biostatistics and epidemiology at the University of North Texas Health Science Center. “If you’re immunocompromised and you’re fully vaccinated, that’s a discussion you really should have with your doctor.”
Cervantes said while research has shown that the vaccines are up to 95% effective against COVID-19, they might not be that effective for everyone who gets them. She said how well a person responds to a vaccine depends on that individual’s overall health.
“People who are at highest risk for severe disease, so those who are diabetic, those who are older … in general they’re pretty covered,” she said. “Those who are taking chemotherapy or immunosuppressant drugs, or have conditions that definitely suppress their immune system, those are the patients [who may not be as covered].”
She said older people might consider more precautions even if they’re fully vaccinated because their health is more fragile.
“My mom is 86. She’s fully vaccinated, but she absolutely still wears her mask when she goes to the store,” Cervantes said. “In general, she’s careful with her health. You can’t compare her state of health to mine.”
Some situations still carry more risk than others
While the CDC says fully vaccinated people can go without a mask in most settings, all three health experts said that people should be aware that some situations will still present more risk than others.
“What I tell my patients, my family, my friends, is that outdoors is lower risk than indoors, mask is lower risk than unmasked, and vaccinated is lower risk than unvaccinated,” said Dr. Luis Ostrosky, a professor and the chief of infectious diseases at the McGovern Medical School at UTHealth in Houston. “With that matrix, you can make decisions about what you want to do in your life.”
Ostrosky said he considers low-risk situations to be groups of less than 20 people or in settings where a large proportion are fully vaccinated.
Dr. Beth Kassanoff, an internal medicine physician with North Texas Preferred Health Partners and president of the Dallas County Medical Society, said the new guidelines should be taken as recommendations and people should still weigh the level of risk they’re willing to accept.
Someone with children who aren’t eligible for the vaccine, for example, may make different choices than a young adult in generally good health. It’s also possible for fully vaccinated people to get COVID-19, and while their case would most likely be mild, people should also consider if they can afford to feel bad for a few days if that were to happen.
“My 19-year-old who has been vaccinated, who is healthy, they may go over to a friend’s house and there may be some people who are vaccinated and some people who are not, and I don’t think they need to be all that concerned about it,” Kassanoff said. “That would be different than me, who has an increased risk of complications from COVID. I probably wouldn’t go sit around in somebody’s house if somebody hasn’t been vaccinated. Even though that’s not necessarily the CDC guidelines, that’s just the guideline that feels right for me.”
Ostrosky said people should remember the CDC’s new guidance still calls for masks in high-risk situations — including public transportation, airports and hospitals — but that those aren’t the only situations fully vaccinated people should consider high-risk.
According to the state’s data, about 40% of Texans 12 and older are fully vaccinated against COVID-19. While that does represent some protection, Ostrosky said things are still sort of “a game of odds.”
Without more individuals getting the shot, a significant amount of transmission can still happen in the community. The longer that goes on, the more likely that variants of the virus, which current vaccines may not protect against, will take over.
“If there’s a lot of unvaccinated people you may encounter just by odds, by chance, somebody who is infected with maybe a variant that’s not covered by the vaccine,” he said. “That’s what we worry about for big crowds and big settings.”
Did the new mask recommendation come too soon?
Kassanoff and Ostrosky said they thought the new mask guidance came a little too quickly.
Ostrosky said that he would have liked to see a larger percentage of people vaccinated nationwide before the CDC issued the new guidance, while Kassanoff expressed concerns that unvaccinated people would increasingly go without masks and that new variants could become dominant.
But the health experts said the hope is that the new guidelines give the people who have not been vaccinated an incentive to get the shots.
“I think that it needed to be done, honestly, because probably most people who were vaccinated were doing it anyway,” Cervantes said. “I think it gives [people] an incentive to be vaccinated because that’s what lots of people were saying, like, ‘Well, what’s the point of me being vaccinated if I still have to go around doing all this stuff?’”
Cervantes said guidance on masks could change if cases spike again.
