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The Wayback Machine - https://web.archive.org/web/20210728015440/https://www.cdc.gov/coronavirus/2019-ncov/vaccines/ful… COVID-19 Interim Public Health Recommendations for Fully Vaccinated People Updated July 27, 2021 Print Updates as of July 27, 2021 Summary of Recent Changes • 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 View Previous Updates 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 following a known exposure, if asymptomatic, with some exceptions for specific settings 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 quarantine following a known exposure if asymptomatic Refrain from routine screening testing if feasible 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. • • 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 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. 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 COVID19 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 o u y acc ated peop e s ou d app oac so at o , qua a t e, a d test g 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. • Continue to follow any applicable federal, state, local, tribal, or territorial laws, rules, and regulations. 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. 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 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. • 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. 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. 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 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, as their risk of infection is low. However, they should still monitor for symptoms of COVID-19 for 14 days following an exposure. Exceptions where testing (but not quarantine) is still recommended following an exposure to someone with suspected or confirmed COVID-19 include: • Fully vaccinated residents and employees of correctional and detention facilities and homeless shelters. Fully vaccinated people with no COVID-19-like symptoms and no known 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 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 or be restricted from work 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. For Healthcare Professionals COVID-19 Clinical Resources This guidance applies to COVID-19 vaccines currently authorized for emergency use by the U.S. Food and Drug Administration: Pfizer-BioNTech, Moderna, and Johnson & Johnson (J&J)/Janssen COVID-19 vaccines. This guidance can also be applied to COVID-19 vaccines that have been authorized for emergency use by the World Health Organization (e.g. AstraZeneca/Oxford). † Previous Updates Updates from Previous Content As of July 16, 2021 • Updated considerations for people who are immunocompromised As of July 12, 2021 • Updated Choosing Safer Activities infographic with new considerations for the example activity for outdoor gatherings with fully vaccinated and unvaccinated people. As of May 13, 2021 • Update that fully vaccinated people no longer need to wear a mask or physically distance in any setting, except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance • Update that fully vaccinated people can refrain from testing following a known exposure unless they are residents or employees of a correctional or detention facility or a homeless shelter Last Updated July 27, 2021
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