The CDC also said fully vaccinated people can gather indoors with those who are also fully vaccinated. And they do not need to quarantine, or be tested after exposure to the coronavirus, as long as they have no symptoms, the agency said.
Peter Hotez, co-director of the Texas Children’s Hospital Center for Vaccine Development, applauded the advice but said it has taken too long for the CDC to tell an exhausted public when their masks can come off.
“The sooner we move to telling people if you’re fully vaccinated you don’t have to wear masks, that will be an incentive for people to get vaccinated,” Hotez said.
For those who have made it through the rocky vaccine rollout, the five pages of guidelines offer a road map of sorts to resuming aspects of daily life that have been on hold for more than a year. They come as states have begun reopening and as government and public health officials are racing to vaccinate people as fast as possible to outpace highly transmissible versions of the virus spreading in nearly every state.
After a slow start, the pace of inoculations is accelerating, with 60 million people in the United States having received one shot and more than 31 million people fully vaccinated as of Monday, or about 9 percent of the population, according to the CDC. About 2.2 million people on average are getting vaccinated daily. President Biden has vowed to have enough supply for every adult who wants a shot by late May, raising hopes of a return to normal life.
The country is “starting to turn a corner,” Andy Slavitt, White House senior adviser for the coronavirus response, said in a briefing Monday, with the guidance highlighting “what a world looks like where we move beyond covid-19.”
CDC Director Rochelle Walensky said the recommendations sought to balance potential risk to those who are unvaccinated and impacts on community transmission against the benefit of “getting back to some of the things that we love in life” for those who are inoculated. She and others warned that millions more people need to be vaccinated before everyone can stop following coronavirus precautions.
The CDC will continue to update this initial guidance, perhaps loosening travel restrictions if new infections continue to decrease as vaccinations increase, Walensky said. But with over 90 percent of the population still unvaccinated and levels of virus high, even those who have received the shots “might get breakthrough infections with lesser amounts of virus,” she said, referring to a fully vaccinated person getting infected.
For now, officials are continuing to discourage travel, because “every time that there is a surge in travel, we have a surge in cases in this country,” Walensky said. “We know that many of our variants have emerged from international places, and we know that the travel corridor is a place where people are mixing a lot.”
The guidance outlines several ways fully vaccinated people can return to old routines, although it is more general than what some might have hoped for. It does not explicitly say, for instance, whether vaccinated grandparents can hug and kiss their unvaccinated grandchildren, but it appears to endorse such behavior by saying vaccinated people can safely gather indoors with those in one unvaccinated household without masks or physical distancing, as long as no one is at risk of severe disease.
A growing body of evidence suggests that fully vaccinated people are less likely to spread the virus to others. While some prevention measures continue to be necessary, the benefits of reducing social isolation “may outweigh the residual risk of fully vaccinated people becoming ill with covid-19” or transmitting the virus to others, the guidance says.
In addition, relaxing restrictions for vaccinated people “may help improve covid-19 vaccine acceptance and uptake,” the CDC says. “Therefore, there are several activities that fully vaccinated people can resume now, at low risk to themselves, while being mindful of the potential risk of transmitting the virus to others.”
Small gatherings probably represent minimal risk — with the safest situations being for the fully inoculated to get together with one another in private settings, such as a dinner among vaccinated friends in their homes, the CDC says.
But risk increases as gatherings get larger, take place outside the home or include more unvaccinated people who may have come from places with high rates of transmission.
The level of caution people need to exercise should be determined by the characteristics of those who are unvaccinated, the CDC says. Unvaccinated people from one household, or people living under one roof who are at low risk of severe covid-19, for instance, can visit with vaccinated people indoors without wearing masks, such as grandchildren visiting their grandparents. But if the unvaccinated neighbors stop by, the visit should move outdoors or to a well-ventilated space and everyone should don masks, because there is a higher risk of virus spread among them.
If a fully vaccinated person visits with an unvaccinated friend who is 70, and therefore at risk of severe disease, the visit should also take place outdoors, with masks and physical distancing, the guidance says.
Vaccinated people should also continue to follow the CDC’s travel recommendations, which include delaying travel while cases are extremely high. That means vaccinated grandparents are advised against flying to see their grandchildren. Grandparents can visit with their unvaccinated children and grandchildren “who are healthy and who are local,” Walensky said.
And vaccinated people need to still follow the same requirements, during and after domestic or international travel, including wearing masks. The CDC requires all international travelers to show proof that they have tested negative for the coronavirus before boarding flights to the United States.
In public settings, vaccinated people should continue to follow all public health precautions, including wearing a well-fitted mask, physical distancing and avoiding poorly ventilated spaces. The virus has been shown to spread in settings such as gyms and bars.
The CDC said fully vaccinated people who have been exposed to someone suspected or confirmed to have the coronavirus do not have to quarantine or be tested if they remain without symptoms. But if the exposure takes place in certain crowded settings that increase the risk of spread, such as prisons and group homes, they still need to quarantine for 14 days and get tested.
Advocates for older people embraced the loosened restrictions on social interaction. Many older people, especially those who live alone, they said, have spent the past year in virtual isolation, hunkered down against a virus that mainly kills people over 65.
“If the CDC is offering new ways for older people to connect more in a way that’s safe and healthy, this is really good news,” said Katie Smith Sloan, president and chief executive of LeadingAge, which represents 5,000 nonprofit organizations that provide services to older people. “I think clarity is so important, and good communication around that. So we welcome this. It takes some of the mystery out of it.”
Bill Walsh, vice president for communications for AARP, the interest group that represents 38 million people 50 and older, said that “after nearly a year of the pandemic, we’re grateful for any signs of return to life as we know it.”
“To the extent this allows people, grandkids, families, loved ones in nursing homes or assisted living [to interact], we welcome that,” he added. “We’ve heard over the past year some heart-wrenching stories of family separation.”
But Walsh warned that health officials have a long way to go to eliminate the trepidation many older people feel about safely resuming their old lives. He said many have struggled to apply vague and often conflicting information to their lives.
Those who have already begun resuming their lives said they are elated.
After Helen Boucher, an infectious-diseases doctor at Tufts Medical Center in Boston, was vaccinated in December, she began shopping at the grocery store again and, wearing a mask, visited her in-laws, who are 88 and 90, to take them kielbasa, macaroni and cheese, and a box of chocolates.
“I felt good that I could bring them stuff,” Boucher said. But she kept her visit short, since the couple had received their first shot only 2½ weeks before. “I had not been willing to put them at risk.”
Hotez and his wife are both fully vaccinated and traveled by plane this past weekend to visit their two oldest grown children, whom they had not seen in person in 14 months. One has been vaccinated, and the other was recently infected.
“The risk of transmission between us is very low,” he said. “It’s as good as it’s ever going to be. Risk is never going to go down to zero.”
Anthony S. Fauci, who is President Biden’s chief medical adviser and has been vaccinated, said he will finally embrace his daughter once she is also inoculated. “I’m going to have her over to the house, and I’m going to give her a big hug that I haven’t been able to do for a year,” he told CNN’s Chris Cuomo recently.