When should vaccinated people wear masks now? expert weighing
To clear up the confusion about masking, we turned to CNN medical analyst Dr. Lena Wayne for her thoughts. Wen is an emergency physician and visiting professor of health policy and management at George Washington University’s Milken Institute School of Public Health. She is also the author of a new book released later this month called Life Lines: A Doctor’s Journey in the Struggle for Public Health.
CNN: Are there circumstances in which vaccinated people must go back to wearing masks indoors?
Dr. Lina Wen: Yeah. Masks are still required in some places, such as airports, planes, trains and hospitals. If the work requires masks, you should still wear a mask, so it’s a good idea to carry a mask with you in case you need one.
As the question becomes more difficult, what about settings where you don’t have to wear a mask – when can you wear a mask? Here are the factors I should take into consideration.
The first is your health and the vaccination status of your family members. If you are immunocompromised, you should wear a mask in all indoor places where you could be exposed to unvaccinated people.
If you live with someone who is immunocompromised or with young children who are not immunized, you may still want to take extra precautions. Your chance of contracting Covid-19 and passing it on to your family is much lower once you receive the vaccination, but it is not zero. Consider wearing a mask in high-risk places, such as crowded grocery stores or indoor church services.
Second, the level of coronavirus infection and vaccination rate in your community. These two types are generally related: regions with higher vaccination rates also tend to have lower infection levels.
If you live in an area where more than 80% of adults are vaccinated, and rates of Covid-19 are very low, your chances of encountering an infected person who is not immunized are greatly reduced. You’d probably be safer when you don’t have a mask there compared to, for example, if you live in an area with less than 30% of adults vaccinated and where the delta variant is high.
CNN: Some people reading this will ask, “Why are we even talking about masks again, when vaccines are supposed to work so well?”
Wen: The Covid-19 vaccines we have in the United States are working very well. But no vaccine is effective 100% of the time. Think of the vaccine as a very effective raincoat. If it’s raining, you’ll be protected. If it rains hard, you may still be fine. But if you’re in and out of rainstorms all the time, you could end up getting wet.
The risks are cumulative. If you have multiple encounters every day with people who are not immunized, and there is a high level of transmission in the community in your area, your chances of getting a sudden infection after vaccination will increase. You can reduce this risk by wearing a mask in the most dangerous places.
CNN: What if you were to go to work and everyone in your office was vaccinated? Do you still need to wear a mask if there is no distance?
Wen: Good question. We know that vaccination greatly reduces your chance of getting infected and being an asymptomatic carrier and can pass the virus on to others. Your chance of getting an infection from someone who has been vaccinated, if you have also been vaccinated, is almost zero. Going to an office where everyone around you is known to be vaccinated, even without masks and distancing, is very safe.
CNN: How about the other way around — what if you have to go back to work, but vaccinations aren’t required? Should you wear a mask?
Wen: This depends on the other factors we have discussed. Consider your health, then the likelihood of someone at work becoming infected based on transmission and vaccination rates in your area. Also consider working conditions. Have the people you’ve been in close contact with been vaccinated? Let’s say your workplace does not have a vaccination policy, but the two people who share your office or the three people who have cubicles closest to you have been fully vaccinated. This will be a very safe environment, and you probably don’t need to wear a mask at your desk.
On the other hand, if you are asked to go into cramped and poorly ventilated meeting rooms with people you suspect have been vaccinated, consider wearing a mask there, or better yet, seeing if you can attend the meeting virtually.
CNN: Does the type of mask matter?
Wen: If you are immunocompromised and you are in a high-risk situation, you should wear an N95, KN95 or double mask. Otherwise, a 3-ply surgical mask should fit well, although if you’re comfortable with an N95 or KN95, there’s no harm in wearing it in crowded indoor spaces.
CNN: Are there any outdoor locations where you’d recommend a vaccinator wear a mask?
Wen: not now. The ventilation that comes with being outdoors greatly reduces transmission, as does vaccination. A severely immunocompromised person may still want to wear a mask at ball games or crowded concerts, but other than that, outside masks should not be needed for vaccinated people.
CNN: What if people assume you’re not immune because you’re wearing a mask?
Wen: Lots of people who have been vaccinated and want to be very careful are wearing masks. People who wear masks in public could have already been vaccinated, and people who are not immunized are those who walk around unmasked. You should focus on doing what makes you feel good. If you feel more comfortable wearing the mask in some places, you should.
CNN: How does the delta variable affect your recommendation?
Wen: Now that this variant has caused more than half of the new infections in the US, you should assume that if you’ve been in contact with someone with Covid-19, that’s the type of delta you’re experiencing. This variant is more transmissible than any of the previous variants. There is some evidence that people with the delta variant carry more viruses, making them more likely to infect others. Our vaccines appear to be effective against the delta variant, although they are less effective than against other strains.
CNN: To be clear, do unvaccinated people still need to wear masks?
Wen: right. The guidelines for non-vaccinated people have not changed. If unvaccinated people are near other unvaccinated people – or unvaccinated people – they should wear masks indoors. Outdoors, the risk of transmission is low, so there is no need for masks there. This applies to children as well, so children under the age of 12 who are not eligible for vaccination should still wear masks indoors when they are near other unvaccinated children.
With the high delta variable, I’ll be more vigilant than before. If there is a situation where you are on the fence about whether to wear your mask, I will err on the side of caution and just do it.