The patchwork system for mask guidance in the US will continue despite federal authorities’ decision last week to say people fully vaccinated against Covid-19 mostly do not need to wear masks indoors.
Companies including Walmart and Starbucks lifted mask mandates in response. Others, including Gap, plan to keep them in place. States including New Jersey and California also plan to keep mask rules in place.
But half of US states had already lifted mask mandates and on Monday the governor of New York, Andrew Cuomo, announced that from Wednesday his state would drop its mask mandate indoors for vaccinated people.
“Let’s get back to life,” Cuomo said, speaking at the Radio City Music Hall in Manhattan, one of the celebrated venues that will now reopen to vaccinated audiences. “If you are vaccinated, you are safe. No masks. No social distancing.”
On Sunday, Dr Rochelle Walensky, the director of the Centers for Disease Control and Prevention, told CNN: “I want to convey that we are not saying that everybody has to take off their mask if they’re vaccinated.
“It’s been 16 months that we’ve been telling people to [wear a] mask and this is going to be a slow process.”
The CDC first advised people to wear masks in April 2020, 13 months ago. Before that, the agency repeatedly said it did not recommend using them for Covid-19.
At least 37% of Americans are fully vaccinated, according to the CDC. People are considered fully vaccinated two weeks after they receive a second dose of the Pfizer or Moderna vaccine or the single-dose Johnson & Johnson vaccine.
The CDC guidance issued last Thursday said fully vaccinated people did not need to wear a mask indoors or outdoors with the exception of healthcare settings, homeless shelters, prison and jails and on public transportation.
In response, businesses including Target and Costco ended in-store mask mandates, but said such rules would still be in place if mandated by local law. Other stores, including Home Depot, said they would continue to enforce mask-wearing rules.
The CDC guidance also leaves open the question of how to tell who has been vaccinated and who has not. For groups as yet ineligible for the vaccine, or not as well protected by it, this uncertainty could pose a serious health risk.
Children under the age of 12 do not have access to the vaccine. Populations not as well protected by vaccines include cancer patients, organ transplant recipients and other immunocompromised people.
“This was not permission to shed masks for everybody, everywhere,” Walensky told NBC. “This was really [a] science-driven individual assessment of your risk.”
Two public health experts, Dr David Holtgrave and Dr Eli Rosenberg, said the CDC guidance failed to include information on the risks vaccinated people still face and may have raised stigma for people who still want to wear masks.
In an opinion piece for CNN, Holtgrave and Rosenberg criticized the agency for not announcing an initiative to get unvaccinated people vaccinated.
“If you are going to cast aside some safety measures,” they said, “you need to devise or scale up other ones.”
Vaccine access remains a pressing issue. White people have received a higher share of vaccinations compared with their share of Covid cases and the total population in most states, according to a Kaiser Family Foundation (KFF) analysis of CDC data.
A doctor in Illinois, Marina Del Rios, tweeted: “If the USA’s overall vaccination rates were as low as they currently are among Latinx and Black people, the CDC would NOT have changed their guidelines. #AmericanExceptionalism #Racism is alive, well, and thriving.”
One-third of unvaccinated Hispanic adults said they want a vaccine as soon as possible, about twice the share among unvaccinated Black and white adults, according to a KFF report. The Hispanic population is half as likely as unvaccinated white adults to say they will “definitely not” get the vaccine.
The KFF report said that compared with white adults, larger shares of unvaccinated Hispanic adults said they were concerned about missing work due to vaccine side-effects or that they might have to pay for the vaccine – though all such shots are free.