Interim Public Health Recommendations for Fully Vaccinated People from CDC

Summary of Recent Changes

Updates as of April 27, 2021 Source: https://www.cdc.gov/

Guiding principles for fully vaccinated people are now provided.
Underscore that immunocompromised people, need to consult their healthcare provider about these recommendations, even if fully vaccinated
Fully vaccinated people no longer need to wear a mask outdoors, except in certain crowded settings and venues.
Clarification that fully vaccinated workers no longer need to be restricted from work following an exposure as long as they are asymptomatic.
Fully vaccinated residents of non-healthcare congregate settings no longer need to quarantine following a known exposure.
Fully vaccinated asymptomatic people without an exposure may be exempted from routine screening testing, if feasible.

Key Points

This set of public health recommendations for fully vaccinated people will be updated and expanded based on the level of community spread of SARS-CoV-2, the proportion of the population that is fully vaccinated, and the rapidly evolving science on COVID-19 vaccines.

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 and Johnson (J&J)/Janssen).^±

± 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 and 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).

The following recommendations apply to non-healthcare settings. For related information for healthcare settings

Fully vaccinated people can:

Visit with other fully vaccinated people indoors without wearing masks or physical distancing
Visit with unvaccinated people (including children) from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing
Participate in outdoor activities and recreation without a mask, except in certain crowded settings and venues
Resume domestic travel and refrain from testing before or after travel or self-quarantine after travel.
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 testing following a known exposure, if asymptomatic, with some exceptions for specific settings
Refrain from quarantine following a known exposure if asymptomatic
Refrain from routine screening testing if asymptomatic and feasible

For now, fully vaccinated people should continue to:

Take precautions in indoor public settings like wearing a well-fitted mask
Wear masks that fit snuggly when visiting indoors with unvaccinated people who are at increased risk for severe COVID-19 disease or who have an unvaccinated household member who is at increased risk for severe COVID-19 disease
Wear well-fitted masks when visiting indoors with unvaccinated people from multiple households
Avoid indoor large-sized in-person gatherings
Get tested if experiencing COVID-19 symptoms
Follow guidance issued by individual employers
Follow CDC and health department travel requirements and recommendations

Overview

Currently authorized vaccines in the United States are highly effective at protecting vaccinated people against symptomatic and severe COVID-19. Additionally, a growing body of evidence suggests that fully vaccinated people are less likely to have asymptomatic infection or transmit SARS-CoV-2 to others. How long vaccine protection lasts and how much vaccines protect against emerging SARS-CoV-2 variants are still under investigation. Until more is known and vaccination coverage increases, some prevention measures will continue to be necessary in some settings for all people, regardless of vaccination status. However, the benefits of reducing social isolation and relaxing some measures such as quarantine requirements may outweigh the residual risk of fully vaccinated people becoming ill with COVID-19 or transmitting SARS-CoV-2 to others. Additionally, taking steps towards relaxing certain measures for vaccinated persons may help improve COVID-19 vaccine acceptance and uptake. 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.

At this time, there are limited data on vaccine protection in people who are immunocompromised. People with immunocompromising conditions, including those taking immunosuppressive medications (for instance drugs, such as mycophenolate and rituximab, to suppress rejection of transplanted organs or to treat rheumatologic conditions), should discuss the need for personal protective measures with their healthcare provider after vaccination.

This guidance provides recommendations for fully vaccinated people, including:

How fully vaccinated people can safely visit with each other or with unvaccinated people in private settings
How fully vaccinated people can safely resume outdoor activities
How fully vaccinated people should approach domestic and international travel
How fully vaccinated people should approach isolation, quarantine, and testing

In indoor public spaces, fully vaccinated people should continue to protect themselves and others by wearing a well-fitted mask, covering coughs and sneezes, washing hands often, and following any applicable workplace or school guidance. Fully vaccinated people should still watch for symptoms of COVID-19, especially following an exposure to someone with suspected or confirmed COVID-19. If symptoms develop, all people – regardless of vaccination status – should isolate and be clinically evaluated for COVID-19, including SARS-CoV-2 testing, if indicated.

CDC will continue to evaluate and update public health recommendations for vaccinated people as more information, including on 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 visits and activities pose minimal risk to fully vaccinated people themselves or to those around them.
Small, private gatherings and visits to public indoor spaces likely represent minimal risk to fully vaccinated people. Therefore, the level of precautions taken should be determined by the characteristics of the unvaccinated people present, who remain unprotected against COVID-19.
Although the risk of COVID-19 infection may be minimal to the fully vaccinated person themselves, vaccinated persons should be mindful of the very low potential risk of transmitting the virus to others if they become infected, especially if they are visiting with unvaccinated people at increased risk for severe illness from COVID-19 or visiting with unvaccinated people who have people at increased risk for severe disease in their own households.
In indoor public spaces, the vaccination status of other people or whether they are at increased risk for severe COVID-19 is likely unknown. Therefore, fully vaccinated people should continue to wear a well-fitted mask, cover coughs and sneezes, wash hands often, and following any applicable workplace or school guidance.
Fully vaccinated people should not visit or attend a gathering or visit public settings if they have tested positive for COVID-19 in the prior 10 days or are experiencing COVID-19 symptoms, regardless of vaccination status of the other people at the gathering.
Fully vaccinated people should continue to follow any applicable state, local, tribal or territorial laws, rules, and regulations.
Although the risk of COVID-19 infection among fully vaccinated people is likely low, the following could increase risk:
- A moderate, substantial, or high level of community transmission
- Settings with a higher percentage of unvaccinated people (including children) present or people at risk of severe COVID-19 disease
- Visits to indoor settings especially with poor ventilation
- The length of the visit, especially if indoors
- Crowding or when there is a decreased ability to maintain physical distance
- Activities that involve behaviors such as singing, shouting, physical exertion or heavy breathing, inability to wear a mask, or inability to maintain physical distancing

Recommendations for Visiting with Others in Indoor Private Settings

Indoor visits or small gatherings likely represent minimal risk to fully vaccinated people. Large-sized indoor gatherings and those including unvaccinated people from multiple households increase the risk of SARS-CoV-2 transmission. Though the risk of acquiring SARS-CoV-2 infection themselves and transmitting the virus to others may be very low, fully vaccinated people should take precautions when visiting with unvaccinated people at increased risk for severe illness from COVID-19 or visiting with unvaccinated people who have people at increased risk for severe disease in their own households. Fully vaccinated people should not visit or attend a gathering if they have tested positive for COVID-19 in the prior 10 days or are experiencing COVID-19 symptoms, regardless of vaccination status of the other people at the gathering.

Indoor visits between fully vaccinated people

Indoor visits between fully vaccinated people who do not wear masks or physically distance from one another are likely low risk. For example, if you are fully vaccinated, it is likely a low risk for you to invite other fully vaccinated friends to dinner inside your private residence.

Indoor visits between fully vaccinated people and unvaccinated people

Indoor visits between fully vaccinated people and unvaccinated people who do not wear masks or physically distance from one another are likely low risk for the vaccinated people.

Therefore, the level of precautions taken should be determined by the characteristics of the unvaccinated people, who remain unprotected against COVID-19.

Vaccinated people visiting with unvaccinated people from a single household that does not have individuals at risk of severe COVID-19

If the unvaccinated people are from a single household that does not have individuals at risk of severe COVID-19, they can visit with fully vaccinated people indoors, without anyone wearing masks, with a low risk of SARS-CoV-2 transmission. For example, fully vaccinated grandparents can visit indoors with their unvaccinated healthy daughter and her healthy children without wearing masks or physical distancing, provided none of the unvaccinated family members are at risk of severe COVID-19.

Vaccinated people visiting with unvaccinated people from a single household that has individuals at risk of severe COVID-19

If any of the unvaccinated people or their household members are at increased risk of severe COVID-19, the safest place to visit is outdoors. If the visit takes place indoors, all attendees should take precautions including wearing a well-fitted mask, staying at least 6 feet away from others, and visiting in a well-ventilated space.

For example, if a fully vaccinated individual visits indoors with an unvaccinated friend who is seventy years old and therefore at risk of severe disease, they should both wear masks that fit snuggly, and maintain physical distance (at least 6 feet) or, to be safer, move the visit outdoors.

Vaccinated people visiting with unvaccinated people from multiple households at the same time

If the unvaccinated people come from multiple households, there is a higher risk of SARS-CoV-2 transmission among them, and the safest place to visit is outdoors. If the visit takes place indoors, all people involved should take precautions including wearing a masks that fit snuggly, staying at least 6 feet away from others, and visiting in a well-ventilated space.

Continuing the example from above, if fully vaccinated grandparents are visiting indoors with their unvaccinated daughter and her children and the daughter’s unvaccinated neighbors also come over, they should all wear masks that fit snuggly and maintain physical distance (at least 6 feet), or, to be safer, move the visit outdoors. This is due to the risk the two unvaccinated households pose to one another.

Recommendations for Large Gatherings

Fully vaccinated people should avoid indoor large-sized in-person gatherings and follow any applicable local guidance restricting the size of gatherings. If they choose to participate, fully vaccinated people should wear a well-fitted mask.

Other Personal or Social Activities Outside the Home

Recommendations for Indoor Activities

Risk of SARS-CoV-2 infection during public social activities such as dining indoors at a restaurant or going to the gym is lower for fully vaccinated people. However, precautions should still be taken as transmission risk in these settings is higher and likely increases with the number of unvaccinated people present. Thus, fully vaccinated people engaging in indoor social activities in public settings should continue to wear a well-fitted mask.

Recommendations for Outdoor Activities

Fully vaccinated people can participate in many outdoor activities without a mask at low risk to themselves or to others. While generally safe for vaccinated people to be outdoors without a mask, CDC continues to recommend requiring masking in crowded settings and venues where there is a decreased ability to maintain physical distance until widespread vaccination coverage is achieved.

Although the risk of COVID-19 spread is low in outdoor settings, especially among those who are vaccinated, the following factors could increase risk:

A moderate, substantial, or high level of community transmission
Settings with a higher percentage of unvaccinated people (including children) present or people at risk of severe COVID-19 disease
The length of the visit
Crowding or when there is a decreased ability to maintain physical distance
Activities that involve behaviors such as singing, shouting, physical exertion or heavy breathing, inability to wear a mask, or inability to maintain physical distancing

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.

CDC prevention measures continue to apply to all travelers, including those who are vaccinated. All travelers are required to wear a mask on all planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and in U.S. transportation hubs such as airports and stations.

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.
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.
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.
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. If they experience symptoms, they should isolate themselves from others, be clinically evaluated for COVID-19, including SARS-CoV-2 testing, if indicated, and inform their health care provider of their vaccination status at the time of presentation to care.

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 non-healthcare congregate settings (e.g., correctional and detention facilities, homeless shelters)
Fully vaccinated employees of high-density workplaces (e.g., poultry processing plants)
Fully vaccinated dormitory residents (or similar high-density housing settings) at educational institutions

Testing in these settings is still recommended because they may face high turnover of residents, a higher risk of transmission, and challenges in maintaining recommended physical distancing.

Fully vaccinated people with no COVID-19-like symptoms and no known exposure to someone with suspected or confirmed COVID-19

It is recommended that fully vaccinated people with no COVID-19-like symptoms and no known exposure should be exempted from routine screening testing programs, if feasible.

#360pms #Fullyvaccinated

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