After the Centers for Disease Control and Prevention released new guidance on face coverings for fully vaccinated people, and several D.C.-area jurisdictions followed suit in alignment with the new federal recommendations, confusion broke out, with many ceremoniously ripping off their masks and others cautiously opting to keep them on.
So how should fully vaccinated people interpret the new CDC guidelines?
“The CDC made the change and their recommendations saying that people who are fully vaccinated can feel safe by not wearing a mask, not only outdoors, but also indoors,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told WTOP on Wednesday.
But that does not mean that people who are not vaccinated, who are not protected, can forget about wearing a mask, he said.
“People who are unvaccinated, who have not yet gotten vaccinated, clearly need to maintain the adherence to the CDC guidelines that were in place before this new guideline, namely, wearing a mask in most indoor settings,” Fauci said.
Despite sowing confusion, the science behind the CDC’s guidance is solid.
Dr. Monica Gandhi, a professor at the University of California San Francisco medical school, said the guidance shocked a lot of people in its abruptness, but the “numbers really do back this up.”
“They just said, essentially, that the vaccines are so effective, that they’re actually more effective than they were in the clinical trials,” Gandhi said.
Information over the last four months show how effective the vaccines are in the real world, not just in clinical trials, she said. One study, Gandhi said, showed that among health care workers, the vaccines were 90% effective; another study from the CDC showed them to be 95% effective; and a study from Qatar showed that despite variants, the vaccines were still 98% effective.
Duration of immunity
The durability of the vaccines currently being administered is “at least six months and likely considerably longer,” Fauci said.
Researchers are continuing to monitor that in people who have been vaccinated to determine if and when a booster shot is needed, based namely on the levels of antibodies in their blood, as well as following the number or degree of breakthrough infections.
“When we start to see the level of protection start to diminish from a laboratory standpoint, and or an increase in breakthrough infections. That will be a very important signal that we’ll have to start giving people booster shots,” Fauci said, adding that he hopes it does not get to that point.
Gandhi said she does not think that boosters would be needed.
“If you look at, essentially, the production of what are called memory B cells and memory T cells, what these vaccines do is they create cells that go into your bank, so to speak. They go into your lymph nodes; they go and hide out there. They’re called memory B and memory T cells. And if they’re ever needed again, they come out and produce antibodies and protective forces against the virus,” she said.
Of course, decisions on boosters will be based on the science, but there is good evidence that these cells can last a lifetime, Gandhi said.
Vaccines vs. variants
Fauci said that laboratory tests have been done on the ability of vaccines to protect against one of the dominant variants currently spreading in India.
“If you look at the ability of vaccines to protect against that, it’s diminished somewhat in its ability, but not substantially,” Fauci said.
Although the efficacy or effectiveness of the antibodies would diminish by a few fold, it’s not enough to make one completely vulnerable to that variant, he said.
So masks on or off?
The answer is vaccines.
The CDC guidelines “really talk to us about how vaccines blocked transmission,” Gandhi said.
“You as a vaccinated person, it is almost impossible for you to transmit to someone because your rate of even having it in your nose, even if you feel well, goes down — so-called asymptomatic infection,” Gandhi said.
The message, backed by the data, is that vaccinated people don’t have to wear masks, she said.
“It’s going take a little while to get used to, but it’s based in the science and you really don’t have to wear masks.”
Gandhi said it was important to update the guidance to give people hope, and she believes part of the reason the CDC did it was to motivate vaccination.
The mask was a protection before the vaccine, but the vaccine blows everything else out of the water, Gandhi said. “And it’s the truth. It’s just sound, sound science.”
WTOP’s Dimitri Sotis contributed to this report.
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