Seyfarth Synopsis: On April 27, 2021, CDC announced updated recommendations for fully vaccinated people in non-healthcare settings (note that on the same day the CDC also posted Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination).
Among other updates, the CDC: provided "guiding principles" for fully vaccinated individuals; explained that fully vaccinated people no longer need to wear masks outdoors (except in certain "crowded" settings and venues); and clarified that fully vaccinated folks, without symptoms, generally are not restricted from work following exposure to a known or suspected COVID-19 case.
Under the updated guidance, 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, according to the CDC, 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-19disease 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
Recognizing that fully vaccinated persons have a minimal risk of contracting or transmitting COVID-19 to others, the CDC states that the "level of precautions taken should be determined by the characteristics of the unvaccinated people present, who remain unprotected against COVID-19." In other words the CDC is focusing on the risks to unvaccinated persons which the CDC assumes "remain unprotected against COVID-19." An obvious gap in the CDC guidance is the role that natural immunity plays for persons who are unvaccinated. However, the CDC is silent on this issue. In other parts of its own guidance the CDC recognizes that natural immunity is sufficient to warrant modified quarantine and exclusion from work treatment, just like for vaccinated persons. Once the guidance is based on the risk to those who are "unvaccinated" it seems clear that all forms of immunity to COVID-19 possessed by those persons should be considered when evaluating the overall risk and therefore the appropriate precautions.
In indoor public spaces, the guidance states that 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.
While the CDC's guidance does not explicitly apply to workplaces, it mentions employers, and is moving in the right direction. We expect the CDC to continue to update its guidance, including addressing how increased vaccinations impact the risk mitigation protocols required at work. Hopefully, now that the CDC has implicitly accepted the significant immunity and protection provided by vaccination, and they are now focusing on the risk to OTHERS, the CDC will more thoroughly evaluate those risks including the role of natural immunity. Of course, other mandates from federal agencies like OSHA or those imposed by state and local governments must be followed, where applicable.
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