Should people who took the Covid-19 vaccine start wearing masks again?

As the Delta variant spreads among the unvaccinated, many fully vaccinated people are also starting to worry. Is it time to hide again?

While there is no single answer to the question, most experts agree that masks remain a wise precaution in some settings for the vaccinated and the unvaccinated. How often you use a mask will depend on your tolerance and risk to your health, infection and vaccination rates in your community, and who you spend time with.

The bottom line is this: While being fully vaccinated protects against serious illness and hospitalization from Covid-19, no vaccine offers 100% protection. Until a large number of people are vaccinated and continue to spread the coronavirus, those vaccinated will be exposed to the Delta variant, and a small percentage of them will develop so-called “breakthrough” infections. Here are answers to common questions about how you can protect yourself and reduce your risk of getting an infection.

When should a vaccinated person wear a mask?

To decide if a mask is needed, first ask yourself these questions.

• Are the people I am with also vaccinated?

• What is the case rate and vaccination rate in my community?

• Will I be in a poorly ventilated indoor space, or outdoors? Will the increased risk of exposure last a few minutes or hours?

• What is my personal risk (or the risk to those around me) of complications from Covid-19?

Experts agree that if everyone you are with is vaccinated and has no symptoms, you do not need to wear a mask.

“I don’t wear a mask to hang out with other vaccinated people,” said Dr. Ashish K. Jha, Dean of Brown University School of Public Health. ” I do not even think about it. I go to the office with a bunch of people, and they’re all vaccinated. I don’t care.

But once you start to venture into enclosed public spaces where the chances of meeting unvaccinated people are greater, a mask is probably a good idea. Being fully vaccinated remains the strongest protection against Covid-19, but the risk is cumulative. The more opportunities you give the virus to challenge the antibodies you have accumulated from your vaccine, the higher your risk of coming into contact with exposure large enough for the virus to cross the protective barrier provided by your immune system. .

For this reason, the case rate and the vaccination rate in your community is one of the most important factors influencing the need for masks. In Vermont, Massachusetts, Connecticut and Rhode Island, for example, more than 70 percent of adults are fully vaccinated. In Alabama, Mississippi and Arkansas, less than 45% of adults are vaccinated. In some countries, overall immunization rates are much lower.

“We are currently two Covid nations,” said Dr Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine and co-director of the Center for Vaccine Development at Texas Children’s Hospital. In Harris County, Texas, where Dr Hotez lives, the number of cases has increased by 114% in the past two weeks, and only 44% of the community is fully vaccinated. “I wear a mask indoors most of the time,” Dr. Hotez said.

Finally, masking is more important in poorly ventilated indoor spaces than outdoors, where the risk of infection is extremely low. Dr Jah notes that he recently rushed to a cafe, without a mask, as vaccination rates are high in his area, and he was only there for a few minutes.

Your personal risk matters too. If you are older or if you are immunocompromised, your antibody response to the vaccine may not be as strong as that of a young person. Avoiding crowded spaces and wearing a mask when you are indoors and do not know the immunization status of those around you is a good idea.

Use The Times tracker to find vaccination rates and case rates in your area.

Why is the Delta variant prompting experts to rethink mask guidance?

When the U.S. Centers for Disease Control and Prevention announced that vaccinated people could stop wearing masks, the number of cases was falling, vaccinations were on the rise, and the highly infectious Delta variant had yet to take hold. Since then, Delta has spread rapidly and now accounts for over 83% of cases in the United States.

People infected with the Delta variant are known to excrete much higher levels of the virus for longer periods of time compared to previous lineages of the coronavirus. A preliminary study estimated that the viral load is 1,000 times higher in people with the Delta variant. These high viral loads give the virus more opportunities to challenge your antibodies and break the protection of your vaccine.

“It is twice as transmissible as the original line of Covid,” said Dr Hotez. “The reproductive number of the virus is around 6,” he said, referring to the number of people a virus carrier is likely to infect. “This means that 85% of the population must be vaccinated. Only a few regions of the country succeed.

Is it safe for people who have been vaccinated to go to restaurants, museums, movies, weddings, or other large gatherings?

The answer depends on your personal risk tolerance and the level of vaccination and Covid-19 cases in your community. The more time you spend with unvaccinated people in confined spaces for long periods of time, the more likely you are to come across the Delta variant or any variant that may arise.

Large gatherings, by definition, offer more chances of getting infected with the coronavirus, even if you are vaccinated. Scientists have documented groundbreaking infections at a recent Oklahoma wedding and July 4 celebrations in Provincetown, Massachusetts.

But even with the Delta variant, the full vaccination appears to be around 90% effective in preventing serious illness and hospitalizations from Covid-19. If you are at a very high risk of complications from Covid-19, however, you should consider avoiding risky situations and wearing a mask when the vaccination status of those around you is unknown.

Healthy vaccinated people who are at low risk of complications should decide what level of personal risk they are willing to tolerate. Wearing a mask during large indoor gatherings will reduce their risk of infection. If you are healthy and vaccinated, but caring for an aging parent or spending time with other high-risk people, you should also consider their risk when deciding to attend an. event or wear a mask.

“If I go to a public space, I will usually wear a mask,” said Dr Hotez. “Until recently, I took my son and his girlfriend to a restaurant for dinner and didn’t wear a mask because the transmission was very low. Now I am not so sure. Maybe I’ll readjust my way of thinking about restaurants as Delta picks up the pace.

If breakthrough infections are rare, why do I keep hearing about them?

Revolutionary infections are getting a lot of attention because people who have been vaccinated are talking about them on social media. When clusters of breakthrough infections occur, they are also reported in scientific journals or in the media.

But it’s important to remember that even though breakthrough cases are relatively rare, they can still happen regardless of which vaccine you get.

“No vaccine is 100% effective in preventing disease in people who have been vaccinated,” the CDC says on its website. “There will be a small percentage of fully vaccinated people who will still get sick, be hospitalized or die from Covid-19. ”

A revolutionary case doesn’t mean your vaccine isn’t working. In fact, most cases of breakthrough infections cause no symptoms or only mild illness, showing that vaccines work well in preventing serious illness from Covid-19.

As of July 12, more than 159 million people in the United States had been fully vaccinated against Covid-19. Of these, only 5,492 had breakthrough cases that resulted in serious illness, including 1,063 deceased. This is less than 0.0007 percent of the vaccinated population. Meanwhile, 99% of deaths from Covid-19 are among the unvaccinated.

Many infectious disease experts are frustrated that the CDC only documents cases in which someone vaccinated with Covid-19 is hospitalized or dies. But many groundbreaking infections are still being detected in asymptomatic people who are frequently tested, such as baseball players and Olympic athletes. Many of these people travel or spend long periods of time closely with others.

“The numbers in sport are different,” said Dr Jha. “Part of the problem is that they also meet a lot of unvaccinated people, including in their own small circle.”

I am vaccinated. How often should I be tested for Covid-19?

If you are fully vaccinated and know you have been exposed to someone with Covid-19, it is a good idea to get tested, even if you have no symptoms.

And if you have cold symptoms or any other sign of infection, experts agree that you should be tested. Many vaccinated people who do not wear masks have caught summer colds which cause a runny nose, fever and cough. But it’s impossible to tell the difference between a summer cold and Covid-19. Anyone with cough or cold symptoms should wear a mask to protect those around them and get tested to rule out Covid-19. It’s a good idea to keep some home Covid tests on hand as well.

“If I woke up one morning and had cold symptoms, I would put on a mask at home and get tested,” Dr Jha said. “I don’t want to cause major infections for other members of my family, and I don’t want to give it to my 9 year old.”