Cohen Medical Associates is a family medical center and research center located in Delray Beach, FL.
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To Mask or Not to Mask?

Ever since the Centers for Disease Control and Prevention (CDC) issued new guidance on wearing a mask for those who are vaccinated against COVID-19, our primary care doctors in Delray Beach have been receiving questions from our patients on what it all means. So we thought we’d take this opportunity to try to clear up some confusion.

Why the change?

The vaccines were originally granted approval based on clinical trial results. However, subsequent testing under real-world conditions has supported the early performance data. For example, a federal study released in late April showed that both the Pfizer-BioNTech and Moderna vaccines were highly effective in adults 65 and older.

In that study, fully vaccinated adults 65 and older were 94% less likely to be hospitalized than unvaccinated people of the same age, according to the CDC. Those who were partially vaccinated were still 64% less likely to be hospitalized than those who hadn’t received the vaccines.

Another study from Qatar released earlier this month showed that the Pfizer and Moderna vaccines were effective against several of the coronavirus variants, while other studies have found the Johnson & Johnson vaccine also showed high protection against the variants.

Breakthroughs can happen

In sum, a growing body of evidence indicates that those who are vaccinated are highly protected from becoming severely ill and spreading the virus to others.

Not everyone supports this move by the CDC, however. Nationwide, only a little more than a third of Americans have been fully vaccinated. In Florida, that number is about 50%. While some have been reluctant to receive the vaccine, others still have not yet had the opportunity. So this population remains highly vulnerable to the coronavirus.

The problem arises in exposing these people—often in the service industry—to the virus. This is because knowing whether someone not wearing a mask has been vaccinated is impossible. This makes it difficult to protect frontline workers.

If the unvaccinated continue to spread the virus among themselves, they cannot only cause another spike in cases that could stress the health care system, but provide more opportunities for the virus to mutate. In that case, the current vaccines may not be effective against those new variants. We’d be back to square one.

In addition, even though the vaccines have a significant rate of efficacy, breakthrough cases can still happen.

They are extremely rare, however. As of the end of April, the CDC reported 9,245 infections among the more than 95 million Americans who have been vaccinated, an infection rate of only 0.01%. Of those, 27% were asymptomatic, 9% were hospitalized, and 1% died.

Where you still have to wear a mask

The CDC guidance said those who are fully vaccinated against COVID-19 “can participate in indoor and outdoor activities, large or small, without wearing a mask or physical distancing.”

It did cite some exceptions to this recommendation:

  • Travel on any public conveyance still requires masks (planes, buses, trains).
  • The CDC also recommends continuing to wear masks in healthcare settings, like hospitals, nursing homes, and doctors’ offices.
  • Retail stores, including pharmacies and grocery stores, are private entities and can set their own masking policies. So will offices and other workplaces.

Who should be wearing a mask?

It’s ultimately up to you whether to remove your mask in public. But if you aren’t fully vaccinated—which means having received one Johnson & Johnson dose or two Pfizer or Moderna doses, plus waiting two more weeks for the immune response to become fully effective—and choose to go without a mask, you are putting yourself at risk of contracting the coronavirus.

In addition, the virus can also infect children under the age of 12, who are not yet eligible for the vaccine. By not wearing a mask, you risk passing it to them. While many believe children can’t get COVID-19, this is a myth. Not only can they become infected, but over 3.7 million children have done so. Of those, approximately 250 have died.

Earlier this month, the American Academy of Pediatrics (AAP) reported children now make up 22.4% of all new weekly cases. In addition, studies suggest they can pass it on to adults, even if they aren’t showing symptoms.

And others may choose to continue to wear masks despite receiving both vaccinations. For instance, immune-compromised persons should continue to wear masks in crowded indoor spaces. Since they can’t know the vaccination status of people in a crowd, they might mask to protect themselves.

“If you are a cancer patient on chemotherapy, or you are on immunosuppressive for a kidney transplant, you also will have a much higher chance of becoming infected despite being vaccinated,” Dr. Leana Wen, an emergency physician and public health professor at George Washington University, told MarketWatch.

If you have not received a coronavirus vaccine, we strongly urge you to do so. And remember: We have the Moderna coronavirus vaccine available to our current patients by appointment only.

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