What’s the news: More than a year after urging Americans to don face cloth coverings to help limit the spread of SARS-CoV-2, the Centers for Disease Control and Prevention (CDC) has released new guidance on mask-wearing while outside.

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It’s safe to take off masks for some outdoor activities, especially for people who are fully vaccinated. This new guidance follows research showing SARS-CoV-2 does not spread readily outdoors. But there are still circumstances when masks should be worn outdoors.

As defined by the CDC, people are considered fully vaccinated two weeks after their second dose in a two-dose series, such as the Pfizer-BioNTech and Moderna COVID-19 vaccines. If a person still needs a second dose, they are not fully protected. Full vaccination is also achieved two weeks after a single-dose vaccine such as that from Johnson & Johnson-owned Janssen Pharmaceuticals.

According to the CDC, both fully vaccinated and unvaccinated individuals can safely unmask while:

  • Walking, running, hiking or biking outside alone or with members of the same household.
  • Attending a small outdoor gathering with fully vaccinated family and friends.

People who are fully vaccinated have additional safe options for outdoor maskless activities. Someone who is fully vaccinated can safely skip the mask while:

  • Attending a small outdoor gathering with a mix of fully vaccinated and unvaccinated people.
  • Dining at an outdoor restaurant with friends from multiple households.

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For these activities, unvaccinated people should continue to wear masks and practice physical distancing, says the CDC. Everyone—vaccinated or not—should also mask up when attending a crowded, outdoor event such as a concert, parade or sporting event. 

The CDC guidance indicates that  it is still important for everyone, fully vaccinated or not, to wear a mask while inside a public space. That includes going to the movies, attending church, getting on a plane, riding the bus, taking an exercise class at the gym or getting a haircut.

While most activities are safer for fully vaccinated people than those who are unvaccinated, CDC guidance says that everyone should still wear a mask to protect themselves and others. This is because people are not likely to know the vaccine status of those around them. Additionally, while early evidence suggests that fully vaccinated people are less likely to have asymptomatic infection and potentially less likely to transmit SARS-CoV-2 to others, further investigation is ongoing.

Why it’s important: The new outdoor mask guidance comes at a time when people are experiencing pandemic fatigue and yearning to safely resume normal activities. It also provides some sense of normalcy as the weather warms up and people look to escape outdoors.

There is increasing data suggesting that transmission is largely occurring indoors. The CDC notes that less than 10% of documented SARS-CoV-2 transmission has occurred outdoors, while there is an almost 20-fold increased risk of transmission indoors. Meanwhile, 37% of adults are now fully vaccinated and COVID-19 cases continue to fall.

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Which COVID-19 vaccine should I get? What to tell your patients

As more people get vaccinated against COVID-19 and case rates continue to drop, the CDC will develop further guidance.

Learn more: When choosing safer activities—whether fully vaccinated or not—it is important for everyone to consider how COVID-19 is spreading in their communities, the number of people participating in the activity and the location, says the CDC.

The AMA has developed frequently-asked-questions documents on COVID-19 vaccination covering safety, allocation and distribution, administration and more. There are two FAQs, one designed to answer patients’ questions, and another to address physicians’ COVID-19 vaccine questions.

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