New CDC Recs on Commingling After COVID Vaccination

WASHINGTON — People who have been vaccinated against COVID-19 will be able to gather together in small groups indoors without wearing masks or social distancing, according to guidance released Monday by the CDC.

“The CDC recommends that fully vaccinated people can visit with other fully vaccinated people in small gatherings, indoors, without wearing masks or physical distancing,” CDC Director Rochelle Walensky, MD, said at a White House COVID-19 press briefing. “What does this mean? You can visit your grandparents if you have been vaccinated and they have been too.”

Things get more complicated when the scenario involves both vaccinated and unvaccinated people, Walensky continued. “When fully vaccinated people visit with unvaccinated people, we have to consider the underlying risks of the unvaccinated people and any unvaccinated members of their household.”

In that case, the agency recommends that “fully vaccinated people can visit with unvaccinated people from one other household, indoors, without wearing masks or physical distancing, as long as the unvaccinated people and any unvaccinated members of their household are not at high risk for severe COVID-19 disease.” Those at high risk include people over 65 or with an underlying condition such as cancer, heart disease, or diabetes that could increase the risk of COVID-19-related hospitalization or death, she said.

However, “if an unvaccinated individual or any unvaccinated member of their household are at high risk for severe disease, everyone, regardless of vaccination status, should still wear a mask and physically distance, and choose to meet outdoors or in a well-ventilated space. This is recommended to keep the individuals at high risk who are unvaccinated safe,” she continued. “Similarly, when fully vaccinated people are visiting with unvaccinated people from multiple households,” the same rules would apply.

“It’s important to note that this is initial guidance,” Walensky said. “The science of COVID-19 is complex, and our understanding of the virus continues to rapidly evolve. The recommendations issued today are just a first step. As more people get vaccinated and the science and evidence expands, and as the disease dynamics of this country change, we will continue to update this guidance.”

She noted that 90% of the population is still not fully vaccinated, “though we are working hard to get there … COVID-19 continues to exact a tremendous toll on our nation,” she said. “Like you, I want to be able to return to everyday activities and engage with our friends, families, and communities. Science and the protection of public health must guide us as we begin to resume these activities. Today’s action represents an important first step; it is not our final destination. As more people get vaccinated, levels of COVID-19 infection decline in communities, and as our understanding of COVID immunity improves, we look forward to updating these recommendations to the public.”

During a question-and-answer session, Walensky said the CDC was not changing its recommendations on travel. “Every time there is a surge in travel, we have a surge in cases,” she said. “We know that many of our variants have emerged from international places, and we know the travel corridor is a place where people are mixing a lot. We are really trying to restrain travel at this current period of time, and we’re hopeful that our next set of guidance will have more science around what vaccinated people can do, perhaps travel being among them.”

Andy Slavitt, White House senior advisor for the COVID-19 response, added that White House officials think that the desire to travel “is part of a growing list of reasons why Americans do want to get vaccinated.”

Although fully vaccinated people can have a few more freedoms, they should still continue to follow many current COVID-19 precautions, Walensky said, including:

• Masking and social distancing in public
• Avoiding medium- and large-sized in-person gatherings
• Getting tested if they experience COVID-19 symptoms

Also at the briefing, Anthony Fauci, MD, President Biden’s chief medical advisor, summarized the latest development in the search for antivirals to treat COVID-19. He noted that some early-stage non-monoclonal antibody candidates such as small proteins and peptides are in preclinical development, while a preliminary analysis of phase IIa trial data for molnupiravir, a polymerase inhibitor from Ridgeback Biotherapeutics and Merck, found that symptomatic COVID-19 patients taking the drug showed a quicker decrease of infectious virus.

Another polymerase inhibitor, AT-527 from Atea Pharmaceuticals, also showed favorable safety and pharmacokinetic data from its phase I trial, he said, while Pfizer is in a phase I trial of a protease inhibitor.

“This is really the beginning of the phase of looking in a strategic way for direct-acting antivirals, which are going to be used to prevent people from progressing in their disease, namely keeping them out of the need for hospitalization,” Fauci said.