Guidelines for COVID-19 Fully Vaccinated People

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The U.S. Centers for Disease Control and Prevention (CDC) released recommendations for fully vaccinated people who are two weeks past their second injection of the Moderna or Pfizer COVID-19 vaccines, or have had the one-dose Johnson & Johnson vaccine (JAMA, March 10, 2021). As of March 8, 2021, more than 31 million people (9.4 percent of the U.S. population) had completed these vaccines. Fully-vaccinated people may continue to shed the virus, even though they are protected from blood-borne infections, and so may still be able to infect others. Fully vaccinated people may still acquire the virus, but are at markedly reduced likelihood to suffer severe disease, be hospitalized, or die, or to transmit the virus to unvaccinated people. The CDC estimates that approximately one third of U.S. adults do not want to get vaccinated. It likely that, as with polio and smallpox, the pandemic will persist until a large percentage of the population are immunized.

Most people who have recovered from COVID-19 appear to gain immunity for more than six months (Science, 2021;371(6529):eabf4063). As vaccination helps to prevent infection from the SARS-CoV-2 variants that have been found so far, the CDC recommends that individuals who have recovered from COVID-19 should receive at least one injection of a COVID-19 vaccine.

At this time, CDC recommends that fully vaccinated people:
• can share gatherings in their private residence with vaccinated family and friends, without masks or physical distancing, but should wear masks and practice physical distancing if any unvaccinated people are present or if multiple households with unvaccinated people are mixing together
• will, with a few exceptions, no longer have to be tested for SARS-CoV-2 infection or quarantine if they are exposed to someone with COVID-19, allowing them to go to work, take care of their families, and continue their daily lives (exceptions to this recommendation include patients and residents of congregate settings)
• should continue to wear a well-fitted mask when in public or with people at risk of severe COVID-19, avoid large gatherings, and postpone travel
• should observe local mask mandates and restrictions on occupancy of indoor spaces or the size of social gatherings. Once vaccinated people make up a greater proportion of the general U.S. population, these community-level restrictions will be readdressed, but not yet.