Do people vaccinated against COVID-19 ever need to wear masks?
Its been more than a month since Minnesotas indoor mask mandate ended. Masks are no longer required by the state in grocery stores, restaurants, theaters or bars. They are still recommended for people not vaccinated against COVID-19 and even for the vaccinated in some settings, like hospitals and child care. In some parts of the state, you wouldnt know the mask mandate had ended, as people  including fully vaccinated people  continue to wear masks, perhaps more as a social measure than a disease preventing one. Experts say if you consider all the factors at play in virus transmission, the answer might not be a hard yes or a hard no.  Article continues after advertisement  The evidence  First off, the Centers for Disease Control and Prevention still recommends people who arent vaccinated keep wearing masks in public. Research has found masks effective in slowing the transmission of COVID-19  offering some protection to the wearer of the mask, but also protecting the people around them by preventing at least some viral particles from being airborne and breathed in by others. But when it comes to the vaccinated, each of the three vaccines approved for use in the U.S. has been found to be highly effective in preventing people from getting sick from COVID-19. Thats been proven not just in clinical trials but in real life, as Minnesotas COVID-19 case numbers have dropped since the introduction of the vaccines in December. And it means that if you are vaccinated, its really quite unlikely you will get sick from COVID-19. Its also unlikely that youll give COVID-19 if youre fully vaccinated. Early on in the vaccine rollout, the science on this wasnt as clear  we only knew that the vaccines prevented people from getting sick. But with so many people vaccinated now, a clearer picture of the vaccines efficacy is emerging. Research finds theyre good at not only preventing sickness but also transmission, said Dr. Beth Thielen, an infectious disease physician with the University of Minnesota Medical School and M Health Fairview. At least for now. The verdict is less clear in terms of how long the vaccines protection will last as well as whether theyll be able to thwart all variants effectively. But even when it comes to the strain of COVID-19 that was predominant last year  before the more infectious variants  the vaccines are not 100 percent effective, said Kris Ehresmann, the infectious disease director at the Minnesota Department of Health. As of last week, Minnesota had seen fewer than 3,000 breakthrough cases (representing less than 0.1 percent of vaccinated people), which refer to cases that have developed in people who have been fully vaccinated. Usually, these cases arent severe, but in rare cases, they are. Its also not a bad idea to consider the vaccination status of the community when deciding whether to wear a mask, Ehresmann said. While more than 50 percent of Minnesotans over the age of 16 statewide have been fully vaccinated, that number varies considerably depending on what part of the state youre in. In parts of Central Minnesota, its far less, which means any given person at the store in some of these counties is less likely to have been vaccinated and more likely to transmit COVID-19. For a fully vaccinated person, the risk is low, but not totally nonexistent. Article continues after advertisement  This is sort of a personal comfort choice issue, Thielen said. I will say for myself, Im fully vaccinated, I have stopped wearing a mask and in grocery stores and those sorts of places.  While the vaccines work well on the whole, theres a certain percent of the population whose bodies dont mount enough of an immune response to the vaccines to give them full protection, whether thats because of ongoing chemotherapy, organ transplant or other conditions, Thielen said. That is a real legitimate area of concern  that people would still want to wear masks to protect themselves or household contacts that they might be putting at risk, for COVID-19 and for other diseases, she said. Ehresmann said that because some people who are immunocompromised dont have the full protection of a vaccine, its important that even where masks are no longer required, peoples wishes to wear a mask is respected. Collateral benefits  Its important to remember, too, that masks have collateral benefits beyond slowing the spread of COVID-19, Thielen said. Right now, the U.S. is seeing an unseasonable wave of RSV, or respiratory syncytial virus, in small children, Thielen said. Usually a winter virus, this common respiratory disease is often mild but sometimes serious, causing lung inflammation and pneumonia. Keeping up the mask-wearing can help slow the spread of RSV and other respiratory diseases. Article continues after advertisement  Its not just protecting against COVID, or preventing transmission of COVID, its protecting against transmission of all these other things, which we had a nice little break from while everybodys been distancing, Thielen said. Thielen also said that, pandemic or not, masks are a good choice in environments where theres lots of potential for disease spread or where people may be immunocompromised, like clinics and hospitals. When Im at work, I am worried about not just myself, but that Im around a lot of immunocompromised people and I dont want to be the one that spreads what could be a potentially fatal infection to one of my patients, she said. A lasting cultural change of wearing masks more in settings like this and other tight quarters, especially during the winter when virus transmission is high, could help keep everyone healthier, she said. And even as many tire of the pandemic the masks signify, Ehresmann said its important to remember that masks dont hurt anyone. Ive always said its never wrong to wear a mask, Ehresmann said. People who are wearing masks have added up all the risks and the benefits and said, Well, OK, I think Im going to still choose to wear a mask.