CDC Updates COVID-19 Guidance for Fully Vaccinated People

October 19, 2021
Updated October 19, 2021. On October 15, 2021, the CDC updated its guidance for fully vaccinated people to recommend, among other things, that fully vaccinated people get tested 5-7 days after close contact with a person with suspected or confirmed COVID-19. The CDC also updated its “When You’ve Been Fully Vaccinated” guidance to provide the same recommendation.

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On April 27, 2021, the Centers for Disease Control and Prevention (“CDC”) issued updated guidance for fully vaccinated people in non-healthcare settings, which, among other things, provides that fully vaccinated workers no longer need to be restricted from work following an exposure to COVID-19 if they are asymptomatic. People are considered fully vaccinated two weeks after a single-dose vaccine, or two weeks after the second dose of a two-dose series vaccine. Employers may want to check whether their applicable state and local guidance has been updated to reflect the CDC’s guidance. Employers should continue to follow state and local guidelines regarding employee and workplace measures during the pandemic, including with respect to fully vaccinated employees.

Recommendations for Isolation, Quarantine, and Testing. The guidance provides the following isolation, quarantine, and testing guidance for fully vaccinated people:
  • Fully vaccinated people with COVID-19 symptoms should isolate themselves from others, be clinically evaluated for COVID-19, and get tested if indicated. A symptomatic fully vaccinated person should inform their healthcare provider of their vaccination status at the time of presentation to care.
  • Most fully vaccinated people with no COVID-like symptoms do not need to quarantine, be restricted from work, or be tested following an exposure to someone with suspected or confirmed COVID-19. Following an exposure, fully vaccinated people should still monitor for symptoms of COVID-19 for 14 days, and if they experience symptoms, they should isolate themselves from others, be clinically evaluated for COVID-19, get tested if indicated, and inform their health care provider of their vaccination status at the time of presentation to care.
  • Fully vaccinated people with no COVID-19-like symptoms and no known exposure to someone with suspected or confirmed COVID-19 should be exempted from routine screening testing programs, if feasible.
Permitted Activities. Under the new guidance, fully vaccinated people can:
  • Visit with other fully vaccinated people in private indoor settings without wearing masks or physical distancing.
  • Visit with unvaccinated people (including children) from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing.
  • Participate in outdoor activities and recreation without a mask, except in certain crowded settings and venues.
  • Resume domestic travel and refrain from testing before or after travel or self-quarantine after travel.
  • Refrain from testing before leaving the United States for international travel (unless required by the destination) and refrain from self-quarantine after arriving back in the United States.
  • Refrain from testing following a known exposure, if asymptomatic, with some exceptions for specific settings.
  • Refrain from quarantine following a known exposure if asymptomatic.
  • Refrain from routine screening testing if asymptomatic and feasible.
Continued Precautions. According to the guidance, fully vaccinated people should continue to:
  • Take precautions in indoor public settings like wearing a well-fitted mask.
  • Wear well-fitted masks when visiting indoors with unvaccinated people who are at increased risk for severe COVID-19 disease or who have an unvaccinated household member who is at increased risk for severe COVID-19 disease.
  • Wear well-fitted masks when visiting indoors with unvaccinated people from multiple households.
  • Avoid indoor large-sized in-person gatherings.
  • Get tested if experiencing COVID-19 symptoms.
  • Follow guidance issued by individual employers.
  • Follow CDC and health department travel requirements and recommendations.
Guiding Principles. The guidance sets forth the following guiding principles for fully vaccinated people:
  • Outdoor visits and activities pose minimal risk to fully vaccinated people themselves or to those around them.
  • Small, private gatherings and visits to public indoor spaces likely represent minimal risk to fully vaccinated people. The level of precautions taken should be determined by the characteristics of the unvaccinated people present, who remain unprotected against COVID-19.
  • Fully vaccinated persons should be mindful of the very low potential risk of transmitting the virus to others if they become infected, especially if they are visiting with unvaccinated people at increased risk for severe illness from COVID-19 or visiting with unvaccinated people who have people at increased risk for severe disease in their own households.
  • In indoor public spaces, the vaccination status of other people or whether they are at increased risk for severe COVID-19 is likely unknown. Therefore, fully vaccinated people should continue to wear a well-fitted mask, cover coughs and sneezes, wash hands often, and follow any applicable workplace or school guidance.
  • Fully vaccinated people should not visit or attend a gathering or visit public settings if they have tested positive for COVID-19 in the prior 10 days or are experiencing COVID-19 symptoms, regardless of vaccination status of the other people at the gathering.
  • Fully vaccinated people should continue to follow any applicable state, local, tribal or territorial laws, rules, and regulations.
  • Although the risk of COVID-19 infection among fully vaccinated people is likely low, the following could increase risk:
  • A moderate, substantial, or high level of community transmission.
  • Settings with a higher percentage of unvaccinated people (including children) or people at risk of severe COVID-19 disease present.
  • Visits to indoor settings especially with poor ventilation.
  • The length of the visit, especially if indoors.
  • Crowding or when there is a decreased ability to maintain physical distance.
  • Activities that involve behaviors such as singing, shouting, physical exertion or heavy breathing, inability to wear a mask, or inability to maintain physical distancing.
Recommendations for Indoor Private Settings. The guidance states that indoor visits or small gatherings likely represent minimal risk to fully vaccinated people, and that large-sized indoor gatherings and those including unvaccinated people from multiple households increase the risk of COVID-19. The guidance recommends that fully vaccinated people take precautions when visiting with unvaccinated people at increased risk for severe illness from COVID-19 or visiting with unvaccinated people who have people at increased risk for severe disease in their own households. The guidance states that fully vaccinated people should not visit or attend a gathering if they have tested positive for COVID-19 in the prior 10 days or are experiencing COVID-19 symptoms, regardless of vaccination status of the other people at the gathering.

The guidance for indoor private settings varies depending on the people in attendance:
  • Indoor visits between fully vaccinated people who do not wear masks or physically distance from one another are likely low risk.
  • Recommendations for indoor visits between fully vaccinated and unvaccinated people are as follows:
  • If the unvaccinated people are from a single household that does not have individuals at risk of severe COVID-19, they can visit with fully vaccinated people indoors, without anyone wearing masks.
  • If any of the unvaccinated people or their household members are at increased risk of severe COVID-19, the safest place to visit is outdoors. If the visit takes place indoors, all attendees should take precautions including wearing a well-fitted mask, staying at least 6 feet away from others, and visiting in a well-ventilated space.
  • If the unvaccinated people come from multiple households, the safest place to visit is outdoors. If the visit takes place indoors, all people involved should take precautions including wearing a well-fitted mask, staying at least 6 feet away from others, and visiting in a well-ventilated space.
Recommendations for Large Gatherings. The guidance states that fully vaccinated people should avoid indoor large-sized in-person gatherings and follow any applicable local guidance restricting the size of gatherings. If they choose to participate, fully vaccinated people should wear a well-fitted mask.

Other Activities Outside the Home. The guidance states that fully vaccinated people engaging in indoor social activities in public settings should continue to wear a well-fitted mask. For outdoor activities, the guidance states that fully vaccinated people can participate in many outdoor activities without a mask at low risk to themselves or to others. The guidance notes that while it is generally safe for vaccinated people to be outdoors without a mask, requiring masking in crowded settings and venues where there is a decreased ability to maintain physical distance is recommended until widespread vaccination coverage is achieved.

The guidance also observes that although the risk of COVID-19 spread is low in outdoor settings, especially among those who are vaccinated, the following factors could increase risk:
  • A moderate, substantial, or high level of community transmission.
  • Settings with a higher percentage of unvaccinated people (including children) present or people at risk of severe COVID-19 disease.
  • The length of the visit.
  • Crowding or when there is a decreased ability to maintain physical distance.
  • Activities that involve behaviors such as singing, shouting, physical exertion or heavy breathing, inability to wear a mask, or inability to maintain physical distancing.
Travel. All travelers, including those who are fully vaccinated, are required to wear a mask on all planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and in U.S. transportation hubs such as airports and stations. The guidance provides the following recommendations for domestic and international travel:
  • Domestic Travel.
  • Fully vaccinated travelers do not need to get tested before or after domestic travel, unless testing is required by local, state, or territorial health authorities.
  • Fully vaccinated travelers do not need to self-quarantine following domestic travel.
  • International Travel.
  • International travelers should pay close attention to the situation at their international destinations before traveling due to the spread of new variants and because the burden of COVID-19 varies globally.
  • Fully vaccinated travelers do not need to get tested before leaving the United States unless required by their destination.
  • Fully vaccinated air travelers coming to the United States from abroad, including U.S. citizens, are still required to have a negative test result or documentation of recovery from COVID-19 before they board a flight to the United States. International travelers arriving in the United States are still recommended to get tested 3-5 days after travel regardless of vaccination status.
  • Fully vaccinated travelers do not need to self-quarantine in the United States following international travel.
As the COVID-19 situation continues to develop, and federal, state, and local governments issue additional guidance, employers need to be cognizant of updated guidance and requirements. For more information, please visit S&C’s page regarding Coronavirus updates.