William Schaffner, MD: Lifting the Mask Mandate

As more and more individuals continue to get vaccinated against COVID-19, the US Centers for Disease Control & Prevention (CDC) has opted to lift the mask mandate for vaccinated individuals.

The decision was seen as another step towards normalcy, as well as a way to incentivize vaccine hesitant individuals to get vaccinated.

In an interview with HCPLive®, William Schaffner, MD, professor of Preventive Medicine and Medicine at the Vanderbilt University Medical Center, explained the reasoning behind the CDC decision and what might happen next.

HCPLive: What are your initial thought’s on the CDC’s decision to lift the mask mandate for vaccinated individuals? Do you think this will harm the goal of reducing COVID-19 cases as much as possible or do you think this will lead to more individuals getting vaccinated that maybe were a little hesitant?

Schaffner: I think it is the latter, at least I hope so. The CDC is listening, getting more suggestions from the field, from public health people and doctors. They’re so convinced and satisfied with the effectiveness of the vaccine, that people are vaccinated really need to get some reward.

The most common question we get is “Doc, now that I’m vaccinated, what can I do that I couldn’t do before.”

I think part of our vaccination hesitancy is that some people haven't really seen an immediate benefit to themselves for having been vaccinated. And I think the CDC has decided to go with the flow.

This may create a social confusion, this was part of the CDC hesitancy I’m sure, because it will now be some people who are unvaccinated who go out unmasked because you can't just tell by looking at somebody whether they're vaccinated or not. They'll take advantage of this, but they're always rascals in every group.

I hope it provides more motivation for good behavior, namely, rolling up your sleeves and getting vaccinated.

HCPLive: Do you think the time of year played a factor in this decision with summer approaching and some believing COVID-19 is seasonal to a degree?

Schaffner: Not exactly for that reason. The seasonality of COVID is still very much a gray area. Of course, it was an entirely new virus in the human population last year, but we had big surges in the summer. Whether that will happen this year remains to be seen and we infectious disease types are still pretty cautious about that.

Having said that, we do much more outdoors in this time of year, so I think the CDC was much more comforted in lifting the mask mandate knowing so much recreational activity takes place outdoors rather than indoors.

HCPLive: Looking at flu rates this year, do you think there might be a time during the winter months people will be more likely to wear masks in public places?

Schaffner: Previous to COVID, only countries in the Eastern part of the world, in Asia, had populations that rather routinely wore masks during the winter flu season. That was not part of our culture, but a lot of people have worn masks this year.

I think recommendations going into the future about mask wearing will become more and more common from the CDC and our local and state health departments. In addition, there are people who are older, who have underlying illnesses, who will even on their own wear masks.

HCPLive: How important is it for the CDC make practical recommendations that promote good behavior but not seem unreasonable?

Schaffner: That has always been the challenge for public health generally and for the CDC. You have to base your recommendations on science, but then as you interpret the science into practical behaviors you have to balance what’s acceptable, what’s functional, and what will actually work.

HCPLive: When we started the vaccine rollout in December, did you think we would get to this point by May?

Schaffner: First of all, I was overjoyed when we got the vaccines that were this safe and effective. I didn’t anticipate they would be this good. I am very excited about the downturn in hospitalizations and cases.

But they’re not anywhere close to what I think they need to be. What I’m worried about is we may come to a plateau in some parts of the country where vaccination has not been nearly well-accepted enough where we’ll continue to have COVID in those under vaccinated parts of the country.

And while I’m excited, I’m at the same time cautious because I didn’t think there would be quite this much hesitancy or even if I may say so resistance to vaccination.

For infectious disease types, we think these vaccines are so splendid, we have a hard time understanding people’s reluctance to get vaccinated.

HCPLive: What is next for the CDC, is there anything we still are awaiting guidance on?

Schaffner: Certainly with COVID there is always something. One of the things we are all interested in is the duration for protection after illness or infection after the virus and what’s the duration of protection after vaccination?

That remains to be determined. Also, what will be the continuing role of these variant viruses. So far, our vaccines have them under control, but could new variants crop up and start to spread? Will we need booster doses of the vaccine?

With COVID we have to keep learning as we’re coping.

HCPLive: Can you assess generally where we are in the US in terms of risk. If you use a crowded movie theater as an example, what is the risk for a vaccinated person and an unvaccinated person to go without a mask?

Schaffner: I think there is a risk. It’s indoors for a long period of time rather close together. So for an unvaccinated person, clearly the risk is much higher than for a vaccinated person.