Wearing masks outdoors no longer necessary for those fully vaccinated, CDC says

(Photo by zoranm/Getty Images)

The Centers for Disease Control and Prevention is relaxing mask wearing standards by allowing individuals who are fully vaccinated to be outdoors in small or medium gatherings without wearing a mask. 

"If you are vaccinated, it's safe to be outdoors without a mask," said Centers for Disease Control and Prevention Director Dr. Rochelle Walensky. "Most of the transmission is happening indoors rather than outdoors."

Walensky did not define the numbers for a small or medium gathering, saying that, in order to do that, the CDC would also have to define the size of the space and ventilation.

WHY THIS MATTERS

Vaccines are seen by most health professionals as the best means of ending the COVID-19 pandemic, but they can only do so if a certain percentage of the population receives the vaccine. Herd immunity can't be reached until a critical mass of vaccinations is achieved.

The U.S has reached a tipping point in which the supply of COVID-19 vaccines is becoming greater than the demand, creating what has come to be known as the "vaccine wall." More Pfizer, Moderna and Johnson & Johnson vaccines are available than there are Americans taking appointments, 

An estimated one in four Americans is hesitant to get a COVID-19 vaccine. 

The Biden Administration plans to meet vaccine concerns by "meeting people where they are and understanding why they're hesitant," Walensky said on a call today with the White House COVID-19 Response Team.

Insurers and hospitals are also taking steps to assure hesitant Americans that the benefits of getting vaccinated outweigh any risks.

The Cleveland Clinic and Mayo Clinic are leading a coalition of 60 hospitals and healthcare institutions in a nationwide campaign to encourage adults to get vaccinated against COVID-19. 

Cigna has joined other companies in offering bonuses to workers to get the vaccine. Cigna is giving $200 to health savings accounts, according to Bloomberg.

America's Health Insurance Plans today released a new survey examining how insurers are working to ensure widespread vaccine acceptance and uptake, as well as equitable access to vaccines. 

The survey also revealed the importance of public-private partnerships for vaccine delivery, vaccination coordination and education on the safety and efficacy of vaccines. 

Conducted in March, before vaccine availability opened to all American adults, the survey found that nearly all insurers have trained their care and disease managers (98%), as well as their customer service representatives (96%), to answer questions on local vaccine availability, rules and locations. A strong majority (77%) have provided transportation for members to get a vaccine when needed.

The most common actions to ensure equitable vaccine uptake include:

• education, awareness and outreach campaigns (90%).
• covering the cost of vaccine administration at no cost to members (88%).
• working with state and local government leaders to ensure equity in vaccine strategies (85%).
• addressing members' vaccine hesitancy (83%).
• engaging with community leaders in communities of color (77%).

A strong majority (73%) have partnered with other stakeholders to optimize allocation and distribution of vaccines. Those stakeholders most frequently include state and local governments, community health centers, pharmacies, and hospitals and health systems.

Phone calls are proving the most effective method for engaging seniors 65 and older, with 79% of health insurers pointing to such calls as the best means of spreading the word. Other effective tactics include community partnerships (48%), social media posts (42%) and email (33%).

While vaccine supply remained a challenge at the time of the survey for at least 92% of respondents, other challenges that were identified and persist in increasing vaccine uptake include addressing individuals' hesitancy to take a vaccine (85%), accessing scheduling systems (75%), getting accurate information on which members have already been vaccinated (65%) and getting information from state government to support vaccination efforts (63%).

While vaccine supplies are no longer a barrier, the other challenges identified in the survey response still exist. 

THE LARGER TREND

The benefits of vaccination are many. According to Johns Hopkins Medicine, getting the vaccine is not only highly effective at preventing illness, but also helps others in the community avoid infection. This is especially important in disadvantaged communities and communities of color, which have been hit disproportionately hard during the pandemic. 

The message from Johns Hopkins is clear: More vaccination means a better chance at returning to normal. It also notes that, although the development of the COVID-19 vaccine was much speedier than for other vaccines, it didn't skip any steps. No corners were cut when testing for safety and efficacy, and there was diversity in vaccine testing. The clinical trials for the two-shot vaccines were composed of 10% Blacks, 20% Hispanics, 25% elderly and people with conditions ranging from obesity, to diabetes, to heart and respiratory conditions.

A study published in February in the New England Journal of Medicine suggests that science denialism may play a role in vaccine hesitancy, as may a distrust of the media, the latter of which tends to be more prevalent among self-identified Republicans. This has created a polarization around the vaccine that hews closely to political ideology.

Rather than offering a tidy solution, the study suggests that messaging alone may not be the answer. In fact, in some cohorts, messaging about the effectiveness and safety of vaccines had the opposite effect: Graphic pictures of a child with measles, for example, increased fears of vaccine-related side effects rather than fear of the disease itself. One thing that is known is that the confidence of physicians and public health officials can be instrumental in allaying people's fears.

The Biden Administration has made vaccination against the coronavirus one of its top priorities, and there have been some successes. The president's team has administered more than four million doses per day on multiple occasions, and, according to Vanity Fair, more than a quarter of Americans are now fully inoculated. But vaccine uptake has slowed, and a new problem has emerged: Many Americans who have received their first shot are opting not to get their second shot.

Attitudes driving that decision range from a fear of the side effects to people feeling like they were well-enough protected with their first shot – despite evidence that a single shot triggers a weaker immune system response and leaves people more susceptible to potentially dangerous virus variants.

Compounding that problem is that the only single-shot vaccine available, the Johnson & Johnson offering, was temporarily paused this month due to reports of rare and serious side effects involving blood clots, all of which occured in women. Distribution of that vaccine was resumed after further study found that such side effects are exceptionally rare.

There is some vaccine data that is encouraging. Last fall, nearly half of older adults were on the fence about COVID-19 vaccination – or at least taking a wait-and-see attitude, according to a University of Michigan poll taken at the time. But a follow-up poll from March showed that 71% of people in their 50s, 60s and 70s are now ready to get vaccinated against COVID-19 when a dose becomes available to them, or had already gotten vaccinated by the time they were polled in late January. That's up from 58% in October.

Three groups of older adults with especially high risk of severe COVID-19 – Blacks, Hispanics and people in fair or poor health – had even bigger jumps in vaccine receptiveness between October and late January.

ON THE RECORD

"Vaccines save lives, and now more than ever we must come together to ensure that every single American has access to free COVID-19 vaccines, and that as many people as possible are fully vaccinated," said Matt Eyles, president and CEO of AHIP.

"Throughout the COVID-19 crisis, health insurance providers have worked hard to ensure that costs are not a barrier to testing and treatment. We are now seeing that commitment extended through their work for equitable vaccine access, particularly among those most vulnerable to the worst effects of the virus, and continued vaccine uptake."

"Health insurance providers are working with a variety of partners to increase vaccine acceptance, including partners who can assist in vaccine delivery, in appointment coordination and overcoming barriers to appointment such as transportation, and in encouraging people to get their vaccines," said Kate Berry, senior vice president of clinical affairs and strategic partnerships at AHIP.

"People want to be connected with trusted organizations, such as primary care and other providers, pharmacies, and faith-based organizations. Health insurance providers are meeting that need by working with volunteers, clinicians, community members and others to get people the information and support they need."
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com