It's time to rethink 'one-size-fits-all' approach to mask guidance, expert says, as Delta variant is spotted in every US state

“Part of the problem is that the CDC is trying to use a one-size-fits-all recommendation for the country rather than being a bit more surgical in identifying hot spot areas where transmission is accelerating,” Dr. Peter Hotez told CNN’s Jake Tapper Wednesday.

Hotez, who is dean of the National School of Tropical Medicine at Baylor College of Medicine, noted people in areas where vaccination rates are low and the virus is more prevalent may not want to do the same activities as people who live in areas where vaccination rates are high and the virus is more contained.

Alabama, Arkansas, Louisiana, Mississippi, and Wyoming have the lowest vaccination rates in the country, with less than 35% of their total population fully vaccinated, according to the most recent data from the US Centers for Disease Control and Prevention.

On the opposite end of the spectrum, Connecticut, Maine, Massachusetts, and Vermont have fully vaccinated more than 60% of their total population, the data shows.

The CDC’s current mask guidance, which says fully vaccinated people do not need to wear a mask indoors or outdoors, needs to be more specific with the Delta variant in mind, Hotez said.

“I think that’s what we need from the CDC is to be able to cut it a little finer, come up with … a force of infection map that combines those two variables: the low vaccination rates, high Delta. Those places are at great risk for lots of transmission, including some vaccinated individuals who will have breakthrough infections.”

With the more contagious Delta variant, some officials are issuing new mask guidance
Breakthrough infections, while rare, occur when vaccinated people contract Covid-19. A recent CDC study showed that when vaccinated people are infected, they experience milder illness than unvaccinated people.

Dr. Anthony Fauci, who heads the National Institute of Allergy and Infectious Diseases, said Tuesday he doesn’t expect the CDC to make changes to its mask guidance but warned Americans must take the Delta variant seriously.

Fauci noted vaccines make Covid-19 case surges “entirely avoidable, entirely preventable.”

Experts: Children should mask up, even around fully vaccinated people

Children under 12 are another vulnerable group in the face of Covid-19 variants because federal officials have not cleared them to receive a vaccine.

Dr. Yvonne Maldonado, chair of the American Academy of Pediatrics’ Committee on Infectious Diseases, told CNN Wednesday that children not yet vaccinated should still mask up, even if they’re around fully vaccinated people.

The Delta variant leaves children vulnerable to Covid-19. Here's how to protect your children

“The vast majority of new infections are occurring among unvaccinated individuals and creating a ‘pod’ of vaccinated individuals around young children, as well as continuing them to mask and distance in indoor settings and among crowded settings, will be important in keeping them safe,” Maldonado said in an email to CNN. “For these unvaccinated children, masking, distancing and avoiding large crowds is recommended.”

Maldonado noted that there is not much information available yet on how the Delta variant may affect children.

Hotez echoed Maldonado’s stance on children wearing masks.

“I would say right now, if your kids are old enough to wear masks, then they should when they’re indoors, at least until we can get our arms around this Delta variant,” said Hotez, noting that parents should take their area’s vaccination rate and variant levels into account.

What parents need to know about children and the Delta variant

“This requires parents, and really anyone, to have some situational awareness of what their region looks like, what their state looks like, what their county looks like in terms of vaccination rates and Delta variants,” he explained.

Federal health officials plan to analyze vaccine data for children younger than 12 in the upcoming fall or winter, said Dr. Peter Marks, who heads the US Food and Drug Administration’s Center for Biologics Evaluation and Research.

“It makes sense that it’s going to take a little longer there, because there had to be dose de-escalation — lower doses used, essentially dose de-escalation — and as well as we want to see longer follow-up data to make sure that we have the kind of safety in that population,” he said during a joint Johns Hopkins University and University of Washington symposium.

More research shows vaccines work and they’re highly effective

As of Wednesday, 46.7% of the total US population is fully vaccinated, CDC data showed. In the past seven days, the US averaged 26.6 new Covid-19 cases per 100,000 people.
While still lagging, vaccination coverage among young adults is improving, CDC data shows. Over the past two weeks, the 18-24 age group made up 12.6% of those becoming fully vaccinated, the CDC said.

CDC Director Dr. Rochelle Walensky highlighted Wednesday the increasing number of hospitalizations among young people ages 12 to 29.

CDC study finds coronavirus vaccines lead to milder disease in rare breakthrough infections

“The first thing I think is really important to recognize is hospitalizations are generally going down for Covid in this country,” Walensky said, but since May, people ages 12 to 29 have accounted for about a third of hospitalizations — a greater proportion than in the past.

“So while all hospitalizations are going down, the proportion that are attributable to our young populations are actually going up,” Walensky said.

Meanwhile, a new study is highlighting the importance of vaccines and the protection they offer.

The study examined nearly 4,000 frontline health and emergency workers shows that the Pfizer/BioNTech and Moderna Covid-19 vaccines were 91% effective in preventing infection after two doses and 81% effective after a single dose.

“If you get vaccinated, about 90% of the time you’re not going to get COVID-19,” Dr. Jeff Burgess of the University of Arizona, which participated in the study, said in a statement. “Even if you do get it, there will be less of the virus in you and your illness is likely to be much milder.”

Rise of Delta variant brings mask question back, even for the vaccinated

The team, led by CDC epidemiologist Mark Thompson, studied 3,975 health care personnel, first responders, and other essential and frontline workers.

The study participants underwent weekly coronavirus testing from December 14, 2020 through April 10, 2021.

The virus was detected in 204 participants, of whom five were fully vaccinated, 11 partially vaccinated and 156 unvaccinated, the report in the New England Journal of Medicine said.

Those who were vaccinated and got infected anyway had less virus in their bodies — 40% less, researchers added. Vaccinated people were 58% less likely to have fevers. “And the duration of illness was shorter, with 2.3 fewer days spent sick in bed,” the researchers said.

Only 39 of the workers got the Johnson & Johnson vaccine, and their results were not included.

CNN’s Sarah Braner, Jacqueline Howard, Virginia Langmaid, Maggie Fox, Naomi Thomas, Christina Bowllan and Lauren Mascarenhas contributed to this report.