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CDC director Rochelle Walensky and top infectious disease expert Anthony Fauci at a Senate HELP committee hearing. Photo: J. Scott Applewhite-Pool/Getty Images

The Centers for Disease Control and Prevention issued updated guidance on Tuesday recommending that vaccinated people wear masks in indoor, public settings if they are in parts of the U.S. with substantial to high transmission, among other circumstances.

Why it matters: The guidance, a reversal from recommendations made two months ago, comes as the Delta variant continues to drive up case rates across the country. Millions of people in the U.S. — either by choice or who are ineligible — remain unvaccinated and at risk of serious infection.

Details: Community leaders in areas with high transmission rates should encourage vaccination and masking, the agency says.

  • In another reversal, the CDC also recommended universal indoor masking for all teachers, staff, students and visitors to K-12 schools this incoming school year, regardless of vaccination status.

By the numbers: The CDC defines "substantial transmission" as 50-100 cases per 100,000 people in a seven-day period and "high transmission" as more 100 cases per 100,000. 

  • Currently, 46% of U.S. counties have “high transmission” and 17% have “substantial transmission," according to CDC data.

What they're saying: "We’re just a few mutations away from it being able to evade our vaccines," CDC director Rochelle Walensky told reporters Tuesday.

  • "This [is a decision that] weighs heavily on me," Walensky said, adding that it was not taken lightly.
  • "I know at 18 months through this pandemic, not only are people tired, they’re frustrated. We have mental health challenges in this country. We have a lot of continued sickness and death in this country," she said.
  • "I know in the context of all of that, it is not a welcomed piece of news that masking is going to be a part of people’s lives who have already been vaccinated."

President Biden later Tuesday urged "all Americans who live in the areas covered by the CDC guidance" to follow the new recommendations.

  • "[M]ore vaccinations and mask wearing in the areas most impacted by the Delta variant will enable us to avoid the kind of lockdowns, shutdowns, school closures, and disruptions we faced in 2020," he noted in a statement.
  • "Unlike 2020, we have both the scientific knowledge and the tools to prevent the spread of this disease. We are not going back to that."
  • He added that he will announce new initiatives to get Americans vaccinated on Thursday.

The big picture: Virtually all hospitalizations and deaths continue to be among the unvaccinated, especially in places with low vaccination rates.

  • In rare occasions, Walensky said some vaccinated people can contract the Delta variant in a breakthrough infection and "may be contagious."
  • Nearly 50% of the U.S. population 12 years and older is fully vaccinated.
  • Los Angeles County, New Orleans, Savannah and Chicago are among the major metropolitan areas that reinstated mask mandates amid a rise in cases.

Editor's note: This story has been updated with additional details.

Go deeper

Updated 11 hours ago - Politics & Policy

Omicron dashboard

Illustration: Brendan Lynch/Axios

  1. Health: Concerns grow over CDC's isolation guidelines — Experts warn of more COVID-19 variants after Omicron — WHO recommends 2 new treatments — What "mild" really means when it comes to Omicron — Deaths are climbing as cases skyrocket.
  2. Vaccines: America's vaccination drive runs out of gas— Puerto Rico expands booster shot requirements— Supreme Court blocks Biden's vaccine mandate for large employers.
  3. Politics: You can start ordering free COVID tests Wednesday — Focus group says Biden weak on COVID response, strong on democracy — Biden deploying military medical staff to help overwhelmed hospitals.
  4. Economy: America's labor shortage is bigger than the pandemic— Nurses across the U.S. strike against COVID working conditions— CDC COVID guidance for cruise ships to be optional starting Saturday — The cost of testing.
  5. States: Biden admin threatens to take back Arizona's COVID aid over anti-mask rules — Students across U.S. walkout of classes to demand safer COVID protocols — West Virginia governor feeling "extremely unwell" after positive test — Youngkin ends mandates for masks in schools and COVID vaccinations for state workers.
  6. World: Beijing reports first local Omicron case weeks before Winter Olympics — Teachers in France stage mass walkout over COVID protocols.
  7. Variant tracker
Nov 3, 2021 - Health

Air Force: Nearly 97% of active members complied with vaccine mandate

A U.S. Air Force service member preparing a dose of a coronavirus vaccine in Boston in February. Photo: Joseph Prezioso/AFP via Getty Images

The Air Force said Wednesday that nearly 97% of its approximately 326,000 active duty service members have complied with Secretary of Defense Lloyd Austin's mandate and have received at least one dose of a coronavirus vaccine before the branch's Nov. 2 deadline.

Why it matters: Around 8,500 active members missed the deadline. Many of them have filed for medical exemptions and religious accommodations, which are being reviewed by the department.

Philly to begin vaccinating children ages 5-11

Illustration: Brendan Lynch/Axios

Philadelphia's Public Health Department said certain providers will begin administering COVID-19 vaccines to children ages 5-11 immediately.

Driving the news: CDC director Rochelle Walensky recommended the two-dose Pfizer-BioNTech vaccine for children aged 5 to 11 years old late Tuesday.

  • The endorsement, which follows CDC independent advisers' unanimous recommendation, marks the final step in the U.S. approval process, clearing the shots for younger kids.