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Illustration: Annelise Capossela/Axios

The Biden administration is essentially asking vaccinated Americans to help save the unvaccinated from themselves.

The big picture: America's "pandemic of the unvaccinated" has gotten bad enough that vaccine mandates are starting to catch on, and masks are coming back — in some cases, even for the vaccinated.

  • Vaccinated people's risk of serious illness is still extremely low. The problem is that there are simply too many unvaccinated Americans. That's taking a toll on the whole country, and vaccinated people will be asked to shoulder some of that burden.
  • "The vaccinated are currently paying a price for the unvaccinated. #covid19 is surging again, with spillover to the vaccinated. Masks are coming back, because the honor system isn’t working," tweeted emergency physician Leana Wen.

Driving the news: Biden administration officials are debating how to expand vaccine mandates for some federal civilian health care workers as they prepare to put more testing pressure — and requirements — on the rest of the federal workforce, Axios' Jonathan Swan and Hans Nichols reported last night.

  • The CDC announced yesterday that vaccinated Americans living in areas with high or substantial coronavirus transmission — about 63% of U.S. counties — should once again wear masks indoors.

Between the lines: The vast majority of coronavirus cases and hospitalizations are among unvaccinated people.

  • But some vaccinated people can still contract the virus, even if they never experience symptoms, and new evidence suggests that some of those "breakthrough" cases might be more contagious than initially thought, according to the CDC.
  • That's the main point of bringing back masks for vaccinated people: To reduce the risk that a person with a breakthrough infection will infect an unvaccinated person, who's still at a much higher risk of serious illness or death.
  • Tuesday's mask guidance was all about reducing transmissibility, even though breakthrough infections are rare, one Biden official told Axios.
  • Requiring some vaccinated people to wear masks indoors again could also get unvaccinated people to mask up, too, which would have a bigger impact.

What they're saying: "Unfortunately, vaccination rates in most U.S. communities remain far too low to minimize COVID-19 transmission, and it is impossible in public settings to know who is vaccinated and who is not," said Barbara Alexander, president of the Infectious Diseases Society of America.

Go deeper: The floodgates have opened for vaccine mandates

Go deeper

Updated 14 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Aïda Amer/Axios

  1. Vaccines: Los Angeles County to require vaccination proof at indoor bars — France suspends 3,000 unvaccinated health workers without pay — Moderna suggests booster shots, citing clinical data.
  2. Health: 1 in 500 Americans has died — Cases are falling, but deaths are rising — Study: Gaps in data on Native Hawaiians, Pacific Islanders alarming amid COVID.
  3. Politics: Gottlieb says CDC hampered U.S. response — 26 states have limited state or local officials' public health powers — Axios-Ipsos poll: 60% of voters back Biden vaccine mandates.
  4. Education: Denver looks to students to close Latino vaccination gap — Federal judge temporarily blocks Iowa's ban on mask mandates in schools — Massachusetts activates National Guard to help with school transportation.
  5. Variant tracker: Where different strains are spreading.
Sep 15, 2021 - Health

Pfizer says data suggests COVID vaccine boosters are warranted

A nurse administering a booster shot of Pfizer's COVID-19 vaccine on Aug. 19 in Pasadena, Calif. Photo: Robyn Beck/AFP via Getty Images

Pfizer told the FDA Wednesday that data from its clinical trials suggests a third shot of its coronavirus vaccine may be necessary six months after the second dose because of waning efficacy.

Why it matters: The FDA's advisory committee on Friday is expected to review Pfizer's clinical trials and other supporting and conflicting data on coronavirus booster shots and make recommendations on whether more Americans 16 years and older should receive an extra dose.

Sep 15, 2021 - Health

Report: 26 states have limited state or local officials' public health powers

A woman holds an anti-mask and vaccine placard outside a meeting of the Volusia County School Board in Deland, Florida. Photo: Paul Hennessy/SOPA Images/LightRocket via Getty Images

Republican lawmakers in more than half of U.S. states have weakened state or local officials' authority to implement policies to protect the public against the coronavirus and other infectious diseases, AP and Kaiser Health News report.

The big picture: Since the coronavirus pandemic began, lawmakers in all 50 states have introduced bills to curb state and local officials' public health authority, a KHN review found.