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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

19 hours ago - Health

America has fallen behind on vaccinations

Data: Our World in Data; Chart: Will Chase/Axios

The U.S. has fallen from the top of the world's list of most-vaccinated countries, largely due to the substantial percentage of Americans who don't want the vaccine.

What we're watching: Vaccine mandates are becoming much more common in the U.S., and children under 12 will likely become eligible for vaccines within the next few months — both of which should help boost the vaccination rate here.

19 hours ago - Health

A second flu

Illustration: Sarah Grillo/Axios

Whatever living with the virus looks like, Delta-level surges aren't considered to be sustainable for the public or the hospitals that will treat the seriously infected.

Why it matters: A major determinant of how seriously we'll take the coronavirus in the future is how many hospitalizations and deaths it's causing — and whether our health system can handle the load.

19 hours ago - Health

Long COVID: A disabling disease

Illustration: Annelise Capossela/Axios

Millions of Americans are still suffering from a wide spectrum of symptoms long after they've recovered from their original coronavirus infections, and it's very unclear what the disease's trajectory is — or even how many people are affected.

What we're watching: We still don't have a good grasp on how susceptible vaccinated people are to long COVID. If the condition remains a threat even for the vaccinated, that could shape the risks people are willing to take in the future.