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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

GE to mandate COVID vaccinations for U.S. workers

Photo: Sebastien Bozon/AFP via Getty Images

General Electric will require all of its workers in the U.S. to be vaccinated against COVID-19, citing President Biden's executive order for federal contractors, the company confirmed to Axios on Tuesday.

Why it matters: General Electric is the latest in a slew of major companies to mandate the vaccine for workers, following in the footsteps of American Airlines, Tyson Foods and Microsoft, among others.

Updated Oct 19, 2021 - Politics & Policy

Coronavirus dashboard

Illustration: Aïda Amer/Axios

  1. Vaccines: Mix-and-matching gains momentum — Boosters overtake first doses in U.S. — Pfizer to vaccinate Brazilian cityPanel endorses J&J booster.
  2. Health: Age is still a huge coronavirus risk factor — Unvaccinated 11x more likely to die from COVID — 5x more police officers died from COVID than guns.
  3. Politics: Over 30 states limited public health powers — Pope Francis calls on companies to release vaccine patents — Melbourne, "world's most locked-down city," to lift stay-at-home orders.
  4. Education: Education secretary reveals limits to Biden’s mask push on states — LA extends deadline for school employee vaccinations — Parent sues Wisconsin school district after child tests positive.
  5. Variant tracker: Where different strains are spreading.
Oct 19, 2021 - Health

Puerto Rico leads U.S. COVID vaccination rates

A mass vaccination event at the Puerto Rico Convention Center in San Juan, Puerto Rico, on March 31. Photo: Ricardo Arduengo/AFP via Getty Images

Puerto Rico has the highest percentage of people fully vaccinated against the coronavirus in the United States as of Oct. 19, according to data from the Centers for Disease Control and Prevention.

Why it matters: The island has managed to accomplish such feats amid frequent power outages, earthquakes and high dependence on imports of health technologies from outside the region.