In a sharp turnabout, federal health officials on Thursday advised that Americans who are fully vaccinated against the coronavirus may stop wearing masks or maintaining social distance in most indoor and outdoor settings, regardless of size.
The advice from the Centers for Disease Control and Prevention comes as welcome news to Americans who have tired of restrictions and marks a watershed moment in the pandemic. Masks ignited controversy in communities across the United States, symbolizing a bitter partisan divide over approaches to the pandemic and a badge of political affiliation.
Permission to stop using them now offers an incentive to the many millions who are still holding out on vaccination. As of Wednesday, about 154 million people have received at least one dose of a Covid-19 vaccine, but only about one-third of the nation, some 117.6 million people, have been fully vaccinated. Individuals are considered fully vaccinated two weeks after the one-dose Johnson & Johnson shot or the second dose of either Pfizer-BioNTech or Moderna vaccine series.
But the pace has slowed: Providers are administering about 2.16 million doses per day on average, about a 36 percent decrease from the peak of 3.38 million reported in mid April.
At the White House Thursday, President Biden hailed the new recommendations as a “milestone” in the nation’s effort to beat back the pandemic.
“Today is a great day for America,” Mr. Biden said during an address in the Rose Garden, where he and Vice President Kamala Harris appeared without masks on. “You’ve earned the right to do something that Americans are known for all around the world: greeting others with a smile.”
The new advice comes with caveats. Even vaccinated individuals must cover their faces and physically distance when going to doctors, hospitals or long-term care facilities like nursing homes; when traveling by bus, plane, train or other modes of public transportation, or while in transportation hubs like airports and bus stations; and when in prisons, jails or homeless shelters.
At a White House news conference earlier in the day, Dr. Rochelle P. Walensky, the C.D.C. director, warned that unexpected twists in the pandemic could require the C.D.C. to once again amend the guidance. Fully vaccinated people who develop symptoms should still use masks and get tested, she said.
Asked how the new guidance might apply to businesses and schools, she said that the agency was working to issue new recommendations soon for specific settings, including for summer camps and travel, which would be published soon.
In deference to local authorities, the C.D.C. said vaccinated Americans must continue to abide by existing state, local, or tribal laws and regulations, and follow local rules for businesses and workplaces.
Still, the changes are likely to galvanize Americans who have become unaccustomed to appearing in public unmasked — or to seeing others do so.
“We’ve got to liberalize the restrictions so people can feel like they’re getting back to some normalcy,” Dr. Anthony S. Fauci, the Biden administration’s senior adviser on the pandemic, said in an interview. “Pulling back restrictions on indoor masks is an important step in the right direction.”
“You can’t inhibit people from doing the things they want to do, which is one of the reasons they wanted to get vaccinated in the first place, because other people are not getting vaccinated,” he added.
The move could raise alarms among more cautious Americans, who may be more reluctant to engage in public activities when more people are unmasked. There is no way to know who is vaccinated and who is not, and the majority of the population is not yet fully vaccinated. Dr. Walensky added that immunocompromised people who have been fully vaccinated should consult their physicians before relinquishing a face mask.
“For those who are more risk averse, you have a choice of continuing to wear it if you want to,” Dr. Fauci said.
At the White House news conference, Dr. Fauci encouraged Americans, some who may still be gradually adjusting to a new normal after more than a year of living through the pandemic, not to be self-conscious if they do not immediately forego masks.
“There’s absolutely nothing wrong with an individual who has a certain level for risk aversion,” he said. “They shouldn’t be criticized.”
Dr. Walensky defended the timing of the new mask guidance, pointing to a steep drop in coronavirus cases, which have dropped by about a third in the last two weeks, and a sustained increase in supply of vaccines.
The new recommendations arrived just two days after Senate Republicans tore into the C.D.C. for what they labeled outdated and overly conservative guidance on mask-wearing, accusing the agency at a hearing on the government’s pandemic response of losing the trust of Americans looking to return to normal life.
Agency officials pointed to several recent studies showing that vaccines are more than 90 percent effective at preventing mild and severe disease, hospitalizations and deaths from Covid-19 in real world settings.
Among them was a study of 6,710 health care workers in Israel, including 5,517 fully vaccinated workers, that found the Pfizer vaccine was 97 percent effective at preventing symptomatic infections among the fully vaccinated, and 86 percent effective at preventing asymptomatic infections among them. (Vaccination rates in Israel are far higher than in the United States, however.)
The C.D.C also emphasized that vaccines in use have also proven effective against variants of the coronavirus that are circulating in the United States.
The C.D.C. has been under fire recently for moving too gingerly to lift restrictions on public activities for those who are vaccinated. Some critics have said the agency’s caution may suggest to Americans that officials lack of confidence in the vaccines.
Allowing immunized people to go mask-free indoors may help persuade more people to opt for the vaccine, said Angela Rasmussen, a virologist at Vaccine and Infectious Diseases Organization in Saskatchewan, Canada. Removing mask requirements “is another incentive that is extremely low cost and is very much supported by evidence.”
Though the C.D.C. historically has been one of the most trusted public health agencies in the world, public confidence in its recommendations lagged during the Trump administration, which sought to muzzle government experts and to alter the agency’s advice, and has not fully rebounded.
Only half of Americans said that they had a “great deal” of trust in the C.D.C., according to a new survey conducted in February and March by the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health.
Eduardo Torres, 53, was up early in Chicago on Thursday morning when he heard the news on the television: Younger adolescents, including his 14-year-old daughter, Raquel, were now eligible for the coronavirus vaccine.
“I told my wife, ‘I’ve got to take her to get vaccinated — immediately,’” he said.
The world’s first mass coronavirus inoculation campaign for children kicked off in earnest in the United States on Thursday after the federal government recommended making the Pfizer-BioNTech vaccine available to those aged 12 to 15. Vaccinations of adolescents had already begun this week in a few states, like Maine.
By 9:30 a.m., Raquel was among the first wave of children in her age group to be vaccinated at a site near Wrigley Field and was excitedly listing the things she could do once she is fully vaccinated. Go to her high school in person again. See her friends without worrying. Return to playing volleyball and bowling.
“It’s just a beautiful thing that this is available,” Mr. Torres said.
The start of shots for younger people marks a pivotal phase of the race to vaccinate as many Americans as possible, opening up the vaccine to millions of adolescents far earlier than many experts had predicted. There are about 17 million children between the ages of 12 and 15 in the United States, representing about 5 percent of the population. The changes — which mean that people ages 12 and up are now eligible — also opened the possibility that many more children may soon return to a semblance of normalcy, attending camps this summer and returning to in-person school by fall.
“Children have suffered this disease, in many ways disproportionately, especially psychologically,” said Dr. Paul Offit, a pediatric infectious disease expert at Children’s Hospital of Philadelphia, describing the disruption to children’s routines, the loss of school and the inability to socialize with friends that has contributed to a sense of isolation and mental health emergencies among children during the pandemic.
“This is your ticket out of that problem,” he said.
Still, many parents remain hesitant to put their children on the frontline of a vaccine that they view as experimental. And unlike in previous phases of the vaccine rollout, there were few reports of crowds and long lines during the first hours of eligibility on Thursday, when many children were in school.
In New York City, Julian Boyce, 14, was among a scattering of teenagers who showed up to be vaccinated first thing Thursday morning at Harlem Hospital Center. His family has known as many as 20 people who have died of Covid-19, his father said, and Julian has spent much of the last year indoors, keeping up with school work and playing video games.
Julian, an eighth grader at The Cathedral School, asked a nurse to administer his shot in his left arm, so any soreness wouldn’t affect his writing. Then he turned his attention to his cell phone.
“I just got my vaccine,” he texted his friends.
Mayor Bill de Blasio encouraged parents to have their children vaccinated to protect their families. “Parents, let’s get our zoomers off of Zoom and back to life as normal,” he said Thursday morning.
Amanda Rosa contributed reporting.
With new infections now engulfing rural regions across India even as the daily death toll in crowded cities remains staggeringly high, regional leaders across the country are engaged in a desperate struggle to secure vaccines and stretch the doses they have on hand.
The states of Maharashtra and Karnataka, where case numbers are surging, have suspended vaccination altogether for people under 45 so that older people can receive second doses.
And a government panel on Thursday recommended widening the gap — for the third time since March — between the first and second doses of the Oxford-AstraZeneca vaccine, also known as Covishield in India.
Prime Minister Narendra Modi of India is facing increasing pressure to quickly expand the scope of the country’s fledging Covid-19 vaccination campaign as major cities run out of doses.
Some states and cities have started floating their own global tenders to import vaccines.
In a rare show of unity, a dozen opposition parties called for free, universal vaccination in a letter that said the pandemic had “assumed unprecedented dimensions of a human catastrophe.”
The parties also said that Mr. Modi’s government should invoke an order temporarily suspending patent protections for vaccines — a proposal India and South Africa jointly made for all virus vaccines globally that is under consideration by the World Trade Organization. In India, the order would allow more factories to make Covaxin, the indigenous vaccine codeveloped by the Indian government’s top scientific research body and the Hyderabad-based company Bharat Biotech.
Covaxin is in such short supply that the capital, New Delhi, has had to shutter about 100 vaccination centers. All of the doses produced by the Serum Institute of India, which is producing the Oxford-AstraZeneca shots and is the world’s largest vaccine maker, are staying in India, but still falling far short of the requirements for a population of nearly 1.4 billion people.
The ad hoc approach could also further fuel the skepticism and hesitancy that greeted the rollout of shots this winter. Leaders of Mr. Modi’s Bharatiya Janata Party claimed that the virus had been all but defeated in India, possibly tempering interest in a vaccine.
Jairam Ramesh, leader of the opposition Indian National Congress party, questioned the validity of widening the intervals between doses.
“Is this because there are not enough stocks of the vaccines for all who are eligible or because professional scientific advice says so?” Mr. Ramesh wrote on Twitter.
India reported about 362,000 cases on Wednesday, with infection numbers appearing to level off in Delhi and in the financial capital, Mumbai, but picking up in the southern city of Bengaluru and across rural India.
Less than 3 percent of the population has been fully vaccinated.
Lockdown restrictions are in place in many parts of India, but on Thursday, when Muslims celebrated Eid al-Fitr, the end of the fasting month of Ramadan, people were seen crowding markets.
The Pfizer-BioNTech and Moderna coronavirus vaccines are safe and effective during pregnancy, according to preliminary results from two continuing studies.
Both vaccines produce robust immune responses in pregnant and lactating women, and are likely to provide at least some protection against two dangerous coronavirus variants, B.1.1.7 and B.1.351, according to a study published in JAMA on Thursday. Vaccinated women can also pass protective antibodies to their fetuses through the bloodstream and to their infants through breast milk, the research suggests.
In a second study, published in the journal Obstetrics & Gynecology on Tuesday, researchers found no evidence that either the Pfizer or Moderna vaccines damaged the placenta during pregnancy.
Covid presents serious risks during pregnancy. Research has shown that pregnant women with coronavirus symptoms are more likely to be admitted to the intensive care unit, to require mechanical ventilation and to die from the virus than are symptomatic women of a similar age who are not pregnant.
Because of these risks, the Centers for Disease Control and Prevention has recommended that the vaccines at least be made available to pregnant people, many of whom have opted to receive the shots.
“We can shift our framework from, ‘Let’s protect pregnant people from the vaccine,’ to ‘Let’s protect pregnant people and their infants through the vaccine,’” said Dr. Emily S. Miller, an expert in maternal-fetal medicine at Northwestern University and co-author of the placenta study. “I think that’s really powerful.”
The Biden administration on Thursday outlined how it will spend $7 billion to expand the nation’s public health workforce, adding tens of thousands of jobs to respond to the Covid-19 pandemic and future outbreaks, including disease investigators, contact tracers and epidemiologists.
Over $4 billion will go to state and local health departments to help with their Covid-19 response, the White House said in a news release, allowing them to “quickly add staff.” Hiring would include vaccine and test administrators, data scientists, epidemiologists and school nurses, who can work to vaccinate teens and children in the coming months. Some of the hiring will boost the ranks at the Epidemic Intelligence Service, the vaunted arm of the Centers for Disease Control and Prevention that investigates disease outbreaks.
C.D.C. leaders have long complained of neglect and underfunding, saying that lawmakers typically only send more resources to the agency when there is a dire public health emergency. Other federal health agencies, particularly the National Institutes of Health, are significantly better funded. Many local health departments have also been short on funding for years.
State and local governments would be able to decide how they use the money, which was allocated through the American Rescue Plan, said Carole Johnson, the Biden administration’s testing coordinator.
The funding underscored a sharp contrast with the Trump administration, which routinely sought to cut off congressional funding for the C.D.C. and stifle its independence within the Department of Health and Human Services.
And it offered relief for local health departments that have been sapped by low morale, firings and harassment. One challenge, though, might be finding enough qualified people to fill new job openings.
Ms. Johnson said money could also go to increasing the number of “disease intervention specialists,” or health workers who would conduct contact tracing, work on case management and help with outbreak investigations. And $400 million would go to a new partnership between the C.D.C. and AmeriCorps, a sprawling national service organization. Called Public Health AmeriCorps, the program would form a “pipeline” for public health workers.
The administration was providing another $3 billion to a new C.D.C. grant program to help smaller local health departments keep staff. The grants would allow those hired to help with the coronavirus pandemic to “continue their careers beyond the pandemic as public health professionals,” the White House said.
“We really are asking grantees to prioritize recruiting from communities they serve and backgrounds that are underrepresented,” Ms. Johnson said.
While some states are offering residents incentives like savings bonds or sports tickets to encourage them to be vaccinated, a few are making a very different pitch: The sooner you get a shot, the sooner the state will fully reopen.
The latest is Oregon, where the governor said on Tuesday that the state’s remaining restrictions would stay in place until at least 70 percent of eligible residents 16 and older had had at least one shot.
“We still have some work to do to reach our 70 percent goal, but I am confident we can get there in June and return Oregon to a sense of normalcy,” said Gov. Kate Brown, a Democrat.
Oregon, where 49 percent of residents have had at least one dose, is one of the few states that is explicitly tying lifting its indoor mask requirement to the adult vaccination rate. Michigan, Minnesota and Pennsylvania also are awaiting the 70 percent threshold before moving forward with reopening plans.
In Michigan, capacity limits for businesses will lift two weeks after 65 percent of eligible residents have been vaccinated, and the gatherings and face mask orders will end two weeks after 70 percent of eligible residents have been fully vaccinated, Gov. Gretchen Whitmer said. Thirty-seven percent of residents there have been immunized in the state, which has shown one of the country’s steepest drops in cases over the past two weeks. The average number of new infections reported daily during that time sank 45 percent and hospitalizations were down 32 percent.
Pennsylvania is waiting for 70 percents of adults to be fully vaccinated before lifting its mask mandate. Only 37 percent have been immunized in Pennsylvania.
The mask requirement in Minnesota will be lifted once 70 percent of residents 16 and older have received at least one dose of a Covid-19 vaccine, but no later than July 1, Gov. Tim Walz said. Half of Minnesotans have had at least one dose.
On Wednesday, Maryland said that every business would be allowed to open, starting on Saturday, at 100 percent capacity, but that the indoor mask requirement would be in place until 70 percent of adults had received one dose. So far, only 52 percent have met that guideline.
“Those who are not vaccinated continue to slow our health and economic recovery efforts, and they also continue to be at risk for infection, hospitalization and death,” Gov. Larry Hogan said on Wednesday.
In New Jersey, Gov. Phil Murphy said on Wednesday that he would be signing an executive order that would put into effect what he called “our most aggressive reopening play” to date. As was announced last week, on Wednesday, May 19, many restrictions on public gatherings will be dropped although social distancing measures will be in effect. In New Jersey, 42 percent of adults are fully vaccinated and 55 percent have received one shot.
And in New Mexico, the state will remove most restrictions once 60 percent of residents have been fully vaccinated. Forty-two percent of people have been inoculated there.
But these statewide vaccination targets are well below what experts now calculate the herd immunity threshold to be: at least 80 percent.
President Biden has called for 70 percent of adults to have at least one dose by July 4. Jeffrey Zients, Mr. Biden’s Covid response coordinator, said that the goal should be to achieve some sense of normality by hitting that target. Reaching 70 percent will create “a pattern of decreasing cases, hospitalizations and deaths and take us down to a sustainable low level,” he said this week.
A group of 18 scientists stated Thursday in a letter published in the journal Science that there is not enough evidence to decide whether a natural origin or an accidental laboratory leak caused the Covid-19 pandemic.
They argued, as the U.S. government and other countries have, for a new investigation to explore where the virus came from.
The organizers of the letter, Jesse Bloom, who studies the evolution of viruses at the Fred Hutchinson Cancer Research Center in Seattle, and David Relman, a microbiologist at Stanford University, said they strove to articulate a wait-and-see viewpoint that they believe is shared by many scientists. Many of the signers have not spoken out before.
“Most of the discussion you hear about SARS-CoV-2 origins at this point is coming from, I think, the relatively small number of people who feel very certain about their views,” Dr. Bloom said.
He added: “Anybody who’s making statements with a high level of certainty about this is just outstripping what’s possible to do with the available evidence.”
The new letter stated: “Theories of accidental release from a lab and zoonotic spillover both remain viable.”
A leading group of scientists urged governments and engineers to improve air quality in the workplace in the wake of the Covid-19 pandemic, drawing a parallel to movements that led to cleaner water, food safety rules and a ban on lead-based paint.
Sweeping public health reforms transformed not just our environment but expectations for what governments can do, according to a group of 39 scientists that published a manifesto of sorts on Thursday in the journal Science. They called for a “paradigm shift” in how citizens and government officials think about the quality of the air we breathe indoors.
The timing of the scientists’ call to action coincides with the nation’s large-scale reopening as coronavirus cases steeply decline: Americans are anxiously facing a return to offices, schools, restaurants and theaters — exactly the type of crowded indoor spaces in which the coronavirus is thought to thrive.
There is little doubt now that the coronavirus can linger in the air indoors, floating far beyond the recommended six feet of distance, the experts declared. The accumulating research puts the onus on policymakers and building engineers to provide clean air in public buildings and to minimize the risk of respiratory infections, they said.
“We expect to have clean water from the taps,” said Lidia Morawska, the group’s leader and an aerosol physicist at Queensland University of Technology in Australia. “We expect to have clean, safe food when we buy it in the supermarket. In the same way, we should expect clean air in our buildings and any shared spaces.”
Meeting the group’s recommendations would require new workplace standards for air quality, but the scientists maintained that the remedies do not have to be onerous. Air quality in buildings can be improved with a few simple fixes, they said: adding filters to existing ventilation systems, using portable air cleaners and ultraviolet lights — or even just opening the windows where possible.