More than a dozen states quickly embraced new federal guidelines that say fully vaccinated Americans no longer need to wear masks indoors or out in most cases. But other states and cities and some major businesses hesitated over doubts about whether the approach is safe or even workable.
As many business owners pointed out, there is no easy way to determine who has been vaccinated and who hasn't. And the new guidelines, issued Thursday by the Centers for Disease Control and Prevention, essentially work on the honor system, leaving it up to people to do the right thing.
Labor groups and others warned that employees at stores, restaurants, bars and other businesses could be left exposed to the coronavirus from customers and could be forced into the unwanted role of "vaccination police." Industry leaders also warned of the potential for confusion and hard feelings among customers because of the varying rules from place to place. Even in states that have dropped mask mandates, stores and other businesses still can require face coverings if they want.
Confusion over the guidance extended to the White House, where press secretary Jen Psaki said: "I think we're still figuring out how to implement it."
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However, other instructions are likely to follow. CDC Director Rochelle Walensky said Friday that the agency would update guidance for travel, schools and other things, and the White House is signaling to government agencies that they also can loosen mask rules.
Several major chains, including CVS, Home Depot, Macy's and supermarket giant Kroger Co., said they are still requiring masks in stores for the time being, though some said they are reviewing their policies.
But Walmart, the world's largest retailer, said late Friday that it won't require vaccinated shoppers or workers to wear masks in its U.S. stores, unless state or local laws say otherwise. Vaccinated shoppers can go maskless immediately, the company said. Vaccinated workers can stop wearing them on Tuesday. As an incentive, Walmart said it is offering workers $75 if they prove they've been vaccinated.
Half the states had mask requirements in place for most indoor spaces when the CDC issued its recommendations as cases fell and vaccination rates rose. Nearly 47% of the U.S. population has received at least one dose of covid-19 vaccine, and cases have dropped to their lowest level since September, at an average of about 35,000 a day.
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The CDC announcement sent airline stocks soaring, though the guidance still calls for masks in crowded indoor settings such as planes, buses, trains, hospitals, prisons and homeless shelters, and says people should obey all local and state regulations.
Michigan, Nevada, Oregon, Ohio, Virginia, Delaware, Maryland, Pennsylvania, Minnesota, Kentucky, Washington, Maine, Vermont, Connecticut, North Carolina, Kansas, Colorado and Rhode Island announced plans to fall in line with the CDC guidance either immediately or in the coming weeks. Some cities, including New Orleans and Anchorage, Ala., did the same.
Oregon Gov. Kate Brown said the new approach makes clear that vaccines are the fastest way to get back to doing the things "we all love." Kentucky Gov. Andy Beshear called the guidance a "game changer." And Washington Gov. Jay Inslee said the change is "a heck of a benefit."
Other states, such as California, Wisconsin, New Jersey, Hawaii and Massachusetts, and cities like Minneapolis and St. Paul, Minn., kept mask rules in place for the time being.
"We're frankly not there yet," New Jersey Gov. Phil Murphy said. And Hawaii Gov. David Ige said: "We are unable to determine who is vaccinated and who is not vaccinated. The best mitigation measure is for everyone to wear a mask."
Restaurant workers in places where mask mandates remain are finding themselves caught in the middle, said Jot Condie, the president of the California Restaurant Association. He said his phone has been "blowing up" with reports of increasingly belligerent customers.
"The person who is not wearing a mask will say, 'My president just told me that the CDC just issued guidance, and I've been vaccinated, and I'm not going to wear a mask,'" he said.
Some said the CDC's instructions might be more effective if paired with a way to verify people's vaccination status since that would give peace of mind to those gathering indoors and provide a real incentive to those yet to get the shots. Biden administration officials have said so-called vaccine passports would be left to the private sector, and numerous Republican-controlled states have moved to ban such tools.
In Detroit, a fully vaccinated Christoph Cunningham, 28, wore a mask as he rode an electric scooter to a bar for lunch and said he agrees with the relaxed guidelines.
"I have confidence in the science behind it all," said Cunningham, who runs a catering business. "I'll eventually take my mask off more and more."
SCIENCE, POLITICS
The change in the CDC's mask-wearing instructions has prompted criticism that the agency might be motivated as much by political pressure as by science.
"The CDC, which is supposed to be our steady force based upon science, is lurching from extreme overcaution to abandoning all caution," said Lawrence Gostin, a health law professor at Georgetown University Law Center. "And this all happened in a matter of weeks when the science really hasn't changed."
Gostin also cast doubt on the notion the move would spur more people to get vaccinated.
"There's zero behavioral evidence that a move like this would encourage people to be vaccinated," he said. "It's much more likely to encourage people to take their mask off."
Others, such as Scott Harris, the top health officer in Alabama, disagreed, saying the agency's emphatic endorsement of vaccines' effectiveness might convince some doubters. Alabama has seen some of the lowest levels of immunization nationwide.
The CDC defended its guidance. Officials pointed to a study released Friday of nearly 2,000 health care workers across 25 states that showed the two mRNA vaccines reduced the risk of illness from covid-19 by 94%.
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"This report provided the most compelling information to date that coronavirus vaccines were performing as expected in the real world," Walensky said in a news release. "This study, added to the many studies that preceded it, was pivotal to CDC changing its recommendations for those who are fully vaccinated against covid-19."
Two other studies were key: A March report in Nature Medicine showed substantially reduced viral loads among Israelis infected with the coronavirus after their first dose of the Pfizer-BioNTech vaccine. Lower viral load is thought to impede transmission of the virus, which would suggest vaccinated people don't spread the virus as easily. And a May 6 JAMA study found that a second Pfizer dose protected against even asymptomatic infections among fully vaccinated health workers.
"Preventing asymptomatic infections, I mean 'wow,'" Henry Walke, a CDC medical officer who has been leading the agency's coronavirus response since July, said in an interview. "That gave us a lot more confidence."
Walke recommended a change in the guidance to Walensky, who made the decision on Monday evening, said a CDC official who requested anonymity to detail internal discussions.
UNVACCINATED CHILDREN
Meanwhile, The government's recommendation that vaccinated people don't have to wear masks indoors or outdoors in most cases has left the parents of children younger than 12 -- a group that cannot yet be vaccinated -- scrambling for answers.
Parents are contending with a flood of questions: Should vaccinated adults go unmasked while their unvaccinated kids cover their faces? Should the whole family go to indoor public places like restaurants, movies or grocery stores while the youngest are not protected?
On Twitter and other social media, teachers, parents of children under 12, people with immune problems and other vulnerable groups expressed frustration that the guidance might leave them with less -- not more -- freedom because the CDC's announcement did not suggest a way to distinguish the vaccinated from unvaccinated.
"I feel like everyone just forgot about all the unvaccinated little kids and their parents," one parent tweeted.
Another quipped: "CDC Guideline: Don't have a kid under 12."
Right now, pediatricians urged parents to remain cautious and vigilant, as so much remains unclear about how the new policy will affect transmission in communities and nationwide.
"Until younger children are eligible to be vaccinated for the coronavirus, they should continue to wear face masks when they are in public and around other people," said Yvonne Maldonado, chairwoman of the American Academy of Pediatrics committee on infectious diseases. "We've already seen how the masks have helped prevent the spread of respiratory infections within schools, camps and other community settings, particularly when everyone wears them, washes hands and follows other infection control guidance."
The president of the American Federation of Teachers, Randi Weingarten, said the 1.7 million-member union is still trying to sort out what the change means for schools. Many school districts already ditched mask requirements in recent weeks, as had many states and cities, as virus numbers fell.
Experts suggested adults and older children who are vaccinated to think about wearing masks if there are younger children in the family -- either in solidarity or to keep the risk to unvaccinated children as low as possible.
"It depends on your comfort with risk. The risk of the vaccinated parents getting infected while they're out and transmitting it to the child is low. And if the child gets infected, the risk of severe illness is low. But that risk does exist. Do you as a parent want to take that risk?" said John Williams, chief of pediatric infectious diseases at UPMC Children's Hospital of Pittsburgh.
He pointed out that more than 300 children have died from covid-19. And roughly 15,000 children have been hospitalized -- far more than in a typical flu season.
Himani Shah, 43, mother of a 13-year-old and a 10-year-old in Berwyn, Pa., said she worries for her youngest child. While everyone else in the family is vaccinated -- including 13-year-old Avani, who got her first shot this week -- for now, her whole family intends to keep wearing masks when going out, she said. It's a question of safety, risk versus benefit and solidarity for 10-year-old Leila.
"Rather than saying sorry, you're alone on the island, I want to be in the fight with her," said Shah. "So our whole family, we're going to be eating outdoors at restaurants, masking up if we go to grocery store or any public place where we don't feel safe."
Williams said mask-wearing decisions shoud be driven by parenting, not science, he said.
"If I have both a 9-year-old and a 12-year-old, am I really going to make only the 9-year-old wear a mask?" Williams said. "You can't tell [a] 9-year-old while the 12-year-old doesn't have to eat veggies at all. Any parent knows that's not going to fly."
Information for this article was contributed by Heather Hollingsworth, Stephen Groves, Sara Burnett, Ed White, Zeke Miller, and Rachel La Corte of The Associated Press; by Isaac Stanley-Becker, Ben Guarino, Frances Stead Sellers, Ariana Eunjung Cha, Lena H. Sun, Fenit Nirappil, William Wan, Akilah Johnson, William Wan and Amy Goldstein of The Washington Post (WPNS); Josh Wingrove of Bloomberg News (TNS).
