Guidance for Fully Vaccinated Persons in Non-Healthcare Settings

March 24, 2021

This interim guidance serves to clarify recently released Centers for Disease Control & Prevention (CDC) Public Health Recommendations for Fully Vaccinated People. Guidance may change or be updated as the situation evolves. These recommendations only apply to non-healthcare settings.

Currently authorized vaccines in the United States are highly effective at protecting vaccinated people against symptomatic and severe COVID-19. Evidence also suggests that fully vaccinated people are less likely to have asymptomatic infection and potentially less likely to transmit SARS-CoV-2 (the virus that causes COVID-19) to others.

However, we are not in a position at this time to broadly exempt fully vaccinated individuals from existing COVID-19 mitigation efforts, including requirements for indoor and outdoor gatherings outlined in current Executive Orders. This is because we are still learning how long vaccine protection will last as well as how much protection is provided against emerging SARS-CoV-2 variants. In addition, since most of New Jersey is not yet fully vaccinated, the chance that someone who is fully vaccinated could inadvertently spread an infection is relatively high. Until more is learned about protection, and vaccination coverage in the state increases, some prevention measures will continue to be necessary for all people, regardless of vaccination status. As with any level of risk, low/minimal risk does not mean no risk exists.

As no vaccine is 100% effective, persons must balance preventive actions to reduce possible transmission and maintain safety. While CDC recommendations indicate that private visits or small gatherings1 likely represent minimal risk to fully vaccinated people, medium or large-sized gatherings and those including unvaccinated people from multiple households increase the risk of SARS-CoV-2 transmission.

Though the risk of disease may be minimal to the fully vaccinated person themselves, they should be mindful of their potential risk of transmitting the virus to others if they become infected, especially if they are visiting with unvaccinated people at increased risk for severe illness from COVID-19 or who have unvaccinated people at increased risk for severe disease in their own households.

People are considered “fully vaccinated” for COVID-19:

• At least 2 weeks after they have received the second dose in a 2-dose series (Pfizer-BioNTech or Moderna); or
• At least 2 weeks after they have received a single-dose vaccine (Johnson and Johnson [J&J]/Janssen ).†

(1) The CDC guidance does not define a “small gathering.”

Although the risk that fully vaccinated people could become infected with COVID-19 is low, any fully vaccinated person who experiences symptoms consistent with COVID-19 should isolate themselves from others, be clinically evaluated for COVID-19, and tested for SARS-CoV-2 if indicated.

Private vs. Public indoor

• Private spaces are defined as a home or personal residence that is not a healthcare facility or institution.
• Public spaces include indoor settings where the public gathers and there is mixing of multiple households or cohorts who may or may not know each other, such as weddings, restaurants, concert and performing arts venues, schools, gyms, social/member clubs, etc. Public social gatherings are more likely to be medium- or large-sized gatherings.

Specific recommendations for Fully Vaccinated Persons

Indoor visits between fully vaccinated persons: Indoor visits between fully vaccinated people who do not wear masks or physically distance from one another are likely low risk. CDC recommends that fully vaccinated persons can visit with other fully vaccinated people in private settings indoors without wearing masks or physical distancing.

Indoor visits between fully vaccinated persons and unvaccinated persons: If someone fully vaccinated is visiting with someone unvaccinated, public health precautions should be determined based on the risk status of the unvaccinated persons. Because gatherings between multiple households pose risk of COVID-19 transmission among unvaccinated persons, masks and physical distancing should be maintained.

Fully vaccinated persons can visit with unvaccinated persons from a single household that does not have individuals at risk of severe COVID-19 in private settings indoors, without anyone wearing masks, with a low risk of COVID-19 transmission.

Travel recommendations: All travelers, including persons who are fully vaccinated, should follow CDC and New Jersey testing and quarantine recommendations pre- and post-travel. A more conservative approach for travel is indicated to prevent the further spread of variant virus strains and considers an increased transmission risk associated with traveling, particularly related to social mixing at travel hubs.

Close contact quarantine recommendations: If identified as a close contact of someone with COVID-19, a fully vaccinated person does not need to quarantine as long as they remain asymptomatic. Although the risk that fully vaccinated people could become infected with COVID-19 is low, if symptoms develop, they should isolate and seek medical evaluation for COVID-19, which may include testing. Refer to NJDOH Minimum Quarantine Timeframes for additional information.

Special Circumstances:

• Fully vaccinated residents of non-healthcare congregate settings (e.g., correctional and detention facilities, group homes) should continue to quarantine for 14 days and be tested for COVID-19 following an exposure to someone with suspected or confirmed COVID-19. This is because residential congregate settings may face high turnover of residents, a higher risk of transmission, and challenges in maintaining recommended physical distancing.

• Fully vaccinated employees of non-healthcare congregate settings and other high-density workplaces (e.g., meat and poultry processing and manufacturing plants) with no COVID-like symptoms do not need to quarantine following an exposure; however, testing following an exposure and through routine workplace screening programs (if present) is still recommended.

Recommendations for Gatherings

CDC continues to recommend that large gatherings be avoided, particularly those in which physical (social) distancing cannot be maintained between people who live in different households. All people, regardless of vaccination status, should adhere to current guidance to avoid medium- or large-sized in-person gatherings and to follow any applicable local guidance restricting the size of gatherings. If they choose to participate, fully vaccinated people should continue to adhere to prevention measures that reduce spread, including wearing a well-fitted mask, maintaining physical distance from others, and washing hands frequently.

All people, regardless of vaccination status, should follow state guidance restricting the size of gatherings (i.e., most current Executive Order limiting capacity). Both indoor and outdoor gatherings must adhere to the most current New Jersey Executive Order regarding gathering capacity limits and requirements for individuals participating in gatherings, which include social distancing and mask wearing.

Persons at increased risk of severe COVID-19/severe disease: Include those who are more likely than others to become severely ill, such as older adults (the risk of severe illness increases with age), pregnant people, people with underlying medical conditions. Severe illness from COVID-19 is defined as hospitalization, admission to the ICU, intubation or mechanical ventilation, or death.

†This guidance applies to COVID-19 vaccines currently authorized for emergency use by the Food and Drug Administration: Pfizer-BioNTech, Moderna, and Johnson and Johnson [J&J]/Janssen COVID-19 vaccines. Considerations for applying this guidance to vaccines that are not FDA-authorized include whether the vaccine product has received emergency approval from the World Health Organization or authorization from a national regulatory agency. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html