Guidance for Implementing COVID-19 Prevention Strategies in the Context of Varying Community Transmission Levels and Vaccination Coverage

Details

• Personal Author:
  Christie, Athalia ; Brooks, John T. ; Hicks, Lauri A. ; Sauber-Schatz, Erin K. ; Yoder, Jonathan S. ; Honein, Margaret A.
• Corporate Authors:
  CDC COVID-19 Response Team.
• Description:
  What is already known about this topic? COVID-19 vaccines authorized in the United States are effective against severe illness and death from SARS-CoV-2 infection; however, current U.S. coverage is uneven. Implementation of layered Prevention strategies reduces SARS-CoV-2 Transmission.
  
  What is added by this report? Given the spread of the highly transmissible Delta Variants, local decision-makers should assess the following factors to inform the need for layered Prevention strategies across a range of settings: level of SARS-CoV-2 community Transmission, health system capacity, vaccination coverage, capacity for early detection of increases in COVID-19 cases, and populations at risk for severe outcomes from COVID-19.
  
  What are the implications for public health practice?Although increasing COVID-19 vaccination coverage remains the most effective means to achieve control of the pandemic, additional layered Prevention strategies will be needed in the short-term to minimize preventable morbidity and Mortality.
  
  COVID-19 vaccination remains the most effective means to achieve control of the pandemic. In the United States, COVID-19 cases and deaths have markedly declined since their peak in early January 2021, due in part to increased vaccination coverage (1). However, during June 19–July 23, 2021, COVID-19 cases increased approximately 300% nationally, followed by increases in hospitalizations and deaths, driven by the highly transmissible B.1.617.2 (Delta) Variants* of SARS-CoV-2, the Virus that causes COVID-19. Available data indicate that the vaccines authorized in the United States (Pfizer-BioNTech, Moderna, and Janssen [Johnson & Johnson]) offer high levels of protection against severe illness and death from infection with the Delta Variants and other currently circulating Variantss of the Virus (2). Despite widespread availability, vaccine uptake has slowed nationally with wide variation in coverage by state (range = 33.9%–67.2%) and by county (range = 8.8%–89.0%).† Unvaccinated persons, as well as persons with certain immunocompromising conditions (3), remain at substantial risk for infection, severe illness, and death, especially in areas where the level of SARS-CoV-2 community Transmission is high. The Delta Variants is more than two times as transmissible as the original strains circulating at the start of the pandemic and is causing large, rapid increases in infections, which could compromise the capacity of some local and regional health care systems to provide medical care for the communities they serve. Until vaccination coverage is high and community Transmission is low, public health practitioners, as well as schools, businesses, and institutions (organizations) need to regularly assess the need for Prevention strategies to avoid stressing health care capacity and imperiling adequate care for both COVID-19 and other non–COVID-19 conditions. CDC recommends five critical factors be considered to inform local decision-making: 1) level of SARS-CoV-2 community Transmission; 2) health system capacity; 3) COVID-19 vaccination coverage; 4) capacity for early detection of increases in COVID-19 cases; and 5) populations at increased risk for severe outcomes from COVID-19. Among strategies to prevent COVID-19, CDC recommends all unvaccinated persons wear masks in public indoor settings. Based on emerging evidence on the Delta Variants (2), CDC also recommends that fully vaccinated persons wear masks in public indoor settings in areas of substantial or high Transmission. Fully vaccinated persons might consider wearing a mask in public indoor settings, regardless of Transmission level, if they or someone in their household is immunocompromised or is at increased risk for severe disease, or if someone in their household is unvaccinated (including children aged <12 years who are currently ineligible for vaccination).
  
  Suggested citation for this article: Christie A, Brooks JT, Hicks LA, et al. Guidance for Implementing COVID-19 Prevention Strategies in the Context of Varying Community Transmission Levels and Vaccination Coverage. MMWR Morb Mortal Wkly Rep. ePub: 27 July 2021.
  
  mm7030e2.htm?s_cid=mm7030e2_w
  
  mm7030e2-H.pdf
  
  
• Subjects:
  CoronaVirus Infections/Prevention & Control COVID-19 Vaccines COVID-19/Prevention & Control Disinfection Masks Physical Distancing Vaccination
• Source:
  MMWR: Morbidity and Mortality Weekly Report 2021; v. 70 Early Release
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• ISSN:
  0149-2195 (print) ; 1545-861X (digital)
• Document Type:
  Journal Article
• Place as Subject:
  United States
• Pages in Document:
  5 pdf pages
• Volume:
  70
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR)
• Main Document Checksum:
  urn:sha-512:bae0a1d04256b72752f85556d45f529c62677d343ad655dfe122e958d5fc525552043bdc2396ddeef424af262f2c8ed4f8d2e8c8b016391b37cc3411a068639c
• Download URL:
  https://stacks.cdc.gov/view/cdc/108358/cdc_108358_DS1.pdf
• File Type:
  [PDF - 344.96 KB ]