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You’re vaccinated but exposed to COVID. What do new CDC guidelines say about testing?

Fully vaccinated people who are exposed to COVID-19 should get tested three to five days after and take additional precautions, new recommendations from the Centers for Disease Control and Prevention say.

The new recommendations are included in the CDC’s updated guidelines for fully vaccinated people. They were released Tuesday in response to new data that shows the highly contagious delta variant behaves differently than other strains of COVID and that in “rare occasions” some vaccinated people may be able to spread it to others.

“This new science is worrisome and unfortunately warrants an update to our recommendations,” CDC Director Rochelle Walensky said during a news briefing Tuesday.

Testing recommendations

The CDC now says that fully vaccinated people who know they were exposed to “suspected or confirmed COVID-19” should get tested for the virus three to five days after they were exposed.

They should also wear a face mask in public indoor settings for 14 days after exposure or until they test negative and should isolate if they test positive.

“Fully vaccinated people who live in a household with someone who is immunosuppressed, at increased risk of severe disease, or unvaccinated... could also consider masking at home for 14 days following a known exposure or until they receive a negative test result,” the CDC says.

Most fully vaccinated people who do not have symptoms of COVID-19 do not need to quarantine after exposure to the virus if they follow the testing and masking guidelines, according to the CDC. But fully vaccinated people who do have symptoms should quarantine and be evaluated and tested.

The CDC still recommends that fully vaccinated people without COVID-19 symptoms and who have not had a known exposure to the virus be “exempted from routine screening testing programs, if feasible.”

Other changes to the guidelines

The CDC on Tuesday also recommended that fully vaccinated people wear a mask in public indoor settings if they’re in areas with substantial or high COVID-19 transmission.

That’s an update from guidance released two months ago, when the CDC said fully vaccinated people could return to pre-pandemic activities without wearing a mask or social distancing except where it’s required by law.

Health officials define substantial transmission as when between 50 and 99.99 new COVID-19 cases per 100,000 people have been reported in the past seven days, while high transmission indicates 100 or more new cases per 100,000 people have been reported in the past seven days.

The CDC breaks down transmission levels by county. You can check your county’s level here. Counties with substantial transmission are marked in orange and counties with high transmission are marked in red.

The CDC says fully vaccinated people may also choose to wear a mask regardless of their area’s transmission level, especially if they’re immunocompromised or at “increased risk for severe disease from COVID-19” or if they live with someone who is immunocompromised, at an increased risk or not fully vaccinated.

It also recommends universal masking at schools regardless of vaccination status — including for all students, teachers, staff and visitors.

The CDC still recommends that unvaccinated people continue to wear masks and take precautions against the virus.

Concerns about the delta variant

The changes come as the highly contagious delta variant is spreading in the U.S. and sparking COVID-19 outbreaks.

“The delta variant is showing every day its willingness to outsmart us and to be an opportunist in areas where we have not shown a fortified response against it,” Walensky said Tuesday.

The World Health Organization in June recommended that fully vaccinated people continue to wear face masks when possible because of the delta variant’s increased transmissibility and the risk of serious COVID-19 infection.

Walensky said at the time, however, that those who are vaccinated are safe from the variants, saying that the WHO takes into account countries with very low or nonexistent vaccination rates and that the CDC will leave mask requirements up to individual states.

Dr. Anthony Fauci emphasized Tuesday on CNN that health officials aren’t “changing the science.”

“The virus changed and the science evolved with the changing virus,” Fauci told CNN. “We were dealing with the alpha virus back a few months ago ... it was a virus that if a person had a breakthrough infection — very very unlikely that that person would transmit it. That’s changed. Now the level of virus in the nasopharynx of an infected person with delta is 1,000 times of what it was with the alpha.”

He also said that the COVID-19 vaccine, “even with the delta variant,” protects against infection and protects even better against serious illness.