This section is an ongoing compilation of tough questions related to COVID-19, with suggested answers. Many of these topics are sensitive and often politicized. The document is designed to provide message guidance and framing for public health officials and others, and it is regularly updated to reflect new developments and emerging issues.

Johnson & Johnson vaccine

On July 12, the Food and Drug Administration announced it is adding a warning label to the Johnson & Johnson COVID-19 vaccine, noting increased risk of Guillain-Barré syndrome. Below are topline messages to guide your talking points, followed by more questions and answers about the Johnson & Johnson vaccine, including information about the rare blood clotting disorder on the vaccine’s warning label, and the safety of other vaccines.

What is the current status of the Johnson & Johnson COVID-19 vaccine?

On July 12, the Food and Drug Administration announced it is adding a warning label to the Johnson & Johnson COVID-19 vaccine, noting increased risk of a rare neurological syndrome called Guillain-Barré syndrome. The new warning label is based on preliminary data, after about 100 reports of GBS were detected in the Vaccine Adverse Event Reporting System, out of more than 12.8 million administered doses of the Johnson & Johnson vaccine administered.

The CDC continues to advise that everyone 12 years of age and older receive a COVID-19 vaccine. The risk of severe adverse events after any COVID-19 vaccination remains rare, far lower than adverse health outcomes associated with contracting COVID-19.

The CDC and FDA will continue to provide monitoring and treatment information to health care providers and vaccine recipients. Anyone with questions about which vaccine is best for them should speak to their healthcare provider.

Added July 13, 2021

The Johnson & Johnson Vaccine, Guillain-Barré syndrome, and topline messages

On July 12, the Food and Drug Administration announced it is adding a warning label to the Johnson & Johnson COVID-19 vaccine, noting increased risk of Guillain-Barré syndrome (GBS). The FDA and CDC take vaccine safety very seriously, which is why all vaccines are closely monitored. The identification of any possible risks, like the low risks associated with the Johnson & Johnson vaccine, is a sign that the nation’s safety monitoring system for COVID vaccines is working.

  • About 100 reports of Guillain-Barré syndrome have been detected in the Vaccine Adverse Event Reporting System, out of 12.8 million administered doses of the Johnson & Johnson vaccine. GBS is a rare condition, and the risk of contracting it due to the J&J vaccine is very low.
  • The risk of severe adverse events after any COVID-19 vaccination remains very low, and far lower than adverse health outcomes associated with contracting COVID-19.
  • Data do not show any increased risk of GBS for the Pfizer or Moderna vaccines.
  • In the U.S., nearly all COVID-19 hospitalizations and deaths are now occurring in unvaccinated people. The CDC recommends that everyone age 12 years and older receive a COVID-19 vaccine.

Added July 13, 2021

Who is at risk for the Guillain-Barré syndrome associated with the Johnson & Johnson vaccine?

The likelihood of the Guillain-Barré syndrome (GBS) resulting from the Johnson & Johnson vaccine is extremely low. The cases have largely been reported two weeks after vaccination and mostly in males, many age 50 years and older. Additional data that details the risk of incidence is forthcoming, but preliminary data is based on about 100 reports of GBS in the Vaccine Adverse Event Reporting System out of more than 12.8 million Johnson & Johnson doses administered. If you have questions about the J&J vaccine or other vaccines, talk to your healthcare provider.

Added July 13, 2021

Should I be concerned about the safety of other vaccines?

The mRNA vaccines (Pfizer and Moderna’s COVID-19 vaccines) are not associated with increased risk for Guillain-Barré syndrome or for a rare blood clotting disorder that appear on the warning label for the Johnson & Johnson vaccine.

The identification of what is approximately a less than 2-in-a-million risk associated with the Johnson & Johnson vaccine is a sign that the nation’s safety monitoring system for COVID vaccines is working. After any vaccine is successful in clinical trials and approved for use, the FDA continues to monitor it for safety. The 10-day pause of the J&J vaccine in April 2021 allowed scientists to evaluate each incidence of the clotting disorder. They determined that the level of risk was very low and that the benefits of continued use of the J&J vaccine greatly outweighed any risk associated with it.

Updated July 13, 2021

Who is at risk for the Guillain-Barré syndrome associated with the Johnson & Johnson vaccine?

The likelihood of the Guillain-Barré syndrome (GBS) resulting from the Johnson & Johnson vaccine is extremely low. The cases have largely been reported two weeks after vaccination and mostly in males, many age 50 years and older. Additional data that details the risk of incidence is forthcoming, but preliminary data is based on about 100 reports of GBS in the Vaccine Adverse Event Reporting System out of more than 12.8 million Johnson & Johnson doses administered. If you have questions about the J&J vaccine or other vaccines, talk to your healthcare provider.

Added July 13, 2021

Why was the Johnson & Johnson vaccine paused?

In April 2021, the Johnson & Johnson vaccine was paused for 10 days while a CDC panel reviewed data concerning a very rare blood clotting disorder. The decision to lift the pause in April was based on the experts’ determination that the benefits of administering the vaccine greatly outweigh the very small degree of risk associated with its use. The risk of blood clotting is much higher for people who contract COVID than it is for people who receive the J&J vaccine.

Added April 24, 2021

What was learned during the April 2021 pause of the Johnson & Johnson vaccine?

The 10-day pause in April 2021 gave health officials time to review additional data to better understand the degree of risk associated with the Johnson & Johnson vaccine related to a blood clotting disorder. It also gave federal agencies and the medical community time to determine and share information on the most appropriate treatment response. During the pause, nine additional cases of the clotting disorder were identified, bringing the total number of known cases to 15 among the nearly 7 million people who received the vaccine.

The decision to lift the pause was based on the experts’ determination that the benefits of administering the vaccine greatly outweigh the very small degree of risk associated with its use, particularly now that the risk and treatment protocols are better understood. The risk of blood clotting is much higher for people who contract COVID than it is for people who receive the J&J vaccine.

Added April 24, 2021

Who is at risk for the blood clotting disorder associated with the Johnson & Johnson vaccine?

The likelihood of the blood clotting disorder resulting from the Johnson & Johnson vaccine is extremely rare. The risk varies by age and gender. There have been fewer than 1 case per million for men and for women who are 50 years or older; the risk is estimated to be about 7 cases per million for women ages 18 to 49. If you have questions about the J&J vaccine or other vaccines, talk to your doctor.

Added April 24, 2021

If I got the Johnson & Johnson shot, am I at risk of Guillain-Barré syndrome or a blood clotting disorder?

If you received the Johnson & Johnson shot and within two weeks have not developed any of the side effects associated with Guillain-Barré syndrome – muscle weakness, tingling in hands and feet, difficulty catching your breath, or choking on saliva – the risk for an adverse reaction is very low.

The symptoms of the blood clotting disorder – severe headache or abdominal pain, shortness of breath, neurological symptoms, leg swelling – usually develop within three weeks of receiving the vaccine. If you are beyond the three-week mark, the risk of your developing an adverse reaction is very low. If you have questions or concerns, consult your doctor.

Updated July 13, 2021

If I’m offered the Johnson & Johnson vaccine, should I wait until I can get either Pfizer or Moderna?

For most people, getting the first available COVID vaccine is the best thing you can do to safeguard your health. Your odds of contracting a possibly life-threatening case of COVID-19 are much higher than your odds of experiencing serious side effects from the vaccine. For example, the risk of blood clots from COVID illness is 165,000 per million cases, which is much higher than the risk of the rare blood clotting disorder associated with the Johnson & Johnson vaccine. That said, Pfizer and Moderna vaccines are widely available. More than 90% of the fully vaccinated population in the U.S. has received the Pfizer and Moderna vaccine, with only about 8% having been vaccinated with the Johnson & Johnson vaccine.

If you have additional questions about which vaccine is best for you, check with your doctor.

Updated July 13, 2021

Delta and other variants

What is the delta variant, and why is it concerning?

The delta variant is a naturally occurring mutation of the SARS CoV-2 virus, the virus that causes COVID-19. Data show that the delta variant is more contagious and spreads more easily than the original COVID-19 virus. The delta variant accounts for a growing proportion of new coronavirus cases across the U.S., and people infected with the delta variant are more likely to need hospitalization than those infected with earlier strains of the virus.

Added July 8, 2021

Are the COVID-19 vaccines effective against the delta variant?

Yes. Data show that the COVID-19 vaccines are extremely effective in protecting fully vaccinated people from catching and spreading the virus, including the delta variant. But it is critical that you are fully vaccinated to be protected.

New data is showing that a small number of vaccinated people can be infected by delta variant in a breakthrough infection and may be contagious, but these cases represent a very small amount of transmission occurring around the country.

Updated July 27, 2021

Why have some local governments reinstated mask policies?

Local and state officials establish policies based on local scenarios, including vaccination and transmission rates. The CDC recommends that in areas with substantial and high transmission, everyone (including fully vaccinated individuals) wear a mask in public indoor settings to help prevent spread of delta and protect others. Where there are lower vaccination rates and higher infection rates, or where disparities persist across population groups, officials may reinstate masking policies — such as indoor masking — with the goal of protecting their communities and people who are not or cannot be vaccinated.

Updated July 27, 2021

Why do WHO and CDC have different recommendations about mask-wearing?

The World Health Organization (WHO) makes recommendations for the entire world, while the (CDC) issues guidance and recommendations to inform U.S. policy decisions at the local and state levels. WHO continues to recommend that everyone, including fully vaccinated people, wear masks. This is not a change, but rather a longstanding recommendation that WHO reiterated in light of the fast-spreading delta variant. A large portion of the world remains unvaccinated, and there are infection hot spots where the delta variant is already, or quickly becoming, the dominant strain. In countries where a large proportion of the population is not vaccinated, masking policies are critical.

In the United States, the CDC continues to urge localized policies based on local vaccination and infection rates. Communities with low vaccination rates are at higher risk for continued infections from COVID-19, including the delta variant. These higher risk levels may require safety measures like masking and social distancing.

Added July 8, 2021

Children and Vaccinations

For additional information and guidance on children and vaccinations, read the American Academy of Pediatrics’ FAQ for parents and register for the Public Health Communications Collaborative next webinar, COVID-19 Vaccination and Children Answering Parents’ Questions.

Added June 14, 2021

Why should children get the COVID-19 vaccine?

Medical and public health experts, including the CDC and the American Academy of Pediatrics, recommend that children and adolescents 12 years of age and older get a COVID-19 vaccine to help protect them from contracting and spreading the virus. Children and adolescents are typically at lower risk than adults of becoming severely ill or hospitalized from COVID-19, but it is still possible. While most children with COVID-19 have mild or no symptoms, they can still spread the disease to others. COVID-19 has caused serious illness, complications, and even death in some children and teens, and those with underlying health conditions may be more likely to become severely ill.

Another important reason for children to get the COVID-19 vaccine is to protect their friends, family, and the broader community. And being vaccinated will allow kids to get back to the things they have missed: in-person school, playing with friends, and participating in sports activities. Vaccinated individuals have a very low risk of contracting COVID-19 or spreading it to others, which adds a layer of protection for unvaccinated individuals around them — such as younger siblings and other children who are not currently eligible. Additionally, as more and more people get vaccinated, the infection rate among the general population will continue to lower, decreasing the chance that the coronavirus will mutate into dangerous variants.

Added June 14, 2021

Is the COVID-19 vaccine safe for children?

Yes. The FDA and CDC have carefully reviewed the clinical trials for Pfizer’s COVID vaccine, and it has been proven to be safe and effective for children 12 and older. Moderna has also applied for authorization for its vaccine for 12- to 15-year-olds, and that data is currently under review. Clinical trials are also underway regarding the potential use of these vaccines for children under 12.                                            

In addition, the vaccines are being closely monitored to ensure the safety of the vaccines for all eligible age groups.

Added June 14, 2021

When can my child get vaccinated?

Everyone 12 years and older is eligible now to get a COVID-19 vaccine to protect from contracting and spreading the virus and to help communities return to normal activities. The Pfizer vaccine, which was shown to be highly safe and effective for children during clinical trials, was authorized on May 10, 2021 for early teens, ages 12 to 15. It was previously authorized for everyone 16 and older. The Pfizer vaccine is a two-dose series; children are considered fully vaccinated two weeks after their second dose. Until children are fully vaccinated, they should continue to wear a mask in public indoor settings or when interacting in crowded settings, even outdoors, and when around people who don’t live in their household.

Currently, no COVID-19 vaccine is authorized for children younger than 12. Clinical trials to test the efficacy and safety of the vaccines in younger children are underway, and a vaccine for younger children could become available as early as this fall. Until a vaccine is available for younger children, children age 2 and older should wear masks in public indoor settings or when interacting in crowded settings, even outdoors, and when around people who don’t live in their household.

Added June 14, 2021

What side effects do children experience from the vaccine?

Children may experience mild side effects, such as soreness in the arm, fatigue, headache, or a slight fever, and most will pass in one to two days. These are signs that their body is building immunity, but even if they don’t experience any side effects, their immune system is still building protection against the virus. Serious side effects are rare and treatable.

Added June 14, 2021

Which children cannot be vaccinated?

If your child has a significant health issue – such as those resulting in a compromised immune system — check with their physician to determine if they should be vaccinated.

Added June 14, 2021

Will children need a COVID-19 vaccine to return to school in the fall?

Vaccination requirements for public schools vary according to state laws, and that will likely be true for COVID-19 vaccines as well. All 50 states require certain immunizations — including tetanus, measles, polio, and chicken pox vaccinations — and some states have additional requirements. While many states and school districts have not yet announced their COVID-19 vaccination policies for the fall, requirements and/or recommendations will be issued at the state, local, and district levels as officials review guidance and as more children become vaccinated. Regardless of any requirement, all children who are eligible are encouraged to get the vaccine to protect themselves and others from catching and spreading the virus.

Added June 14, 2021

Schools and in-person learning

Is in-person learning safe?

In-person learning is critical for the educational and social development of students of all ages. The top priority is to ensure that schools open and operate in a manner that prioritizes the health and safety of students, teachers, school staff, their families, and the community. Preventing the spread of COVID-19, keeping children healthy, and meeting their educational and social needs are not mutually exclusive goals.

The CDC has made recommendations for how schools can safely open, emphasizing that approaches should be informed by local trends. For that reason, safety and prevention protocols and strategies will vary across the country. The CDC continues to recommend that all adolescents and adults age 12 and older get a COVID-19 vaccine, coupled with other mitigation strategies including mask-wearing by unvaccinated people (students and adults), ventilation, cleaning and disinfecting, screening and testing, and other precautions such as distancing, hand-washing, and staying home when sick.

Added July 27, 2021

Why does school reopening and in-person learning guidance vary across districts, counties, and states?

School policies, including COVID-19 guidance, are made at the state, local, district and school levels. The CDC continues to urge that policies be based on local vaccination and infection rates.

Added July 27, 2021

How will COVID-19 variants, such as the delta variant, affect children and schools?

Data show that the delta variant is roughly twice as contagious as the initial strain of COVID-19 and that it has a much higher viral load. Scientists and public health officials are still learning about how the delta variant affects children, including whether it is more severe for children than other COVID-19 strains. As COVID-19 cases rise across the country, pediatric cases are rising alongside adult cases.

As students return to in-person learning, the goal is to keep students safe and physically in school. Data show that the COVID-19 vaccines are extremely effective in protecting fully vaccinated people from catching and spreading the virus, including the delta variant. But it is critical that people are fully vaccinated to be protected. New data show that a small number of vaccinated people can be infected by the delta variant and may be contagious, but these cases represent a very small amount of transmission occurring around the country. The best way to reduce the spread of the delta variant in schools and communities is for all eligible adolescents and adults to get vaccinated, while following COVID-19 prevention and mitigation strategies informed by local trends.

Added July 27, 2021

I’m hearing different recommendations about masks at school. Will children be required to wear masks at school? Should they wear a mask, even if it’s not required?

The CDC, along with other organizations such as the American Academy for Pediatrics, recommends universal indoor masking for all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status.

The CDC issues recommendations and guidance to inform policy decisions made at the local and state levels. Decision-makers for public and private schools, on the state, local, district and school levels, establish policies such as mask requirements. Some areas will require that all children, teachers, and staff wear masks at school, while others will only require unvaccinated people to wear masks. Others will not have any school mask requirements.

Even if schools’ policies don’t require masks, many students may decide to wear a mask at school based on their personal risk assessment, preference, or other individual circumstances. It’s important that all students, teachers, families, and staff follow local requirements, while also being supported in any personal decisions about taking additional safety precautions.

If you have further questions about the CDC recommendations on mask-wearing, read our Tough Q&A on mask guidance.

Updated July 29, 2021

What are the best ways to keep my child safe while at school?

There are many ways that schools contribute to the full picture of students’ health and safety, including their social and emotional well-being, access to nutrition and other health services, and opportunities for physical activity. In addition to following local and school requirements and getting vaccinated if eligible, children can protect themselves and others from contracting and spreading COVID-19 by wearing a well-fitting mask if they are not fully vaccinated (and if otherwise required and/or preferred), washing their hands, social distancing when needed, staying home if they are feeling sick, and getting tested if they were exposed to the virus or are symptomatic.

Added July 27, 2021

Mask Guidance

On July 27, the CDC updated its recommendations on mask wearing based on the latest data on the delta variant. In communities with high COVID-19 transmission rates, everyone should wear a mask in indoor settings to help prevent the spread of the virus. Vaccination and mask wearing are the best defense against further spreading of the virus. The CDC is urging local jurisdictions to monitor local vaccination and transmission rates and base their masking regulations on these trends. The following message guidance is based on the new CDC recommendations. When developing messaging, state and local health officials should also consider local scenarios and transmission rates.

Updated July 27, 2021

Why did the CDC guidance on masks change?

The CDC bases its recommendations on the latest scientific data, including evidence on the safety and effectiveness of COVID-19 vaccines. In May, before the fast-spreading delta variant became the dominant strain in the U.S., the CDC updated its recommendations for fully vaccinated individuals based on evidence that the COVID-19 vaccines are extremely effective in protecting fully vaccinated people from catching and spreading the virus. The CDC’s updated masking guidance (July 27) advised that vaccinated and unvaccinated people communities with substantial or high transmission rates should wear a mask in indoor, public settings. This new guidance is based on data showing that in rare instances, vaccinated people can catch and spread the virus. In addition, the CDC continues to encourage that everyone be vaccinated.

Topline messages about the July CDC update:

  • The CDC bases its recommendations on the latest scientific data, so it updates  recommendations when there is new information. When the CDC revised its guidance in May, the delta variant represented 1% of all cases. Today that number is more than 80%.
  • The CDC continues to recommend that policies be based on local transmission rates.
  • Data demonstrate that the vaccines are preventing severe illness, hospitalization, and death, and are effective against the delta variant. New data is showing that a small number of vaccinated people can be infected by the delta in a breakthrough infection and may be contagious, but these cases represent a very small amount of transmission occurring around the country.
  • Getting vaccinated prevents severe illness, hospitalization, and death; it also helps reduce the spread of the virus and continues to be the leading public health strategy to end the COVID-19 pandemic.

Updated July 27, 2021

I’m fully vaccinated. What does the new CDC mask guidance mean for me?

If you are fully vaccinated — which means two weeks have passed since your second dose of the Moderna or Pfizer vaccine or since your one dose of the Johnson & Johnson vaccine — you have a very low risk of contracting COVID-19 or spreading it to others. You can resume many normal activities without wearing a mask, but if you live in an area with substantial and high transmission of COVID-19, the CDC recommends that everyone (including fully vaccinated individuals), wear a mask in public, indoor settings to help prevent the spread of the delta variant and protect others. 

In addition to those local scenarios, there continue to be a few other notable exceptions where fully vaccinated people should wear masks: health care settings, homeless shelters, correctional facilities, public transportation, and airplanes. Additionally, vaccinated people should continue to follow local and state regulations, including individual business (such as retail stores and restaurants) and workplace requirements, which may differ from CDC guidance depending on local scenarios and transmission rates.

While COVID-19 vaccines are highly effective, no vaccine provides 100% immunity. New data  show that a small number of vaccinated people can be infected by the delta variant in a breakthrough infection and may be contagious, but these cases represent a very small amount of transmission occurring around the country. Additionally, fully vaccinated individuals may make the personal decision to continue to wear a mask based on their own risk assessment and preference. Those with certain medical conditions such as immuno-suppression should consult their physicians regarding the continuation of mask-wearing and other protective measures.

Updated July 27, 2021

What does the CDC mask guidance mean for local and state regulations where I live? My workplace? Local businesses?

Everyone should continue to follow local and state rules and regulations, which may or may not have changed since the CDC released new recommendations. In addition, everyone should comply with the practices of businesses that continue to require masks. This is particularly important in indoor settings where vaccinated and unvaccinated people may interact. While many local and state governments, workplaces, and businesses updated their mask policies since the CDC issued its new recommendations, others have not, and others still may wait for additional guidance from the CDC.

Added May 19, 2021

How does the new CDC mask guidance affect my children and their summer activities?

Currently, no COVID-19 vaccine is authorized for children under 12 years old. Children age 12 to 15 can now receive the Pfizer vaccine. Once children age 12 to 15 are fully vaccinated — two weeks after their second Pfizer dose — they can resume summer activities without wearing a mask unless required by local, state or business rules. Children age 2 and older who are unvaccinated or only partially vaccinated should wear masks in public settings, particularly where social distancing is not possible, and when around people who don’t live in their household.

Choosing summer activities with lower risk, in addition to wearing masks, can reduce unvaccinated children’s risk of contracting and spreading COVID-19. These activities include exploring the outdoors, taking a road trip with members of your household, or visiting vaccinated friends or family from another household. No activity is totally risk free: our kids ride bikes, they go skateboarding, etc. Parents should also monitor infections rates in your community and will need to make choices that feel best for their family. Being in crowds and poorly ventilated spaces puts unvaccinated people, including children, at higher risk for COVID-19.

Added May 19, 2021

Why do my local or state regulations differ from the new CDC guidance about masks?

The CDC does not make laws, but rather, it issues recommendations and guidance to inform policy decisions made at the local and state levels. Throughout the pandemic, many local and state officials have established policies — such as mask requirements and capacity limits — based on local scenarios and transmission rates. Now that the CDC has issued new recommendations on mask-wearing for fully vaccinated people, many cities, counties, states, and other entities have updated their policies, while others continue to review the guidance and their local transmission rates. Everyone should continue to follow the rules and regulations in their area.

Added June 1, 2021

Why do some businesses or workplaces have mask requirements and others don’t?

The CDC does not make laws, but rather, it issues recommendations and guidance to inform policy decisions made at the local and state levels. Businesses and workplaces also establish individual policies within the context of their local and state regulations. As some local and state governments have begun easing or lifting mask requirements, businesses and workplaces can still require employees and patrons to wear masks, just like they can issue certain other non-discriminatory requirements such as “no shirt, no shoes, no service” for customers, or a uniform for workers. These decisions might be informed by local scenarios and transmission rates, protections for workers, or other individual risk assessments. Employees should continue to follow the policies of their individual workplaces, and members of the public should continue to abide by the requirements of businesses they choose to patronize.

Added June 1, 2021

I’m fully vaccinated. Why do I need to wear a mask in some places?

On May 13, the CDC updated its public health recommendations for fully vaccinated individuals, including guidance on when people can safely resume normal activities without wearing a mask. However, there are a few important exceptions within the new CDC guidance. Everyone should continue to wear a mask in health care settings, homeless shelters, and correctional facilities, and while traveling on public transportation and planes. While the COVID-19 vaccine is highly effective, and vaccinated people have a very low risk of contracting COVID-19, spreading it to others, or getting severely sick, no vaccine is 100% effective. To protect people at increased risk for contracting COVID-19 or at increased risk of severe illness, and to reduce spread of the virus, everyone should continue to wear masks in these settings. Additionally, everyone should continue to follow local and state regulations, along with individual business and workplace requirements.

Added June 1, 2021

How effective are face masks in preventing the spread of COVID-19?

Because COVID-19 spreads from person to person via respiratory droplets, properly wearing a mask helps prevent the spread of the virus to others, including those at a higher risk of severe illness, especially when paired with other prevention tactics such as proper social distancing and frequent hand washing.

Updated May 7, 2021

What type of mask is the most effective for preventing the spread of COVID-19?

Surgical and fitted N95 masks are the most effective for the prevention of spread of COVID-19. In the absence of these, homemade masks should have two or more layers of washable, breathable fabric, fit tightly against the face, cover the nose and mouth, and have wire to prevent air from leaking out of the top of the mask. For extra protection, you can layer two fabric masks or a fabric mask over a surgical mask. Masks that have any exhalation vales or vents are not recommended, as these allow for the escape of respiratory droplets.

updated February 24

Why should we trust the CDC on wearing masks when they explicitly told us not to do so at the start of the pandemic?

At the onset of the pandemic, the CDC recommended that those who exhibited COVID-19 symptoms and those who were caring for someone who had COVID-19 wear face masks. Others were dissuaded from wearing surgical masks due to a severe shortage of personal protective equipment (PPE) among health workers treating COVID-19 patients and because, at that time, there wasn’t sufficient evidence of the efficacy of mask-wearing for the general public. As new research demonstrated that the virus could be easily spread by asymptomatic individuals, the CDC updated its recommendations to indicate that everyone should wear face coverings in public settings. Updating guidance based on new scientific evidence is one of the many important roles the CDC plays in protecting public health. The agency will continue to update guidance as more people get vaccinated and we better understand how effective the vaccines are against variants and preventing the spread of COVID-19.

Updated May 7, 2021

Vaccines

Will I need a COVID-19 vaccine booster?

Because this is a new virus and these are new vaccines, we don’t yet know how long immunity will last and whether additional doses will be needed. Vaccine boosters are common, such as the flu vaccine, which is needed every year. The scientists and health and medical experts who developed the vaccines are continuing to monitor for signs of waning immunity and how well the vaccines protect against new mutations of the virus.

Data continue to show that the COVID-19 vaccines are extremely effective in protecting individuals from catching and spreading the virus. In addition, new data suggests that vaccines are effective against variants of the virus. Booster doses may be needed if immunity in vaccinated individuals begins to wane, if fully vaccinated individuals are at risk of serious breakthrough infections, or if fully vaccinated people experience decreased protection from variants or other complications. Right now, the best way to protect yourself and your loved ones is to get vaccinated, which will reduce your own risk and help protect your community against the chance that the coronavirus will mutate into dangerous variants.

Added July 8, 2021

Can I visit friends and family after I am vaccinated?

Fully vaccinated people can visit with other fully vaccinated people indoors without wearing masks or physical distancing. You can also visit with unvaccinated people from a single household who are at low risk for severe COVID-19 disease without wearing a mask or physical distancing.

See graphic “I got a COVID-19 vaccine. Now what?

Added March 11, 2021

Is it important that I get the second dose?

The Johnson & Johnson vaccine is a single-dose vaccine, while the Moderna and Pfizer-BioNTech vaccines are based on a two-dose regimen. It’s important to get both doses of these vaccines because that’s what was shown to be effective during the clinical trials. Vaccine supply is improving and health departments nationwide, including ours, are working to ensure that everyone who receives the Pfizer-BioNTech or Moderna vaccines is able to get both doses as recommended.

I already had COVID-19, why do I still need the vaccine?

Not enough is yet known about how long immunity from natural COVID-19 illness might last and protect you from becoming re-infected and spreading the illness to others. For that reason, even if you have already been infected, vaccination is an important step to protect yourself and those around you.

Why should I trust that the vaccine is safe when it was developed so quickly?

The FDA approves a vaccine for use only if it is proven safe and effective, after clinical trials have been conducted with thousands of people, and when its benefits outweigh any risks. The COVID-19 vaccine builds on years of scientific research and an unprecedented level of scientific investment and cooperation. Every study and every phase of every trial was carefully reviewed and approved by a safety board and the FDA. The process was transparent and rigorous throughout, with continual oversight and expert approval.

The identification of what is approximately a less than 2-in-a-million risk of a blood clotting disorder associated with the Johnson & Johnson vaccine is a sign that the nation’s safety monitoring system for COVID-19 vaccines is working. After any vaccine is successful in clinical trials and authorizes it for use, the FDA continues to monitor it for safety. The pause in the use of the J&J vaccine allowed scientists to evaluate each incident of the clotting disorder. They determined that the level of risk was very low and that the benefits of continued use of the J&J vaccine greatly outweigh any risk associated with it.

The likelihood of a medically significant reaction is extremely low. Temporary side effects like soreness, headaches, or a mild fever are signs that the body is responding and building an immunity to the virus. They typically go away in a day or two.

Updated May 7, 2021

How can I be sure the long-term side effects of the vaccine won’t be worse than having COVID-19?

The threat of COVID-19 is real and urgent, and the benefits of getting vaccinated far outweigh the risks. COVID-19 is killing thousands of Americans every day and leaving many others with lasting symptoms and disability. Getting vaccinated will help keep you, your family, and your community healthy and safe and will allow for the full reopening of the economy.

I understand your concern.  What I can tell you is that vaccines don’t generally have long-term side effects and there is no reason to believe the COVID-19 vaccine will.  To be sure, the FDA and the scientists, health and medical experts, and researchers who developed the vaccine are closely monitoring for side effects and symptoms reported by anyone who is vaccinated, watching out for any patterns that are out of the ordinary. Data will continue to be collected for two years after each vaccine is first administered to ensure that they are safe for the long term.

How long does it take for the vaccine to provide immunity?

You are considered fully vaccinated for COVID-19 two weeks after you have received the second dose in a two-dose series (Pfizer-BioNTech or Moderna) or two weeks after you have received a single-dose vaccine (Johnson & Johnson). While vaccines must be highly effective to be approved for use, no vaccine provides 100% immunity, so fully vaccinated individuals should continue to take precautions in public and when around unvaccinated people.

Added March 12, 2021

Am I permanently immune after getting vaccinated?

Because this is a new virus and these are new vaccines, we don’t yet know how long immunity will last and whether additional doses will be needed, as they are for the flu. The FDA and the scientists and health and medical experts who developed the vaccines are continuing to study the virus and vaccines closely to understand how long immunity lasts and how well the vaccines protect against new mutations of the virus. While vaccines must be highly effective to be approved for use, no vaccine provides 100% immunity. Fully vaccinated individuals should continue to take precautions in public and when around unvaccinated people.

See graphic “I got a COVID-19 vaccine. Now what?

Added March 12, 2021

What is the risk of having an adverse reaction to the vaccine?

The risk of a medically significant adverse reaction to the COVID-19 vaccine is extremely low and the CDC and FDA are closely monitoring the safety of all approved vaccines. Mild side effects — like some soreness in the arm, fatigue, headache, or a slight fever — are signs that your body is building up protections and go away in one to two days. Even if you don’t experience any side effects, your immune system is still building your protection against the virus.

Cases of anaphylaxis (an allergic reaction) after a COVID-19 vaccination are extremely rare, occurring in approximately 2 to 5 people per million vaccinated in the United States. The identification of what is approximately a less than 2-in-a-million risk associated with the Johnson & Johnson vaccine is a sign that this safety monitoring system is working. The pause in the use of the J&J vaccine allowed scientists to evaluate each incident of the clotting disorder. They determined that the level of risk was very low and that the benefits of continued use of the J&J vaccine greatly outweigh any risk associated with it.

If you have a question about whether the vaccine is safe for you, you should talk to your physician.

Updated May 7, 2021

How will we know if a COVID-19 vaccine is safe?

The U.S. has a long history of assuring vaccines are safe through the use of specific, detailed, and time-tested protocols. The Food and Drug Administration (FDA) announced on October 6 that before approving a potential COVID-19 vaccine, it will need to see two months of follow-up data after volunteers get their second vaccine doses in a clinical trial. This is a sign that the FDA is taking every precaution to ensure the safety of a COVID-19 vaccine.

Clinical development for vaccines is a three-phase process. During Phase I, small groups of people receive the trial vaccine. In Phase II, the clinical study is expanded and the vaccine is given to people who have characteristics (such as age and physical health) similar to those for whom the new vaccine is intended. In the case of COVID-19 vaccines, Phase II trials in the U.S. should have a demographic makeup similar to that of the country, spanning a wide range of ages, races, ethnicities, and any other factors that would affect risk and efficacy. In Phase III, the vaccine is given to thousands of people and tested for efficacy and safety. During clinical development, a trial vaccine’s effectiveness is determined by comparing outcomes of patients who have received it with outcomes of patients who received the placebo.

In the U.S., the findings from clinical trials are presented to and reviewed by the FDA. The FDA also inspects manufacturing facilities to ensure safety and reviews product labels to ensure clarity. After approving a vaccine, the FDA continues to monitor and oversee its production to ensure that all safety protocols are followed. In addition, many vaccines undergo Phase IV formal, ongoing studies after the vaccine is approved and licensed. The FDA and CDC also collect and analyze information from reports of any side effects that may occur after a vaccine has been licensed.

In summary, before any new vaccine is brought to market, it has been given to thousands of people under stringent monitoring for safety. Sometimes, very rare side effects are recognized only after the vaccine is licensed because they occur so infrequently, but such side effects are very rare and must be weighed against the good the vaccine will do.

Updated January 12, 2021

Why is it important to have diversity among clinical trial subjects?

Everyone is susceptible to infection by the coronavirus. For that reason, a coronavirus vaccine needs to be safe and effective for all people regardless of their age, race, ethnicity, or gender.  Therefore, it’s important to have diversity among participants in clinical trials that measure a potential vaccine’s safety and effectiveness. Safety and effectiveness for all groups of people is particularly important for a COVID-19 vaccine because of the virus’s disproportionate impact on people of color, people with underlying medical conditions, and the elderly. A vaccine that is not sufficiently tested in a diverse clinical trial pool could lead to unexpected effects that didn’t appear in a trial with a more general population.

In May the FDA “strongly encouraged” the inclusion of diverse populations in COVID-19 clinical vaccine trials, including racial and ethnic minorities, the elderly, people with underlying medical conditions, and pregnant women. However, according to Clinical Research Pathways, a nonprofit that focuses on increasing diversity in clinical research, Black people typically represent only about 5 percent of clinical trial pool participants, even though they make up 13 percent of the U.S. population. Hispanics are typically about 1 percent of clinical trial pool participants but make up 18 percent of the population. Overall, Blacks, Hispanics, American Indians, and Alaska Natives make up approximately 32 percent of the U.S. population; optimally, they should be at least 32 percent of the people participating in the COVID-19 clinical trials.

Updated January 12, 2021

Pandemic fatigue

Why should we continue to put our lives on hold when there’s still no agreement on how to end this pandemic?

We understand that people are tired, but public health measures are not the enemy – they are the roadmap for a faster and more sustainable recovery. Public health policy measures are in place to prevent crippling surges and make re-opening possible.

As more people across the country get vaccinated, public health officials are reevaluating and adjusting public health measures to safely re-open and return to more normal day-to-day activities. Getting vaccinated and following the 3 Ws – wearing a mask indoors (beyond your own home) and in crowded places, watching your distance, and washing your hands – are the best tools we have to stop the spread of the virus.

CDC can’t provide the specific risk level for every activity in every community. Consider your own personal situation and the risk to you, your family, and your community before venturing out

Updated May 7, 2021

Trust in public health officials

There have been reports suggesting the CDC’s reputation has been diminished as a result of its role in the COVID-19 response. Is the CDC’s leadership still credible?

For decades, the CDC has put its scientific expertise to work to protect Americans from infectious disease, chronic illness, and preventable injuries. Around the world, the agency is a trusted source for public health and health promotion guidance; the CDC’s career staff remain a respected and credible information source.

The CDC is at its best when its scientists are free to provide public health advice based on the best available data and free of any political or non-scientific considerations.

There’s no avoiding the fact that the COVID-19 pandemic has been extremely challenging for the entire country, including the CDC. There was an early misstep at the CDC with the initial development of a COVID-19 test. However, since then CDC has gathered and shared data on the pandemic’s impact, produced educational materials, distributed billions of dollars in grant funding to local, state, tribal, and territorial agencies, and supported essential services necessary for testing, contact tracing, and protection of the public.

During the initial response, the CDC did not have the central and visible roles in coordinating and messaging during the COVID-19 pandemic that it had during past infectious disease outbreaks, including malaria, HIV, H1N1, Ebola, and Zika. This lack of a central, public-facing role for the CDC impeded the federal response, contributed to mixed messaging on the optimal response to the pandemic, and delayed and sometimes distorted the guidance needed by the American public.

That has changed. The CDC has been empowered to take a central role in developing guidance and messaging and coordinating the national response. Everyone benefits when the CDC is allowed to do its job without interference and with regular, unfettered science-based messaging offered directly to the public and policymakers. Under the new leadership, the thousands of rank-and-file CDC employees scientists and public health experts dedicated only to the protection of the public are leading the day in and day out work necessary to fight the virus.

Going forward, the nation needs to ensure that science guides public health without any interference. When statements are made or policies suggested that are not grounded in science, public health experts need to continue to say so.

Updated May 7 , 2021

Why should people trust public health officials?

Public health officials are trained and experienced in responding to infectious disease outbreaks and life-threatening emergencies. They work closely with scientists and researchers to translate the latest findings into action with the express goal of keeping people as safe and healthy as possible.

Public health officials strive to be guided by science and independent of political or partisan considerations. The most effective way to address COVID-19 is to have state, local, and federal officials working in coordination and operating based on scientific guidance.

What is a public health official’s most important role during a health emergency?

As always, the role of public health officials is to follow the science, develop programs and guidelines that protect health, advise elected officials, work with public and private sector partners, and keep the public informed.

updated November 3

Herd immunity

What is herd immunity, and is it a viable strategy to combat COVID-19?

Herd immunity is achieved when a virus stops circulating because a large segment of the population has already been infected or has been vaccinated against the virus. Public health officials estimate that 70 to 85% of the population will need to be vaccinated before herd immunity is achieved. Until then, getting vaccinated and the 3 Ws – wearing a mask indoors (beyond your home), watching your distance, and washing your hands – are the best tools we have to stop the spread of the virus.

Updated May 7, 2021

Hospital shortages

Health care providers have had months to build capacity and supplies to manage the COVID-19 outbreak. Why are we hearing about shortages of beds and supplies again?

The most serious potential shortage is for hospital intensive care capacity. The only way to prevent such shortages is to control the spread of COVID-19. In the last year, we have seen increased risk for shortages following unprecedented surge in cases, often after holidays or other moments of large gatherings. In those situations, patients may be at risk if the capacity of local hospitals to provide intensive care is exceeded by the number of patients needing that care. That’s why it is vital for us to work together and follow the latest public health guidance to prevent the spread of the virus.

updated February 24

Economy + jobs

Have public health measures had a negative impact on the national economy?

Public health measures are not an obstacle to a return to normalcy, they are the roadmap to faster and sustained recovery. Americans are coping with job losses, school closures, social isolation, and fears around health and safety. Many people are frightened, angry, and frustrated. As public health officials, we share this frustration. We want the economy and our schools to open. At the same time, we want to protect our families, friends, and neighbors from the virus, and we know that if we don’t, there will be even worse consequences for the economy and for schools.

Nobody should have to decide between the health of their family and putting food on the table. The goal is both public health safety and economic security; the two are dependent on each other.

Updated May 7, 2021

Testing

Is rapid testing effective for diagnosing and preventing the spread of COVID-19?

Rapid antigen tests are relatively inexpensive and, with proper interpretation, can be used to quickly confirm a suspected case of COVID-19 in a clinical setting. However, these tests are less sensitive than the recommended RT-PCR tests and more likely to return a false negative. Because they are less sensitive, rapid tests perform best when the person is tested in the early stages of infection, when viral load is generally highest. There is limited evidence to confirm the efficacy of rapid antigen tests to detect or exclude COVID-19 in asymptomatic people accurately or determine whether a previously confirmed case is still infectious.

In short, rapid tests are useful for confirming infection in someone with symptoms. They are less reliable in screening of people who are asymptomatic.

Why is it important to get tested?

Widespread testing is critical to identifying and forecasting outbreaks, conducting effective contact tracing, and preventing the spread of COVID-19. Anyone with signs or symptomsof COVID-19 should get tested, regardless of vaccination status or prior infection.

People who are not fully vaccinated and who have had close contact with an infected individual should get tested for COVID-19 regardless of symptoms. Fully vaccinated people with no COVID-19 symptoms do not need to get tested after close contact. People who have tested positive for COVID-19 in the past three months and recovered do not need to get tested following an exposure as long as they do not develop new symptoms.

Updated May 7, 2021

Treatment

What is the difference between “emergency use” and “compassionate use” for drugs and other therapies?

Emergency Use Authorization (EUA) allows the Food and Drug Administration (FDA) to authorize use of unapproved drugs, or unapproved uses of approved drugs, for life-threatening conditions when there are no adequate, approved, and available options and other conditions are met. In the case of COVID-19, the FDA has issued an Emergency Use Authorization for remdesivir, an investigational antiviral drug that is not currently FDA-approved, to treat hospitalized adult and pediatric patients with severe COVID-19.

Compassionate use, also called expanded access, is when a patient with an immediately life-threatening condition or serious disease or condition is given access to an investigational medicine for treatment outside of clinical trials when no comparable or satisfactory alternative therapy options are available. Patients must petition for compassionate use and meet a series of criteria to get expanded access. In the case of COVID-19, patients with life-threatening cases of COVID-19 can petition for expanded access to COVID-19 treatments that are currently in the clinical trial phase.

What is an experimental drug or treatment?

Experimental or investigational drugs and treatments have not yet been approved by the FDA and are currently being studied in clinical trials. During these trials, scientists determine whether a drug is safe and effective, how it should be used, the correct dosage, and the benefits and risks for people taking the drug.

added October 18

Contact tracing

How can a public health department expect someone who has just been diagnosed with COVID to provide information on possible contacts if those contacts may face hardship by being identified, such as being unable to go to work?

Contact tracing is currently one of the most important tools we have for controlling the spread of the virus. While we understand that no one wants to be the reason someone is unable to work, allowing the virus to spread unchecked will be much more harmful to your community and would have an even greater impact on employment. Cooperating with contact tracers will help prevent people from getting sick. Preventing further spread of the virus is the best strategy we have to protect jobs and livelihoods.

That said, efforts are being made to lessen the impact of going into quarantine. There are both formal and informal ways to assist people who need to quarantine. In some communities, there are services available or volunteers to help – for example, by delivering meals to people who are at home. Hardship can also be lessened when employers offer paid sick leave to employees who need to stay home

Why aren’t communities prepared to do contact tracing at an effective scale?

Contact tracing is the practice of informing people when they’ve been exposed to a contagious disease. It is an essential part of a comprehensive response to slowing the spread of COVID-19. However, because the scale of contract tracing required by the COVID-19 outbreak is beyond anything we’ve ever experienced, the size of the necessary contract tracing effort was not planned or funded.

There are ways to make contract tracing more manageable and therefore more effective. Health departments need faster COVID testing, funding to hire and train more contact tracers, and sufficient financial and social service support for those who are asked to isolate rather than return to work. We also need the public’s cooperation if they are contacted by a contact tracer.

updated October 18

Changes in official guidance

With guidance from the federal government changing so frequently, where can I go for reliable COVID-19 information?

Safety guidance has changed as more has been learned about the virus and how to prevent its spread. The rate of virus spread in your local community, in addition to your individual health and vaccination status, will largely determine the safest options for you. Your local health department is an important source of COVID-19 information that’s specific to your community.

Updated May 7, 2021

How can people trust public officials when guidance has been unclear and is constantly changing?

We understand it is frustrating that guidance continues to change. It’s the job of public health officials to tell you what we know, when we know it, and guidance regarding COVID-19 has evolved as our understanding of the virus evolves.

Public health officials and scientists are continuing to learn about how this virus spreads, how it affects different people, and how best to control it. As knowledge evolves and scientists discover new information about COVID-19, public health officials are committed to providing accurate and timely guidance.

updated September 25

Sports

Can my child safely participate in sports?

Providing the opportunity for kids to get exercise is as important as ever. While the best way to limit your child’s risk from the coronavirus is by ensuring they only engage in activities that allow participants to maintain six feet of distance, there are additional ways that leagues, players, and parents can protect families and communities and slow the spread of COVID-19. Participants should stay home if they’re sick, bring their own equipment to practice, maintain six feet of space from others, wear a mask if possible, and ensure proper hygiene. At the same time, leagues can focus on lower-risk activities like outdoor skills-building and conditioning rather than running the risk of contact between players. Certain activities are also safer than others — like tennis, soccer drills rather than scrimmages, and passing and catching football drills.

Is it safe for scholastic sports leagues to play? Professional leagues have been operating.

The risk of activities varies greatly depending on local community spread, so any decision about school sports should be made based upon the virus status locally. What may be considered moderate risk in some areas would be high risk in others.

Professional leagues are different from high school and college athletics in many ways, most notably that they can keep their athletes in a bubble and oversee their other activities. By contrast, student athletes do not occur in a bubble, which means they face increased risk for themselves, their family members, and their school’s students and staff. While many Americans enjoy watching and playing sports, we need to ensure we aren’t putting the health and safety of students, staff, families, and our community at risk.

updated September 17

Data and reporting

Are the death tolls for COVID-19 being inflated? The CDC reports that only a small number of COVID deaths were due exclusively to COVID.

The novel coronavirus remains a serious threat to public health, and there is no evidence that the number of COVID-19 deaths has been inflated. In fact, they are probably under-reported because some people have died of COVID without being tested for the virus. The CDC’s report gives a detailed account of something we’ve known since the beginning of the pandemic – having comorbidities like diabetes, heart disease, or obesity greatly increases a person’s risk for life-threatening consequences from the infection. We also know that COVID-19 can cause other illnesses, such as pneumonia or respiratory distress.

The high rate of chronic illness in the U.S. (6 in 10 adults have a chronic disease) has contributed to the high number of COVID-19 deaths, but the cause of these deaths is COVID-19, not some other illness.

Why has data reporting been slow or incomplete under the CDC?

One of the challenges the entire public health system is facing is that most COVID-19 cases go undiagnosed due to asymptomatic infection (people who have the virus but no symptoms).

The CDC relies on local, city, state, and federal reporting systems that have been neglected for decades. CDC is also focused on providing accurate information based on reports from health departments; this means that these reports may sometimes be more delayed than reports from news organizations, which often report unconfirmed information from unofficial sources.

Investing in the data systems at CDC and state and at local health departments is essential to collecting and sharing data across different systems in an automated manner. More efficient data collection is central to controlling any infectious disease outbreak.

Equity

Has the public health response been adequate in communities of color and low-income communities?

Prevention and treatment of infectious and chronic disease for low-income people and communities of color is woefully insufficient in our country, and the COVID-19 pandemic has been no exception to that pattern.

In general, access to affordable health care services for these communities, including testing, has been more challenging than in white communities. Limited economic opportunity and substandard housing have led to higher rates of underlying chronic health conditions, making serious illness and death from COVID more likely among communities of color. In addition, people of color and lower-income Americans have also been disproportionately designated as essential workers during the pandemic, with fewer job protections, placing them at increased risk for exposure. They also tend to live in more densely populated neighborhoods, making social distancing difficult.

These circumstances are the results of our country’s long history of structural racism in housing, jobs, education and healthcare. Addressing this racism is not only critical to protecting communities of color from the impact of COVID, it is critical to address them to allow all people to lead healthy lives.

Public health turnover

Why is there so much turnover among public health officials?

Public health officials are facing unprecedented levels of scrutiny and backlash as the COVID-19 pandemic takes a toll on health systems, the economy, and our nation’s education system. Despite the inevitable challenges of constantly evolving research and evidence, public health officials are the people who are best positioned to help our country emerge from this crisis as safely as possible. Unfortunately, some officials are being harassed and threatened, and have experienced intense, politicized pushback. Public health experts want the economy, schools, and businesses to open as much as anyone else. Data show that the best way to re-open and avoid being shut down repeatedly is to re-open safely while continuing to take precautions. When re-opening isn’t done safely, the economic consequences are much worse. Dismissing or attempting to intimidate the very officials working to ensure the public’s safety is undermining and delaying the full and safe re-opening of our economy and education system.

Seasonal flu

Should people get a seasonal flu shot? Will the seasonal flu vaccine and the COVID-19 vaccine interact in harmful ways?

It is more important than ever to protect against influenza, which, like COVID-19, is a respiratory illness. Vaccination for the flu is critical to help reduce the overall impact of respiratory illnesses on the general population and lower the resulting burden on the healthcare system during the pandemic.

State + local response

What role do state and local public health officials play during COVID-19?

National, state, local, tribal, and territorial health officials are all working hard to ensure the safety of their communities and the country as a whole. While federal public health experts can coordinate national response strategies, the impact of COVID-19 varies by state, city, county, village, and town. Local and state health officials have the best understanding of how the virus is impacting their immediate community, the level of community spread, community-specific risks, and who the community will trust to provide public health information. They use that understanding to adapt national guidelines for their communities.

U.S. response + infection rate

Why has the response in the U.S. been so poor? Why was the CDC unprepared for this crisis?

The COVID-19 pandemic has exposed the impact of chronic underfunding of America’s public health and emergency preparedness systems. Only five states serve over 50 percent of their populations with a comprehensive public health system. More than 56,000 local public health jobs were eliminated between 2008 and 2017 — nearly one-quarter of the workforce. And in 2018, the White House Office of Global Pandemics was eliminated, leaving the country less prepared for pandemics like COVID-19. This chronic under funding has real consequences, as we’re learning now with health departments struggling to respond to the biggest public health crisis in a century with outdated technologies and inadequate staffing levels. Building and maintaining a public health system capable of effectively protecting and promoting health requires a significant increase in funding. This would be a wise investment considering the much higher costs of responding to uncontrolled epidemics.

How have other countries been able to significantly reduce their COVID-19 cases, and could those tactics be applied in the U.S.?

While COVID-19 has affected some countries more than others, there are places like South Korea and Taiwan that have been able to significantly reduce their surge in cases for a variety of reasons. Those governments took action early; made testing widely available; effectively implemented isolation and quarantine practices, with careful monitoring for compliance and assistance with social and economic supports; and reinforced the importance of social distancing and mask-wearing. In the U.S., some of these steps would be more difficult than others because of cultural and legal differences and resource availability, but many are being advanced here as well. We continue to urge the public to wear face masks and practice social distancing rules outside the home. And we continue to advocate for increased access to reliable testing with quick turn-around time for results and for efficient case finding and contact tracing.