More Information on Masks, Boosters, and Halloween

With community levels of vaccination high and infection rates relatively low, many of you have asked when we can loosen campus restrictions, particularly with regard to indoor masking. In this week’s message, I describe some of the conditions that would allow us to change our masking guidance. I also provide additional information on booster eligibility, an update on international travel requirements, and some tips for safer trick-or-treating.

When can we stop wearing masks indoors?

Wearing masks is an important component of our layered strategy to prevent COVID-19 infections, especially with the highly transmissible Delta variant. That said, masks can be uncomfortable and create challenges in our communications and interactions with colleagues and classmates. Our current masking policy, which requires masking indoors regardless of vaccination status, is based upon advice from our public health experts, who regularly reevaluate the need for this protective measure in light of both the current risks of COVID-19 infection and the practical disadvantages of mask wearing.

Recently, masking requirements that impact our community have also emerged in President Biden’s Executive Order 14042 (EO) and companion guidance from the Safer Federal Workforce Task Force (Task Force). The EO requires all institutions—including Yale University—that enter into federal contracts to have adequate COVID-19 safety protocols in place. The related Task Force guidance specifies that “adequate COVID-19 safety protocols” must include masking policies that follow relevant guidance from the Centers for Disease Control and Prevention (CDC).

At this time, the CDC advises indoor masking for all individuals, regardless of vaccination status, in areas of substantial or high community transmission. Although COVID-19 case rates have been declining in recent days, New Haven County is still designated by the CDC as an area of substantial transmission.

The university will be able to consider changing its indoor masking policy when advised by our public health experts and when New Haven County is at CDC’s low or moderate transmission levels.

What else does Executive Order 14042 require?

In addition to requiring masks, the EO and Task Force guidance require all employees in the workplaces of federal contractors to be fully vaccinated against COVID-19 by December 8, 2021, unless they have approved exemptions for medical or religious reasons. As a federal contractor, Yale is required to comply with this mandate.

Accordingly, Yale staff and faculty members who had previously complied with Yale’s Vaccination Policy by receiving strongly held personal belief exemptions have been advised that they must now either become fully vaccinated or obtain a medical or religious exemption by the December 8 deadline. Those who are impacted by this requirement may contact our Public Health Ambassadors who can help each individual identify the path that is best for them.

What’s new on travel from the White House?

On October 25, 2021, the White House issued a Proclamation: “Advancing the Safe Resumption of Global Travel During the COVID-19 Pandemic.” Effective November 8, 2021, the Proclamation lifts current geographic travel bans and replaces them with the requirement that all noncitizens who are nonimmigrants traveling to the United States by air from any part of the world establish that they are fully vaccinated, with some exceptions. Additionally, air travelers will continue to be required to show proof of a negative COVID-19 test performed prior to their flight’s departure to the United States. Yale’s travel policy provides additional information about this requirement.

Who is eligible for a COVID-19 booster? Should I get one? May I get one?

Last week I provided information about the CDC’s approval for booster doses for all three COVID-19 vaccines—Pfizer-BioNTech (Pfizer), Moderna, and Johnson and Johnson/Janssen (J&J). Since that time, the CDC has updated its website to make clear which categories of individuals should receive a booster because they may be at higher risk for severe COVID-19 infection and/or decreasing immunity after their initial vaccinations. More specifically:

• Anyone 18 years of age or older who received the J&J vaccine initially should receive a booster shot at least 2 months after receiving their initial J&J vaccinations.
• People 65 years of age and older who received any of the three authorized vaccines should receive a booster.
• People 50-64 years of age with underlying medical conditions who received any of the three authorized vaccines should receive a booster.
• People 18 years of age or older who live in long-term care settings who received any of the three authorized vaccines should receive a booster.

Additionally, the CDC recommends that:

• People who initially received the Pfizer or Moderna vaccines and who are moderately or severely immunocompromised should receive an additional full dose of their initial vaccine at least 28 days after their second dose in the initial series.

The CDC has determined that many more individuals may choose to receive a booster at least 6 months after receiving their initial Pfizer or Moderna vaccinations because of the favorable effect it may have on their levels of immunity to COVID-19. More specifically:

• People 18-49 years of age who have underlying medical conditions may receive a booster.
• People 18-64 years of age who work or live in high-risk settings may receive a booster; because the CDC explicitly includes education staff and individuals who work or reside in health care or school settings in this category, many members of our community are now eligible to receive boosters.

Boosters are available on an appointment-only basis through the Yale COVID-19 Vaccine Program at its 310 Winchester Avenue clinic and through Yale New Haven Health. You can also search for options throughout the state.

What about vaccines for children?

Earlier this week, an advisory committee of the U.S. Food and Drug Administration (FDA) recommended the authorization of the use of the Pfizer vaccine in children ages 5 to 11. The FDA Commissioner will consider this recommendation and issue the agency’s final decision, likely in the next few days. The CDC’s Advisory Committee on Immunization Practices has scheduled meetings on November 2 and 3 where it will consider the FDA decision and make recommendations to the CDC Director. A final recommendation from the CDC Director could come as early as the middle of next week. If it is authorized by the FDA and recommended by the CDC, vaccinations for children ages 5 to 11 will be available immediately.

How can I celebrate Halloween more safely?

While vaccines will not be available for younger children in time for Halloween, CDC Director Rochelle Walensky recently endorsed a return to trick-or-treating if it is done outdoors, while maintaining adequate distance and avoiding mingling in large crowds. Please also bear in mind that a costume mask is not an adequate substitute for a protective face covering. Additional guidance for safer holiday activities is available from the CDC.

For those of you planning Halloween festivities on campus, please be mindful of the university’s events, gatherings, and meetings guidelines.

I realize that I had much to share in this week’s message. I hope you found these updates informative and useful in planning your fall activities. Once again, thank you for your many efforts to keep our campus as safe as possible.

Stephanie S. Spangler, M.D.
Vice Provost for Health Affairs and Academic Integrity
Clinical Professor of Obstetrics, Gynecology and Reproductive Sciences
University COVID-19 Coordinator