Immunocompromised? What to Do If You Get Pushback for Wearing a Mask in Public

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When the U.S. Centers for Disease Control and Prevention (CDC) released updated guidance saying fully vaccinated people no longer had to masks indoors and outdoors in most situations (unless doing so is required by federal, state, local, tribal, or territorial laws, rules, and regulations), the news came as a shock to many — but particularly to those who are immunocompromised.

People who are immunocompromised because they take immunosuppressant medication may still be vulnerable to COVID-19 even after being vaccinated since we don’t have enough data yet on how well the COVID-19 vaccine protects these individuals. For instance, certain medications like methotrexate may reduce the body’s immune response to the vaccine. For now, many experts recommend that immunocompromised patients continue to follow standard mitigation efforts even after they are fully vaccinated.

Because of this, and other reasons, many patients with underlying health conditions or taking medications that affect their immune system plan to continue wearing masks for their safety. Unfortunately, it’s possible that others won’t always respect that decision.

Members of our community have reported receiving “weird” looks and getting jeered at for continuing to wear masks. Some have even gone as far as to purchasing an “Immunocompromised” T-shirt to offer an explanation for their decision. The widespread use of masks may vary greatly depending on where you live, but you certainly shouldn’t feel ashamed or uncomfortable for taking an important step to protect yourself.

If you’re continuing to wear a mask as an immunocompromised individual (as many experts recommend you do) here are tips for handling negative feedback, which will we hope will be a rare occurrence.

1. Know Your Reasons for Protecting Yourself

It’s important to first feel confident in your decision to continue to wear a mask. You may feel like you’re “standing out” if you’re one of few wearing a mask in public, but that may not bother you as much if you think about the many ways it can benefit you.

“I think a lot of people are dropping masks too fast, and we don’t realize how effective masks have been not only in containing cases of COVID-19, but also in preventing other infections,” says Stuart D. Kaplan, MD, Chief of Rheumatology at Mount Sinai South Nassau in Oceanside, New York and a partner in practice at Rheumatology Consultants, LLP. “A lot of my patients have told me they’ve gotten fewer colds or even fewer flares of chronic infections, like herpes simplex, since wearing masks.”

And, as an immunocompromised patient, you’re likely already accustomed to making choices that others don’t.

“As a community, we’re good at planting those flags and setting those limits,” says Kim Gorgens, PhD, Clinical Professor and Director of Continuing Education at the Graduate School of Professional Psychology at the University of Denver.

Use those skills that you’ve built to state your case — both personally and outwardly — for wearing a mask. Knowing your reasons for masking up will make skeptical or inquisitive glances seem more trivial.

And if you do want to offer up an explanation to passersby (even though it’s not necessary), Dr. Gorgens “loves the T-shirt idea.”

2. Remove Yourself from a Situation

If someone jeers at you simply for wearing a mask, understand that they may not be in a position to have a reasonable conversation. Because of that, it may be best to walk away without saying anything to avoid escalating the situation.

“With anyone who would be rude and approach someone they don’t know wearing a mask, you know right out of the gate they can’t really be reasoned with,” says Dr. Gorgens. “They don’t have the type of inhibitory skills that would have said, ‘It’s not a good idea to approach someone you don’t know and accuse them of something you know nothing about.’”

In other words, that person likely will not listen to your reasons, change their mind about mask wearing, or apologize for their behavior. The safest, quickest way to get away from that person is to simply walk in the opposite direction.

Disarm the Other Person

In some cases, you may feel like you need to say something. Although it can be difficult, Dr. Gorgens recommends “disarming” the skeptic with a simple phrase: “Thank you, have a great day.”

Think of disarming as encouraging someone else to get out of attack mode — and in this case, drop their verbal weapons.

If the skeptic continues to bother you or a more terse response is required, you might try a simple, straightforward: “This is none of your business. Keep walking.”

“You don’t want to invite conversation,” says Dr. Gorgens. “There’s certainly nothing fruitful being gained by engaging that person in a discussion. We know from cognitive psychology that the likelihood of a statement we say yielding any actual impact on someone else’s beliefs is pretty minimal, so this is about de-escalating the situation.”

But remember, the circumstances in which you’re criticized for wearing a mask really should be the exception rather than the norm. You’re likely to encounter many others who not only respect, but applaud, your decision to continue wearing a mask to protect yourself.

Find Your Allies

Despite the CDC’s guidance, many people (even those who are not immunocompromised) plan to continue wearing masks. Nearly one-fifth of Americans see themselves continuing to wear a mask in public for some time into the future, even as restrictions are lifted, according to a March 2021 Consumer Reports survey of 2,144 American adults.

A more recent survey from Vox and Data for Progress of 1,203 registered voters from May 14 to 17, 2021 — soon after the CDC made its announcement regarding masks — showed even more striking results. According to the survey, 61 percent of those surveyed, including more than half of those who are fully vaccinated, said they were continuing to wear masks outdoors. When asked why:

• 49% said to protect themselves from COVID-19
• 42% said to protect those around them
• 21% said to protect themselves from other illnesses

The Global Healthy Living Foundation’s COVID-19 Patient Support Program conducted a similar survey to gain insight into whether people who are fully vaccinated but immunocompromised would continue to wear masks, as well as how they felt about the new recommendations. Not surprisingly, most people who have chronic illnesses or autoimmune diseases don’t plan to stop wearing masks anytime soon — especially when indoors. About 90 percent of respondents said they would continue wearing masks in indoor public spaces and at indoor events. When it came to socializing indoors (where groups might be smaller and include people they know), nearly 70 percent said they would continue to wear a mask.

As part of the poll, patients were asked if they would continue to wear a mask for various situations if masks are no longer required.

When asked if they would continue to wear masks in indoor public spaces:

• 90.6% said yes
• 8.9% said no
• Less than 1% said they’ve never worn a mask for this scenario

When asked if they would continue to wear masks at indoor events:

• 90.1% said yes
• 9.2% said no
• 1% said they’ve never worn a mask for this scenario

When asked if they would continue to wear masks when socializing indoors:

• 69.3% said yes
• 29.11% said no
• 1.6% said they’ve never worn a mask for this scenario

In other words: You’re not alone. Go out with friends or family who will wear masks with you. You may be less likely to be singled out if you’re with someone else wearing a mask — or your loved one may be able to help you exit or de-escalate a situation.

“There’s a way we can try to insulate ourselves with our people,” says Dr. Gorgens. “If you’re traveling with a friend and they’re wearing a mask because they want to protect you as well, that may be a way to insulate yourself from the ugliness of certain people in those settings.”

And of course, take a moment to appreciate the other mask wearers you may see in public.

“There’s a solidarity with other folks wearing masks, and there are still a lot of them,” says Dr. Gorgens. “Find your people, make eye contact, give a nod, and remind yourself of the protection you’ve committed to.”

Finally, know that CreakyJoints and the Global Healthy Living Foundation are here for you as a patient community filled with many immunocompromised people who are opting to keep wearing masks. Follow us on social media (Twitter, Instagram, Facebook) for ongoing connection and consider joining our COVID-19 Patient Support Program below for ongoing news about the pandemic that is catered to people with chronic illness.

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