- Andrejko, Kristin L;
- Pry, Jake M;
- Myers, Jennifer F;
- Fukui, Nozomi;
- DeGuzman, Jennifer L;
- Openshaw, John;
- Watt, James P;
- Lewnard, Joseph A;
- Jain, Seema;
- Abdulrahim, Yasmine;
- Barbaduomo, Camilla M;
- Bermejo, Miriam I;
- Cheunkarndee, Julia;
- Cornejo, Adrian F;
- Corredor, Savannah;
- Dabbagh, Najla;
- Dong, Zheng N;
- Dyke, Ashly;
- Fang, Anna T;
- Felipe, Diana;
- Frost, Paulina M;
- Ho, Timothy;
- Javadi, Mahsa H;
- Kaur, Amandeep;
- Lam, Amanda;
- Li, Sophia S;
- Miller, Monique;
- Ni, Jessica;
- Park, Hyemin;
- Poindexter, Diana J;
- Samani, Helia;
- Saretha, Shrey;
- Spencer, Maya;
- Spinosa, Michelle M;
- Tran, Vivian H;
- Walas, Nikolina;
- Wan, Christine;
- Xavier, Erin
The use of face masks or respirators (N95/KN95) is recommended to reduce transmission of SARS-CoV-2, the virus that causes COVID-19 (1). Well-fitting face masks and respirators effectively filter virus-sized particles in laboratory conditions (2,3), though few studies have assessed their real-world effectiveness in preventing acquisition of SARS-CoV-2 infection (4). A test-negative design case-control study enrolled randomly selected California residents who had received a test result for SARS-CoV-2 during February 18-December 1, 2021. Face mask or respirator use was assessed among 652 case-participants (residents who had received positive test results for SARS-CoV-2) and 1,176 matched control-participants (residents who had received negative test results for SARS-CoV-2) who self-reported being in indoor public settings during the 2 weeks preceding testing and who reported no known contact with anyone with confirmed or suspected SARS-CoV-2 infection during this time. Always using a face mask or respirator in indoor public settings was associated with lower adjusted odds of a positive test result compared with never wearing a face mask or respirator in these settings (adjusted odds ratio [aOR] = 0.44; 95% CI = 0.24-0.82). Among 534 participants who specified the type of face covering they typically used, wearing N95/KN95 respirators (aOR = 0.17; 95% CI = 0.05-0.64) or surgical masks (aOR = 0.34; 95% CI = 0.13-0.90) was associated with significantly lower adjusted odds of a positive test result compared with not wearing any face mask or respirator. These findings reinforce that in addition to being up to date with recommended COVID-19 vaccinations, consistently wearing a face mask or respirator in indoor public settings reduces the risk of acquiring SARS-CoV-2 infection. Using a respirator offers the highest level of personal protection against acquiring infection, although it is most important to wear a mask or respirator that is comfortable and can be used consistently.