The LAM Foundation Statement on Masks and Social Distancing for COVID-19

Posted on May 28, 2021   |   


On May 16, 2021 the Centers for Disease Control and Prevention (CDC) released updated guidance for individuals who have been fully vaccinated (at least two weeks following the full course of your vaccination) against COVID-19. According to this guidance, fully vaccinated individuals can resume normal activities without wearing a mask or social distancing.

The exact implications of this recommendation for the LAM community are not clear given the potential for increased risk of complications from COVID-19 due to underlying lung disease. In addition, whether being on sirolimus impacts the degree of immune response following COVID-19 vaccination is not well understood and is the subject of active investigation. Although there are no disease-specific data, given the uncertainty posed by the above factors, members of The LAM Foundation Scientific Advisory Board have developed tiered recommendations for fully vaccinated LAM patients that are stratified based on disease severity.

Disease Category


Definition (any one of the listed criteria under the category)

Risk category




Lung function (FEV1 or DLCO) >70% and not on sirolimus


Follow CDC recommendations similar to the general public



1. Lung function (FEV1 or DLCO) >70% on sirolimus


2. Lung function (FEV1 or DLCO) between 50-70%, on sirolimus or not


Relax precautions while outside and inside in well-ventilated areas but continue all precautions for crowded events and in indoor settings with limited ventilation



1. Lung function (FEV1 or DLCO) <50%

2. Patients requiring continuous supplemental oxygen regardless of lung function

3. Patients undergoing transplant evaluation

4. Post-transplant patients


Relax precautions outside but continue all precautions indoors and for crowded events



Please note that the above recommendations are only applicable to fully vaccinated patients with LAM. If you are not yet fully vaccinated, please continue to maintain all precautions including wearing a mask and social distancing. Also, in addition to the CDC guidelines, be mindful of state and local policies, as well as the policies of specific businesses, health care environments, public transportation agencies, and airlines. Lastly, individual risk does not always fall so neatly into categories. In addition to FEV1 or DLCO impairment, individual risk is also dependent upon other factors such as age, underlying health conditions, and overall health status. Patients should exercise their best judgment and seek guidance from their healthcare providers when making decisions.

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