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Washington — Vice Admiral Dr. Jerome Adams, the former surgeon general of the United States, said Sunday that the coronavirus pandemic is “spiraling out of control” again because too few people are vaccinated.

In an interview with CBS News’ “Face the Nation,” Adams urged those who have yet to receive their coronavirus vaccines to do so, as the highly contagious Delta variant continues to sweep across the country and leaves some governors pleading with unvaccinated residents to get their shots.

“There’s also real harm to you because, guess what? More mitigation is coming, whether it’s masking or whether it’s closures or whether it’s your kids having to return to virtual learning, that is coming,” Adams said on “Face the Nation,” speaking to unvaccinated Americans. “And it’s coming because this pandemic is spiraling out of control yet again, and it’s spiraling out of control because we don’t have enough people vaccinated. So get vaccinated because it helps your neighbors, but get vaccinated because it’s going to help every single American enjoy the freedoms that we want to return to.”

• Transcript: Vice Admiral Dr. Jerome Adams on “Face the Nation”

Coronavirus cases rose in all 50 states, and hospitalizations and deaths are also up as the Delta variant represents more than 83% of the virus circulating in the U.S. The Delta variant poses a significant risk to those who remain unvaccinated, who account for nearly all of the coronavirus hospitalizations and deaths.

With the rise in coronavirus infections, some local officials have decided to reimpose their mask mandates, even as the Centers for Disease Control and Prevention (CDC) is leaving its guidance — masking is necessary for the unvaccinated — unchanged for now. 

But Adams is calling for the CDC to update its guidance to urge even those who are vaccinated to wear masks in public settings. 

“If you’re out in public, if you’re around people who you don’t know whether they’re vaccinated or not, and especially if you’re in a community where prevalence is going up … it is probably going to be safest for you to mask it whether or not you’re vaccinated or not,” he said. “And your public health officials who don’t have a good way of knowing, or your businesses who don’t have a good way of knowing who’s vaccinated or not, they’re going to find that they have no other choice but to call on more people to mask it. And the CDC needs to give those businesses, those health officials, a little bit of cover by clarifying the guidance that they have out there.”

Adams said he reflected on his own statements about mask-wearing in 2020, while he was surgeon general under former President Trump, and said, “I wish in hindsight I hadn’t been as definitive. I wish I had been humble enough to understand that this is a new virus. I wish that my message had been heard differently.”

Adams said the CDC changing its mask guidance will provide cover to businesses and cities who want to enforce mask mandates, allowing them to point to the federal health agency as the reason for a return to more stringent mitigation measures amid the rise in coronavirus infections.

But Adams also said getting a coronavirus vaccine will also ensure a quicker return to normalcy. 

“I always say to people, it is your choice, but choices come with consequences to you and to other people,” he said.

According to the CDC, just under 50% of the total U.S. population is fully vaccinated, while 57.3% of the population over the age of 12 have received their shots. 

Adams said there are any people “who have legitimate questions and who have legitimate barriers” that have kept them from getting their vaccines, but also said the lack of full approval of the vaccines from the Food and Drug Administration is also a hurdle. All three vaccines being administered in the U.S. received an emergency use authorization from the FDA.

“We still have no clear timetable on when we can expect FDA licensure of these vaccines for adults. And a lot of people say that that is still causing their hesitancy, number one,” he said. “But number two, I can tell you the quickest way to get people vaccinated is through mandates. And we can’t have mask mandates. We won’t — you’re hearing this from the military and from other businesses until you have full licensure of these vaccines. So if you want to get a bunch of people vaccinated, really quickly, get the vaccines licensed and then you’ll see the military make it mandatory. You’ll see businesses make it mandatory.”