California’s public health agency recommended on Wednesday that people wear masks indoors, regardless of their vaccination status, while more employers announced that workers must be vaccinated or face testing.

State officials said they were following the lead of the U.S. Centers for Disease Control and Prevention, which reversed course on masking rules Tuesday and advised fully vaccinated people to mask up in public indoor settings in areas where transmission is high or substantial.

Meanwhile, the San Jose Unified School District, with more than 30,000 students, said it will require teachers and staff to get inoculated against the coronavirus or get tested twice a week for the coronavirus. Google and Facebook announced a vaccine mandate for returning workers, with exceptions for medical or other reasons. Gov. Gavin Newsom on Monday said more than 2.4 million state and health care workers must provide proof of vaccination or be tested.

The changes come amid spiking coronavirus infections and hospitalizations as the highly contagious delta variant sweeps the country with widely varying vaccination rates. The vaccine protects most people from becoming seriously ill or dying. But unlike with previous variants, new data shows that vaccinated people infected with the delta variant “have the potential to spread that virus to others,” said CDC Director Dr. Rochelle Walensky.

Virginia McCuistion, who had her mask in her bag while visiting a San Diego beach on Wednesday, said she agrees with the masking recommendation, but is frustrated the country is once again wrangling over masks because people refuse to get vaccinated.

“I think it’s selfish,” she said of people refusing shots. “Too many people are not getting vaccinated so that puts us at risk. I’ve been vaccinated and I’m still worried.”

Although case numbers in California remain well below the winter peak, infections and hospitalizations are rising and health officials fear that not enough people are vaccinated. In California, more than 62% of residents 12 and older are fully vaccinated.

California and some of its counties have been stricter than most in the U.S. in battling the pandemic, imposing earlier and longer economic shutdowns. Despite the caution, officials said more than 90% of the state’s nearly 40 million residents live in areas where community spread is now high or substantial. California’s seven-day positivity rate has jumped to 5.9% from 1.4% a month ago.

“The delta variant has caused a sharp increase in hospitalizations and case rates across the state. We are recommending masking in indoor public places to slow the spread while we continue efforts to get more Californians vaccinated,” said Dr. Tomás J. Aragón, the state’s public health officer.

Yolo and Los Angeles are the only counties to mandate masks for everyone, while most San Francisco Bay Area counties have been encouraging people to cover up indoors.

In announcing the vaccinate-or-test policy this week, Newsom said he wanted to encourage other employers to do the same. The state policy applies to nearly 250,000 state workers and an estimated 2.2 million people who work in private or public health care and long-term care facilities.

San Francisco is now requiring new hires get vaccinated or get an exemption before they start work, while an estimated 35,000 employees already on the job must show proof of inoculation, seek an exemption or risk disciplinary action once the vaccines are given full approval by the Food and Drug Administration.

California State University, the largest four-year university system in the U.S., said on Tuesday it would no longer wait for full FDA approval and instead will require faculty, staff and students to be immunized against COVID-19 if they plan to be on campus this fall.

In San Jose schools, officials are going a step beyond state guidelines and said everyone will be required to mask up indoors and outdoors.

The federal recommendation is a shift from May, when the CDC announced that fully vaccinated people could skip masking in most indoor spaces.