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Background Mask wearing mitigates the spread of COVID-19; however, many individuals have not adopted the protective behavior. Purpose We examine mask wearing behavior during the height of the pandemic in Los Angeles County, and its association with COVID-19 testing and willingness to get vaccinated. Methods We conducted a cross-sectional survey using representative sampling between December 2020 and January 2021, through an online platform targeting Los Angeles County residents. Survey items include demographic characteristics, health conditions, access to health care, mask wearing, COVID-19 testing, exposure risk factors, and willingness to receive COVID-19 vaccine. We performed logistic regression models to examine factors associated with always mask wearing. Results Of the analytic sample (n = 1,984), 75.3% reported always wearing a face mask when leaving home. Being a female, Asian or African American, or non-Republican resident, or having higher education, having poor or fair health, having a regular doctor, knowing someone hospitalized for COVID-19, and being willing to receive the COVID-19 vaccine were associated with always wearing a mask. Residents who were younger, had a highest risk health condition, and had ≥2 COVID-19 tests had lower odds of always mask wearing. Conclusion Mask wearing guidelines are easing; however, as vaccination rates plateau and new virus variants emerge, mask wearing remains an important tool to protect vulnerable populations. Encouraging protective measures among younger adults, those with less education, republicans, men, and White residents—groups that are least likely to be vaccinated or wear a mask—may be critical to reducing transmission.

Relationship between mask wearing, testing, and vaccine willingness among Los Angeles County adults during the peak of the COVID-19 pandemic