Catching COVID-19 After Vaccination: What To Know

Breakthrough COVID-19 cases are extremely rare but can occur. Here's what we know so far. (Photo: FotografiaBasica via Getty Images)
The coronavirus vaccines have rightly been hailed as a miracle of science and technology. Due to widespread vaccination, the average number of new COVID-19 cases in the US is the lowest since last fall. Hospital stays and deaths among elderly Americans have decreased. Anthony Fauci, the nation's leading infectious disease expert, admonishes us all, "Be really grateful that we have three really effective vaccines."
Despite all the good news about COVID-19 vaccines, it can still be difficult - and even scary - to grapple with the fact that it is still possible to get COVID-19 once you are fully vaccinated. It doesn't help that anti-vaccination campaigners looking for seeds and spreading doubts have encountered breakthrough cases.
Are you wondering why and how often so-called breakthrough cases occur? Here are some basics to keep in mind.
Breakthrough cases are really rare.
First, a simple (but important) reminder from the Centers for Disease Control and Prevention: “No vaccine prevents 100% disease.” For every vaccine there are breakthrough cases. Moderna, Pfizer, and Johnson & Johnson's COVID-19 vaccines are no exception, and experts have known this from the start.
In clinical trials prior to widespread vaccination, the Pfizer vaccine was 95% effective against symptomatic disease, the Moderna vaccine 94.5% effective against symptomatic disease, and the Johnson & Johnson vaccine 66% effective against symptomatic disease (as well as 85% effective) in preventing serious diseases).
The CDC has since followed breakthrough cases in real time as millions of Americans rolled up their sleeves and health officials got a better sense of how high the risk of infection actually is after vaccination. By late April, the CDC announced that among more than 95 million people in the United States who were fully vaccinated, the agency knew of around 9,000 breakthrough infections.
"It's nothing unexpected, and the numbers we're seeing now are really tiny," Taylor Nelson, infectious disease specialist at MU Health Care, told HuffPost. "It's a small fraction - of a percentage - of the people who have breakthrough infections."
Experts are still unsure how many breakthrough infections are related to the worrying varieties that groups like the CDC are tracking, although the earliest evidence of how the vaccines hold up in real-world conditions looks promising.
“When we have a case that we believe to be a breakthrough infection, we try to send the sample off for sequencing to see: is there a pattern? Is it this or that variant that is more likely to give someone a breakthrough? Nelson said, "But I don't know we still have those answers."
It is quite likely that breakthrough cases will be less severe.
The CDC is cautious about beating this point, saying, "There is evidence that vaccination may make the disease less severe."
For example, about 27% of the breakthrough cases the CDC is aware of were asymptomatic infections. This doesn't mean that really serious results are impossible. There were 835 hospital admissions among those fully vaccinated against COVID-19 (although 30% of them were classified as asymptomatic or unrelated to COVID-19), and there were also 132 deaths - although again not all were necessarily directly related COVID-19 related.
"The vaccine still triggers some immune response to help your body fight infections, which translates into a milder infection," said Nelson. "There is probably also a lower probability of sending."
There are no clear patterns of who is at risk.
The current CDC data on breakthrough cases suggests that around 60% of reported breakthrough infections have occurred in women, although it is too early to say anything about why this might be the case. This could be because women are getting more medical care, or because women’s immune systems are responding differently to the vaccine than men’s.
And about 40% of breakthrough cases occurred in people aged 60 and over, although again this could simply be because older Americans were vaccinated in greater numbers. All of this means that there are currently no really clear patterns of who appears to be at higher risk for a breakthrough infection.
"I don't know if there's a pattern that we can really identify yet," said Nelson. "I would say that we are obviously thinking about these new variations that are out there."
It's also worth noting that it is still not entirely clear how long immunity will last after vaccination, although research suggests it is at least six months. As a result, there could be some confusion in the future about what real breakthrough cases are and which ones if people's immunity may weaken.
"Unfortunately, only time can tell us how long these vaccines will be as effective as they are," Nelson said. "I think the general thought is that probably at least a year." But we won't have a clear picture of it until next fall or winter, she added.
It is important to be aware of - and to follow - changing recommendations for life after vaccination.
The CDC has changed its guidelines on what people can do when they are fully vaccinated. It's okay to hang out with a small group of friends while you're exposed, for example, or go for a walk or bike ride. If you are fully vaccinated it is generally safe to travel within the US as well. Our current COVID-19 vaccines really offer solid protection, and health professionals want anyone who is genuinely starved for normalcy, connection, and physical affection to enjoy vaccination over the freedom offers.
Remember, the fact that there have been (and will continue to be) breakthrough cases "is by no means a vaccination failure," Nelson said.
However, there are still times when the CDC urges fully vaccinated Americans to take preventive measures like wearing masks, maintaining social distance, and washing hands - especially if you are in a crowded or poorly ventilated room.
“When you are around people who are not fully vaccinated, or when you are around someone who cannot be vaccinated ... or when you are in a crowd or in an area with poor ventilation it's probably important to keep these other mitigation measures going, ”Nelson said.
Experts are still learning about COVID-19. The information in this story is known or available at the time of publication. However, guidelines may change as scientists learn more about the virus. Consult the Centers for Disease Control and Prevention for the most up-to-date recommendations.
When should you get a COVID-19 test after vaccination?
What the new CDC guidelines for outdoor face masks mean for you
Why it feels so uncomfortable to resume your life after the vaccine
CDC says some vaccine reactions were caused by anxiety
This article originally appeared on HuffPost and has been updated.

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