“Nothing in this world is 100%”

Everyone wants vaccines to be perfect – and COVID-19 vaccines almost are. Only a tiny fraction of those who are vaccinated become seriously ill from infection.

But still, some people who are fully vaccinated will get sick, some will pass the virus on, and very few will die despite their vaccines.

“The effectiveness of vaccines in preventing hospitalizations and deaths is incredible,” said Carlos del Rio, epidemiologist and distinguished professor of medicine at Emory University School of Medicine in Atlanta. “It’s not 100%. But nothing in this world is 100%.”

At a time when the infection rate has doubled, many go unvaccinated and the delta variant is much more contagious than the original, it’s important to recognize that vaccines aren’t perfect, said he and others. .

“I understand this is a tough pill for a lot of people to swallow,” said Anthony Santella, a public health expert at the University of New Haven in Connecticut.

Several recent high-profile cases have drawn public attention to the fact that people who are vaccinated can still catch the virus.

Last Thursday’s Yankees-Red Sox game was postponed because six Yankees – most, but not all, have been vaccinated – have tested positive for the virus. At a homeless shelter in northern California, a number of vaccinated residents have tested positive during an ongoing outbreak. And six vaccinated members of the Texas Legislature, who fled the state to prevent a vote on changes to state election laws, have tested positive for the coronavirus in recent days.

The fourth wave of COVID-19 cases has arrived. Are we going to escape the fate of the UK? It is too early to know.

The common thread running through all of these infections was that they were caught through routine testing, not because people were getting seriously ill, noted Ali Ellebedy, an immunologist at the Washington University School of Medicine in St. Louis.

According to the Centers for Disease Control and Prevention, of the more than 159 million Americans fully vaccinated as of July 12, 5,492 have been hospitalized and 791 have died from symptomatic COVID-19.

The story continues

In May, the CDC stopped tracking all so-called “breakthrough” infections, focusing only on state and local health department reports on hospitalizations and deaths, so there’s no way of knowing how many infections there have been or are increasing due to the delta variant.

Dr Leana Wen, an emergency physician and former Baltimore health commissioner, called the decision “inexplicable”.

Without this data, she said, it is impossible to know how many people are infected after vaccination, whether some people, perhaps older people, are more vulnerable to breakthrough infections, and how much it is. easy for people who are vaccinated and then infected to pass the infection on to others.

“We just don’t know the answers to these questions, which really makes it difficult for clinicians to give our patients good advice,” she said.

Groundbreaking COVID-19 cases are likely on the rise because more viruses are circulating, not because vaccines don’t work against the delta variant, which now accounts for more than half of infections in the United States, experts say.

The vaccines remain effective against severe delta variant disease, said Ellebedy, who studies the body’s response to vaccination.

But the variant is much more contagious than the original virus, so the unvaccinated are particularly vulnerable.

“If you are vaccinated, you shouldn’t worry about the delta variant,” del Rio said. “If you are not vaccinated you are really in trouble because it is likely that you will be infected.”

Protection range

Even healthy people respond to vaccination differently, so it’s normal to see variation in protection among those vaccinated, Ellebedy said.

For 95 out of 100 people, the vaccines from Pfizer-BioNTech and Moderna will provide effective protection.

The problem is that it is essentially impossible to determine in advance who is the most vulnerable. Certain factors like age, obesity, and lung disease increase the risk of serious illness if a person is infected. The same goes for the virus load they inhale and the medications they take, he said.

Some people will test positive for the virus despite being vaccinated, but the immune protection they have received will prevent virtually all of these people from becoming seriously ill.

Vaccination also makes people less likely to shed large amounts of the virus, Ellebedy said, which means they are less likely than an unvaccinated infected person to make someone else sick. Anything that decreases the amount of virus replicating in the airways will decrease the likelihood of transmitting that virus, he said. “Transmission will decrease like everything else.”

And although the data remains thin, vaccination also likely protects against long-term COVID-19, in which people show symptoms weeks or months after clearing their initial infection, said David Holtgrave, Dean of the University of Albany School of Public Health. , State University of New York.

“Long-term symptoms in people who have been fully vaccinated may be theoretically possible but are probably rare given the overall effectiveness of the vaccines (after being fully vaccinated); However, we could use more data to find out for sure, ”he said via email. “That’s why we need this more robust national surveillance system. “

A previous coronavirus infection offers some protection against the delta variant, but a person who contracted COVID-19 months ago may not have enough immune response, del Rio said.

“My advice, if you’ve been infected, is to trust your natural immunity for about three months. But after three months you should get the vaccine,” he said.

People who are infected and then vaccinated are probably well protected. Ellebedy said.

Context matters too, Ellebedy and others said. Someone who is vaccinated and lives in a community with a high vaccination rate and a low infection rate can probably get by without a mask.

Ellebedy lives in Missouri, where infections have recently doubled and where only 40% of the population is vaccinated. It is therefore hidden in public and interior places.

After: Why are fully vaccinated people positive for COVID? Do I have to start wearing a mask again?

While the CDC has said that wearing a mask is not mandatory except in medical and transportation settings, many experts have told USA TODAY that it is a good idea to wear a mask indoors with people who may not have been vaccinated.

Wearing a mask in addition to being vaccinated is the safest way to avoid becoming infected or spreading the virus to someone whose weakened immune system has prevented them from obtaining full protection against the virus. vaccine.

“Everyone should take a close look at the environment they find themselves in,” Ellebedy said. “Delta unfortunately brought those doubts back again.”

In the United States, infections have more than doubled since the week of June 22. The total number of cases has increased in all 50 states since last week, and deaths are also starting to rise, although infection rates remain 90% below where they peaked in January.

This puts vaccinated people at risk because there are simply more viruses, said Dr George Rutherford, an infectious disease specialist at the University of California, San Francisco.

“The more people there are around contagious, the more likely you, as a person who has been vaccinated, will come into contact with it,” he said.

The unvaccinated get sick

At Staten Island University Hospital in New York City, there are 15 COVID-19 patients, 13 of whom are unvaccinated, said Dr. Theodore Strange, president of medicine at the hospital.

One of the vaccinated patients, a 93-year-old man with many other health problems, received his injections earlier this year but may have had a poorer response due to his age and condition. health, Strange said. The remaining vaccinated patient was hospitalized for something else and was unaware he had COVID-19 until a coronavirus test came back positive.

Strange said his COVID-19 patients were about 10 years younger than a year ago, with an average age of 55 to 60. Some are even younger, he said, listing the ages: “29, 38, 42, 50.”

Vaccinations deserve credit, he said, because about 70% of Staten Island people over 65 are vaccinated, compared to 38% of people 40 and under.

He is disappointed that more people did not want to be vaccinated, despite the risk of infection and ‘being shot in the arms’, potentially bringing the virus home to older and more vulnerable relatives .

He recounted a conversation he had last week with a patient who did not want to be vaccinated. Strange had recently prescribed the man a drug with far more potential side effects than vaccines.

“The pill I gave him was clearly more toxic than any vaccine,” Strange said, but the man didn’t want to take something he saw as coming from the government.

Strange tried a one-on-one approach to persuade people to get the shots, including visiting a local bowling alley, churches, park benches, “whatever.”

But still, he said, the curve for coronavirus infections is very similar to that followed by the 1918 flu, a pandemic that lasted for three years.

“If we’re not going to take advantage of current technology and science,” he said, “then shame on us. “

Contribute: Mike Stucka

Contact Elizabeth Weise at [email protected] and Karen Weintraub at [email protected].

Patient health and safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial contributions.

This article originally appeared on USA TODAY: COVID After Vaccine: Serious Illness Rare With Breakthrough Cases