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For Moira Smith and her mother, July promised a glimmer of normalcy after months of isolation. The two flew from Alaska to Houston and visited their family, celebrating the first birthday of their cousin’s granddaughter. Ms Smith’s mother bought a patterned pink jumpsuit to give as a gift, and they all took photos of the baby’s face smeared with chocolate.
Ms Smith, 46, knew her cousin’s family weren’t vaccinated but tried not to dwell on it. She and her mother had both received their Pfizer injections months earlier. In the hotel room one evening, Ms Smith’s mother made a casual comment to her relatives: “You can take off your masks but you have to promise to get the vaccine,” she admonished them.
The next morning, Ms Smith and her mother were on their way home, on a layover at Seattle airport, when they received the phone call: Their parent’s baby had fallen with a fever and had tested positive for Covid-19.
Two days later, Ms Smith woke up feeling like she had been ‘hit by a Mack truck’, with body aches and a sore throat, and tested positive for the coronavirus. The following week, her mother, who is 76 and has lung cancer, sent her a thermometer emoji indicating that she too had a fever, and then she ended up in the emergency room with Covid.
Ms Smith and her mother are part of a wave of Americans who are falling ill with Covid even though they are fully immune, in what are known as breakthrough infections.
Public health experts continue to believe that breakthrough infections are relatively rare and rarely lead to serious illness or hospitalizations. The vaccines available in the United States offer powerful protection against serious Covid illness, hospitalization, and death. A recent analysis of state-reported data from the Kaiser Family Foundation found that more than nine in 10 Covid-19 cases leading to hospitalization and death occurred among people who were not fully vaccinated.
“We always predicted that there would be breakthrough infections because vaccines at their best were 95% effective,” said Dr William Schaffner, professor of infectious diseases at Vanderbilt. “Vaccines were designed to prevent serious disease, and they’re doing it dramatically. “
But as the more transmissible Delta variant becomes dominant in the United States, an increasing number of groundbreaking cases are being reported, although most are mild.
“The delta is much more contagious, so as it spreads among the unvaccinated, there is an overflow into the vaccinated population,” Dr. Schaffner said. “The unvaccinated are a great highway of transmission. The vaccinated are a small side street.
Because people infected with the Delta variant have many more viruses in their nose and upper respiratory tract, the importance of wearing a mask has become paramount. After the Centers for Disease Control and Prevention changed its masking guidelines, recommending that people vaccinated in sensitive areas resume wearing masks in indoor public spaces, millions of fully immune Americans have struggled to adjust their expectations for the autumn months which had seemed to offer a semblance of celebration. And a small subset of Americans have already seen their routines disrupted by revolutionary infections.
Spurred on by concerns about breakthrough infections, federal health officials recently recommended that Americans who have received Pfizer or Moderna vaccines receive a third dose in the coming months. This week, Johnson & Johnson reported that a booster of their vaccine had increased levels of antibodies to the coronavirus.
For some, the pierced infections have felt like mild allergies, accompanied by symptoms such as coughing, sniffling, and a sore throat. Others have had more severe cases, where they are bedridden with body aches, fever and chills. And still others have had some of the telltale signs of Covid such as loss of taste and smell, “Covid rash” and brain fog.
“We called it floating head syndrome,” said Molly O’Brien-Foelsch, 47, a marketing manager in Pennsylvania who tested positive for Covid after a trip to the British Virgin Islands with her husband last month. . “I felt like there was a huge marshmallow on my head.”
Scientists believe peak infections rarely lead to serious illness, but there have been cases of prolonged hospitalizations. Isaac, the father of Elaina Cary-Fehr, a 64-year-old Uber driver in Austin, was transferred to a long-term care facility after being hospitalized with Covid pneumonia in June and later receiving a tube of tracheotomy. He was released from the facility this week.
“I believe in the vaccine, I kept hoping it would work and it worked,” Ms. Cary-Fehr said. “But I hate that this has to happen to my family.”
Dr Rebecca Hughes, 32, works as an emergency medicine resident in Boston, so she spent the past year with latent feelings of anxiety about exposure to Covid. She still remembers the fear she felt the first time she treated a patient coded Covid and wondered for hours if her mask could have slipped off and put her in danger. But all year round she was protected by her protective gear.
Then, last month, her family took a vacation to visit her grandparents in Utah. It was a trip they hoped to take last February but postponed as the rate of Covid cases increased. Four days after they landed, Dr Hughes felt his throat scratch. She was sure it was allergies but took a Covid test just in case; he came back positive. Soon after, her 9 week old newborn baby started sneezing and also tested positive, along with Dr Hughes’ three other children, aged 8, 6 and 3.
“It was ironic after spending so long caring for Covid-positive patients every shift since the start of the pandemic,” Dr Hughes said. “My 8 year old knows that I have seen people die from this. She looked at me and said, ‘Are you going to be okay?’ “
While some breakthrough infections like Dr. Hughes’ are difficult to attribute to a specific exposure event, other Americans have found that their vacation plans overlap with well-known outbreaks.
Understanding the mandates of vaccines and masks in the United States
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- Vaccination rules. On August 23, the Food and Drug Administration fully approved Pfizer-BioNTech’s coronavirus vaccine for people 16 years of age and older, paving the way for increased tenure in the public and private sectors. Private companies increasingly require vaccines for their employees. Such warrants are authorized by law and have been confirmed in court challenges.
- Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of their immunization status, wear masks in indoor public places in areas affected by epidemics, a reversal of guidelines it offered in May. . See where the CDC guidelines would apply and where states have instituted their own mask policies. The battle for masks has become controversial in some states, with some local leaders defying state bans.
- College and universities. More than 400 colleges and universities require students to be vaccinated against Covid-19. Almost all of them are in states that voted for President Biden.
- Schools. California and New York City have both introduced vaccination mandates for education staff. A survey released in August found that many American parents of school-aged children are opposed to mandatory vaccines for students, but were more in favor of mask mandates for students, teachers and staff who don’t. don’t have their vaccines.
- Hospitals and medical centers. Many hospitals and large healthcare systems are requiring their employees to be vaccinated against Covid-19, citing an increase in the number of cases fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their hand -work.
- New York City. Proof of vaccination is required from workers and customers for indoor meals, gyms, shows and other indoor situations, although enforcement does not begin until September 13. Teachers and other education workers in the city’s vast school system will need to have at least one vaccine dose by September 27, with no possibility of weekly testing. Employees of the city’s hospitals must also get vaccinated or undergo weekly tests. Similar rules are in place for New York State employees.
- At the federal level. The Pentagon has said it will seek to make coronavirus vaccination mandatory for the nation’s 1.3 million active-duty soldiers “no later than” mid-September. President Biden announced that all federal civilian employees should be vaccinated against the coronavirus or undergo regular testing, social distancing, mask requirements and restrictions on most travel.
Jimmy Yoder, 25, felt no worries as he and his boyfriend, both vaccinated, packed their bags for a weekend in Provincetown in July. And because their days and nights were a blur of clubs and dances, he assumed the Monday morning fatigue that greeted him in Brooklyn was just a bad hangover.
“I felt a bit exhausted but attributed it to a party weekend,” Mr. Yoder said. “Deep in my head I was like, ‘There’s no way I’m getting Covid, I’m immune. “”
On Wednesday morning, Mr. Yoder didn’t feel so confident anymore. “I felt like I had a really bad flu,” he said, with a high fever and congested sinuses. He and his boyfriend both tested positive that day. Mr. Yoder slept for the next 18 hours, and when he and his boyfriend started to feel better, they ordered a party pizza. They then realized that they had both lost their sense of taste and smell.
Mr Yoder was relieved to find that of all the people he had exposed – friends who brought him back from Provincetown, an office full of colleagues – only one tested positive. “Obviously this shows that vaccines still work great,” he added.
As many Americans begin the familiar exercise of questioning and undoing plans, scientists stress the continued importance of mask wear in reducing transmission and infection.
“If you are infected and you breathe out the virus, it will be trapped by your mask,” said Dr. John Moore, professor of microbiology and immunology at Weill Cornell. “These viruses don’t have scissors that can cut through masks.”
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