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The CDC’s flip-flop recommendation this week that people vaccinated in high-risk areas should resume wearing masks in indoor public spaces was boosted by new data which showed that even vaccinated people infected with the disease. Delta variant can spread it, the agency said on Friday. The data analyzed a large outbreak of COVID-19 cases among vaccinated bathers in Cape Cod, Massachusetts, during the July 4 vacation.
The outbreak has led to massive cases of COVID-19 among those vaccinated, demonstrating that vaccines still do their primary job of preventing serious illness and death, even against the highly contagious Delta variant.
So far, vaccines have also largely prevented fully vaccinated people from passing the virus on to others. But new findings released by the CDC have revealed that vaccinated people who are infected with the Delta strain of the coronavirus – so-called breakthrough infections – can carry high levels of the virus that could make them as contagious as people who have not been vaccinated.
It is still not clear exactly how often breakthrough infections occur, but they are believed to be relatively rare. Still, the new findings suggest that even people vaccinated in areas with high levels of infection should take more precautions.
“This finding is concerning and was a crucial finding leading to the CDC’s updated mask recommendation,” CDC director Rochelle Walensky said in a statement on Friday. “The masking recommendation has been updated to ensure that the vaccinated public will not unknowingly transmit the virus to others, including their unvaccinated or immunocompromised loved ones.”
Outside experts contacted by BuzzFeed News broadly supported the CDC’s decision based on the new data, arguing that the results only add more urgency to speeding up the country’s lagging vaccination campaign.
“The long-term outlook is that it will be very difficult to avoid getting infected with Delta or even future more transmissible variants if you are not vaccinated,” the University of Arizona immunologist said. Deepta Bhattacharya, by email. “At some point you are very likely to get infected if you are not vaccinated. “
On Tuesday, the CDC recommended that in places with moderate to high transmission, all people – vaccinated and unvaccinated – should wear masks in indoor public places. It was a partial reversal of its guidance from May, when the agency said those vaccinated no longer needed to wear masks in most settings. In explaining the decision, Walensky cited new findings on breakthrough infections, but did not share any new data to support the decision, causing confusion and frustration.
The data, released Friday, came from a series of events and large gatherings around July 4 – held both indoors and out – in a town that reports identified as Provincetown, in Barnstable County, Massachusetts. Outsiders and residents alike said they attended densely populated parties at bars, restaurants, guest houses and rental homes. As of July 26, approximately 450 Massachusetts residents have tested positive. Disturbingly, three of the four Massachusetts residents in the group were fully vaccinated, most of them infected with the Delta variant.
An analysis of the outbreak conducted by the Massachusetts Department of Health and the CDC showed that the amount of virus in fully vaccinated patients was similar to those who were not vaccinated, not fully vaccinated, or had no known vaccination status. This suggested that people vaccinated with COVID-19 were also able to infect others.
George Rutherford, epidemiologist at UC San Francisco, said the data appeared to be a “tipping point” forcing the CDC to change its masking advice.
Delta is now the dominant strain of the virus circulating in the United States. According to a recent study, the amount of virus present in the body of a person infected with the Delta variant is a thousand times greater than with the original strain of the coronavirus. The variant is as contagious as chickenpox and can cause more severe disease than previous strains of the virus, according to internal CDC documents first reported by The Washington Post. The document urged health officials to recognize that “the war has changed.”
It is not surprising that the virus has evolved to become more transmissible, given that it has been able to spread rapidly around the world in areas with low vaccination rates, experts said. “We expected that the continued circulation of SARS-CoV-2 would lead to additional mutations,” said Yvonne Maldonado, professor of infectious diseases and global health at Stanford University by email. “In this case, it appears that the mutations in the Delta variant allow it to replicate almost unchecked, even among vaccinated individuals.”
But some scientists are skeptical that the CDC’s new findings can be interpreted very broadly. Bhattacharya, the University of Arizona immunologist, called it “immunologically unlikely” that breakthrough cases are as contagious as infections in unvaccinated people. “It’s hard to imagine a scenario where vaccines would work as well as they do without reducing viral loads and / or the duration of infectivity,” he said via email.
“Equating viral loads with infectivity is very complicated, especially when comparing vaccinated and unvaccinated people,” Bhattacharya added. “It has a very high probability of being false and it is the kind of unnecessary statement that has come back to haunt public health boards time and time again throughout the pandemic,” he said, citing data. Israel’s preliminary findings that vaccinees are less likely to infect. others in general.
The CDC also questioned its findings, noting that measurements of how much virus people had come from only their genetic tests for the virus, and not precise counts of viral particles in the lab.
Still, Bhattacharya added, “I think it’s reasonable to warn people that vaccinated people are at a greater risk of breakthrough infections and transmission to others with delta than with previous variants.”
In Cape Cod, the reported symptoms that manifested among the breakthrough cases were mild: cough, headache, sore throat, muscle pain, fever. This is a very promising sign that vaccines are still doing their job in reducing severe cases and deaths. Pfizer and Moderna injections shown to be 96% effective against hospitalizations and deaths with the Delta variant.
The real risk continues to be for unvaccinated people, experts said. Unvaccinated people are more likely to be infected with the Delta variant, and more than 97% of patients hospitalized with COVID-19 in the United States are unvaccinated.
“Unvaccinated people are now entering a period where they are at a very high risk of becoming infected if they live and work in areas where the variant is circulating,” Rutherford said.
The findings also raise questions about whether or not the booster injections will be helpful in combating Delta and other future variants. “This information alone does not make a booster more necessary at this time, unless it is shown that those vaccinated are losing their immunity,” said Maldonado. “So far it’s not clear, but it could probably be demonstrated in the weeks or months to come.”
Minority House Leader, Representative Kevin McCarthy of California and other Republican lawmakers skeptical of the mask’s new direction on Thursday expressed doubts about the evidence for the change, saying it was motivated by a study in India among people vaccinated with less effective vaccines. McCarthy’s office did not respond to a BuzzFeed News query about recently released CDC data.
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