VACCINATION BREAKTHROUGH INFECTIONS
COVID-19

COVID-19 vaccination breakthrough infections can be defined as  COVID-19 virus infections that appear in COVID-19 vaccinated persons more than 14 days after getting a final dose. Unfortunately, there is a great deal of misinformation out there being presented to an already terrified public, especially on social media.

The truth is that in recent weeks (as of September 2021) every state has seen rising cases, hospitalizations, and deaths from COVID. This rise is driven largely by the delta variant, a far more contagious strain of the virus than the preceding ones. Reports of a number of fully vaccinated persons becoming ill with COVID-19 have become a cause for concern.

DO VACCINATION BREAKTHROUGH INFECTIONS MEAN VACCINES DON'T WORK?

If a fully vaccinated person gets COVID, does this mean the vaccines don’t work or don't work as well as expected? The data that has been collected thus far gives evidence to the contrary. The actual breakthrough COVID cases have so far been much less severe, rarely causing hospitalization. As of this point in time no use of ventilators or other advanced lifesaving measures have been necessary for those few who have been hospitalized.

Unfortunately, the COVID-19 vaccines are less effective at preventing infection than they are at preventing disease. Vaccinated persons exhibiting the virus who come into their doctor’s office or a hospital and are tested prior to procedures tend to be either asymptomatic or have some mild symptoms. Over 96% of people with COVID that need hospitalization are the unvaccinated.

Yes, it is possible a fully vaccinated person can still get breakthrough infections of COVID. After all, the vaccines are not 100% effective. But as per the current data available, that person will be much better off than an unvaccinated person who contracts COVID.

It is so important to understand that when large numbers of people do not get vaccinated, the virus continues to evolve because it must infect humans to live. There is a distinct possibility that a very resistant strain may one day come our way that the vaccines might not work against at all.

There was a global effort to come up with the COVID-19 vaccines we have now and there has to be a continuing world-wide effort to control the virus by combining the production and equitable distribution of vaccinations with constant shared research to learn more about how the virus evolves.

Good examples of the results of such efforts against COVID-19 are the mRNA vaccines developed by Pfizer and Moderna. These are types of vaccines that work well with the current variants but they could possibly be ‘recoded’ to produce antigens from emerging variants of the SARS-CoV-2 (COVID-19) coronavirus in order to generate antibodies against those new antigens.

THE DELTA VARIANT

The delta variant of the COVID-19 virus went through a mutation or a number of mutations that have made it extremely effective in attaching its spike protein to human cells and gaining entry. This makes it very dangerous.

It has been shown that the viral loads in the back of the throats of infected patients are 1,000 times higher with the delta than with previous variants. It is almost akin to a completely different pandemic event. In previous strains, the number of people an infected person would be expected to transmit the virus to was 2 to 2.5. Delta can infect about eight! That is as efficient as chickenpox and measles at spreading.

Another recent data study showed that the viral loads in the throats of vaccinated persons with breakthrough infections from the delta variant rises at the same rates as in unvaccinated persons. But, the important point is that after about 5 days, these viral rates drop in the vaccinated people but persist in the unvaccinated. During that short period, vaccinated persons may have symptoms or may be completely asymptomatic and can spread the virus to others.

The very scary data is that young people are being hit very hard by the delta variant. Children’s hospitals are filling up and this variant is capable of causing severe disease. We do not have vaccines for the 5 to 11 year-olds yet and the school year is beginning. This is an very alarming situation.

ARE THE VACCINES WE HAVE NOW WORKING?

Absolutely, the vaccines we have are doing what they are supposed to do. When a person gets a vaccine shot, a specific antibody response occurs. This antibody is one that circulates in high numbers in the blood. The virus can still attach itself but when it is detected this antibody clears it before the person gets ill.

There is second antibody type that the vaccine shot does not produce and that particular type could prevent the virus from binding in the first place on the surface of the throat mucosa. But the first antibody is more effective at eliminating the virus than this one. The COVID-19 vaccines are designed to prevent disease and death through that first antibody response. THE CDC has recently released data stating that the vaccines are doing remarkably well with a very small side effect profile.

Getting vaccinated for COVID-19 has been shown to be far safer than acquiring immunity by becoming ill. Vaccines, in general, are not only safer but produce a more vigorous antibody response.

One of the reasons for vaccine hesitancy today - the vaccines have only been approved for emergency use - may change with the announcement of the full approval for ages 18 and up by the FDA for the Pfizer vaccine on 8/23/21.  Hopefully, the Moderna and J&J vaccines will follow suit.

WILL VACCINATED PERSONS NEED BOOSTER SHOTS?

There will probably be large groups of people who may require boosters. Right now, we do not have enough scientific data to know how long the effects of the COVID-19 vaccines last. The elderly and immunosuppressed patients, including people with transplants, rheumatoid arthritis, lupus, and cancer appear to be at an increased risk for COVID-19 vaccination breakthrough infections.

At this time, it is believed that at least those populations will be the first to receive boosters. The FDA is currently working on an approval for a booster for immunosuppressed persons. Several other countries, including Israel and the UK are also considering booster shots.

WHAT ABOUT MASK WEARING?

The CDC has recently updated masking guidelines and recommends fully vaccinated persons wear a mask in public when in areas with high transmission. Unfortunately, that can vary from state to state and town to town.

It is important to understand that we are in the middle of a COVID resurgence. It would seem to make sense that everyone, vaccinated or not, wear a mask inside in crowded public places, especially if they live with children who are too young to be vaccinated or with immunosuppressed or elderly members of the family living in the household.

As noted above, the virus fades from the back of the throat rather quickly in a vaccinated person. Therefore, since we now know that a vaccinated person can transmit this very infectious virus to others for at least a couple of days, the best we can do is wear a mask to protect others when vaccinated because we do not know when we might be infectious. Once again, we desperately need to interrupt the transmission cycle of the virus.

In the early days of the pandemic, researchers did not believe the COVID-19 virus would evolve into as many variants as it has. But now we know that it did evolve so as to better avoid human antibodies. It also has become a lot more infectious.

It seems likely that the COVID -19 virus will continue to evolve and possibly become even more infectious and deadly. Hopefully, it may take a long enough time for researchers to adapt vaccines to the changing threat.

In the meantime, please keep checking the latest information on the CDC website, wear a mask in public places whenever 6 feet of distance between people is not possible, and wash hands frequently.

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