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More than half of the adult population in the United States has been vaccinated, which adds up to approximately 180 million people.

So far, the vaccines have seemingly mitigated COVID-19 symptoms and have offered protection against severe illness and death. But there are still fully vaxxed people who are testing positive and getting sick.

What’s been referred to as “breakthrough infections” are starting to become more common than the highly-contagious Delta variant.

According to data from the Centers for Disease Control and Prevention (CDC), there is one group of fully vaxxed people who are the most likely to get a breakthrough infection.

Vaccines Do Not Prevent COVID-19

Dr. Christelle Ilboudo, pediatric infectious disease expert and MU Health Care’s medical director of infection control and prevention, says people need to understand that “vaccines are not designed to prevent exposure or transmission of the SARS-coV2 [Covid-19] virus.”

She explains that COVID is a respiratory virus, a concept that’s similar to the flu and its yearly vaccination recommendations.

“Every year, because the influenza virus mutates, we tell people to get a flu shot because we know that it changes, and last year’s protection may not be as good against this year’s viruses,” Dr.Ilboudo explains. “Although SARS-CoV2 is not an influenza virus, it also mutates and the new strains—as we have seen with Delta—can become more virulent.”

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Dr. Ilboudo also noted that the viruses that cause COVID actually mutate more frequently than flu viruses. This reason being that they are an “RNA-based virus.” She says the scientific community is tracking a lot of different variants. And the ones that are becoming more dominant are the ones that “get better at evading our protection mechanisms.”

According to Dr. Ilboudo, this is one of the reasons that we are seeing breakthrough cases.

What Is A Breakthrough Case?

According to the CDC, a vaccine breakthrough case is defined as the detection of “SARS-CoV-2 RNA or antigen” in someone more than two weeks after they’ve completed all recommended doses of a COVID-19 vaccine that’s been authorized by the Food and Drug Administration (FDA).

Simply put, a breakthrough case occurs when someone who has been fully vaccinated tests positive for COVID-19 more than two weeks after getting the jab.

Because it takes time for the immune system to build protective antibodies against COVID, someone is not considered “fully vaccinated” until 14 days after finishing vaccine protocol.

Dr.Ilboudo says that it’s hard to get a good national estimate in the U.S. when it comes to determining how common breakthrough infections are. This is because tracking is varied among states, and they can only track breakthrough cases that get hospitalized.

The CDC says that as long as COVID is circulating, infections in fully vaccinated people “cannot be completely eliminated.”

Who Is Most Likely To Get A Breakthrough Infection?

The CDC has been working with all 50 states and the U.S. territories to get an idea of how common breakthrough cases are among the vaccinated. As of Sept. 20, they have reported nearly 20,000 breakthrough cases that have resulted in hospitalization or death.

However, that number doesn’t really give a full picture of the situation because it doesn’t count mild or asymptomatic cases. But what it does make clear is that there is one group of fully vaxxed group who is most likely to get a breakthrough infection—folks aged 65 or older. People with other underlying health conditions are also more at risk.

Image of old woman with mask on
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Of the nearly 20,000 breakthrough cases they’ve tracked, the CDC reports that 86% of those cases that ended in death were among adults 65 and older. In cases that ended in hospitalization, 69% were in that same demographic of 65 and older.

What To Do If You Get A Breakthrough Infection

If you don’t fall in the above age group, you’ve been vaccinated, and you get a breakthrough infection, the odds are you won’t have any symptoms at all. If you do, they will most likely be similar to seasonal allergies or the common cold.

The CDC says that if you are fully vaxxed but develop symptoms, you should get tested and stay home. If your test is positive, they advise isolating at home for 10 days. But of course, that advice could change at any time.

As Pamela Aaltonen, PhD, RN, professor emerita at Purdue University School of Nursing points out, people “sometimes forget that science is kind of like a journey.”

“It’s not that we come to a conclusion and it stays that way forever,” Aaltonen says. “Especially with the virus—it keeps producing variants.”

Are The Vaccines Really Working?

And while vaccines themselves don’t prevent a COVID-19 infection, getting vaccinated does offer some protection—especially if you are in that older age group. After all, per the CDC, the vast majority of COVID-related hospitalizations and deaths occur among the unvaccinated.

“One of the good things about vaccines and being vaccinated is that you can feel confident that you are very protected against getting severely ill, being hospitalized, or dying from COVID,” Dr. Angela Branche, co-director of the University of Rochester Medical Center Vaccine Treatment and Evaluation Unit, told Health.

So get vaccinated, watch out for symptoms, and stay safe.

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