Updated: 22 Jul 21 08:19 ET
By Katia Hayter, CNN
(CNN) – Coronavirus infections are on the rise again in the United States. While more than 99% of deaths occur in those uninfected, anecdotal reports have been cases of breakthrough infections, or fully vaccinated people who still test positive for COVID-19 – including many New York Yankees Baseball Players.
How concerned should vaccinated people be about getting infected with COVID-19? If you have been vaccinated, are you still able to transmit coronavirus to others, such as young children who are too young to receive the vaccine themselves? Does the more permeable delta variant change the equation, and what precautions should people who are vaccinated still take?
To give us some guidance during these uncertain times, we turned to CNN medical analyst Dr. Lena Wayne. Wayne is an emergency physician and visiting professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also the author of a new book next week.”Lifelines: A Doctor’s Journey in the Fight for Public Health“
CNN: Can vaccinated people become infected with COVID-19?
Dr. Lena Wayne: Yes he can. Here’s what the Covid-19 vaccines do. First, and most importantly, they protect you from serious illness very well. That’s the key. It is a disease that has killed more than 600,000 Americans and millions of people worldwide. If you get vaccinated, you know that you are unlikely to become seriously ill to the extent that you will need to be hospitalized or contract the disease. According to federal health officials, 99.5% of Kovid-19 deaths are now among illiterate people. This is a true testament to the power of vaccines.
Vaccines also protect against getting sick with COVID-19, but this protection is not 100%. With the delta version, Vaccines may be even less effective against mild disease Although still effective against severe disease.
This means that breakthrough infections – or infections in fully vaccinated people – can and do happen.
CNN: Does it matter if you’re in a community with a lot of infections? Are you more likely to have a successful transition?
Wayne: Yes, and that’s why it matters what’s going on around you, even if you’ve been fully vaccinated. The risk is additive. The vaccine protects you well, but if you are constantly in contact with people who have the coronavirus, you could get a successful infection at some point.
I’ve used the analogy before with raincoats. Vaccine is an excellent raincoat. If you’re in a drizzle occasionally, you’ll probably be fine. But if you’re going from thunder to thunder, you can get wet at some point.
This is why we don’t have to see vaccination as just a personal choice. Even if you have vaccinated yourself, it matters that other people around you are also vaccinated.
CNN: Do we know how common breakthrough infections occur or are people who have been vaccinated but become infected are able to transmit them to others?
Wayne: These are really important questions, and unfortunately, we don’t know the answers. in May, U.S. Centers for Disease Control and Prevention Decided to stop tracking mild breakthrough infections. They are reporting only cases of severe infection, which can result in hospitalization and death. Many of us in public health have argued that we need to know the statistics for even mild breakthrough infections. It is important to know how often and between whom these are happening. For example, are they more common in older individuals and those with compromised immune systems, suggesting that these individuals may need a booster shot sooner? Do they increase in frequency after a certain point after vaccination, and are they more common with one vaccine versus another? Do people with successful infection develop long-distance covid?
Another important question is whether people with successful infection are able to transmit COVID-19 and infect others. Earlier studies found that vaccination also significantly reduces the amount of virus exposed to COVID-19. That even if they test positive or develop mild symptoms, they are unlikely to infect others. However, these studies were done before the delta variant became the dominant form of the virus in the US – the CDC reports. 83% of cases in the US are now due to Delta.
Other research has found that people who are infected with the delta variant carry 1,000 times more virus than people with the original version. This raises the question of what happens if someone is vaccinated but is infected with the delta variant. We just don’t know, at this point, how likely it is for a person vaccinated with a successful infection caused by the delta variant to be contagious to others.
CNN: Has the unknowns around Delta Edition changed your recommendations for vaccinated people interacting with others?
Wayne: I’ll be very careful until we have more data. A vaccinated person is probably quite safe around other fully vaccinated people and will not need precautions like masking and distancing. On the other hand, a vaccinated person who is constantly in contact with unvaccinated people, in a crowded, indoor setting where no one is wearing a mask, can become infected themselves. And even if they don’t have symptoms, there is certainly a possibility that they can carry the virus and infect others.
Until we know more about whether vaccinated people with the delta variant can transmit it to others, I would urge people to be vigilant if they live at home with unvaccinated or immunocompromised family members. Stay. They should consider wearing masks in indoor locations such as grocery stores and try to avoid high-risk settings such as crowded bars, where others around them are unmasked and vaccination status is unknown.
CNN: To be clear, would you still recommend vaccines?
Wayne: Absolutely. Most importantly, Covid-19 vaccines prevent hospitalization and death. They have proven to be remarkably effective at this, even with the delta version. Breakthrough infection is to be expected, and the more infections that occur in uninfected people, the more infections will be among those who are vaccinated.
The key to stopping the pandemic is for us to reach such high levels of immunity that the virus doesn’t have anywhere else to go. We can get there – but we all have to do our part and get vaccinated. Vaccination protects the individual, and it also protects others around us.
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