Carol Bryant returned to Grand Island from Estes Park, Colorado, last Saturday after a vacation that included a family wedding, solo hiking and shopping.
Sometime Sunday or Monday, her voice began to deepen. By Tuesday, she was feeling worse, so she went to her doctor’s office, suspecting bronchitis or something like it.
On Wednesday, Bryant, 59, learned that she had COVID-19, despite receiving two shots of the Pfizer vaccine in March. Officials with the Grand Island-based Central District Health Department, where she went for a second swab, told her that she had the delta variant of the coronavirus.
“It was kind of a shock,” she said. “I wasn’t expecting this to happen.”
But reports of so-called breakthrough cases in vaccinated people have prompted questions about the protection provided by the vaccines. The issue drew added attention this week as infections were reported in a vaccinated White House aide, an aide to House Speaker Nancy Pelosi and at least a handful of Texas Democratic lawmakers.
Dr. Maureen Tierney, assistant dean for public health and clinical research at Creighton University School of Medicine, said breakthroughs are still uncommon but are probably increasing.
But the important takeaway, she said, is that such cases are unlikely to result in serious illness, hospitalization or death. In Nebraska, she said, 97% of hospitalizations for COVID-19 now involve unvaccinated people.
“We might be having more vaccine breakthroughs, but those vaccine breakthroughs are overwhelmingly … asymptomatic or mild,” Tierney said.
While it’s important to be transparent that breakthroughs occur, she said, she doesn’t want them to become an argument against getting the vaccine.
As in the rest of the U.S., the majority of cases in Nebraska are now delta variant infections, she said. Delta is at least twice as infectious as other COVID-19 strains.
The marked increase in cases caused by the delta variant, Tierney said, means that the benefits of getting vaccinated outweigh more than ever the low risk of adverse events from the shots.
“It’s more important than ever to get vaccinated,” she said.
As of Wednesday, 49.5% of Nebraskans were fully vaccinated, according to the Nebraska Department of Health and Human Services. But vaccination rates vary widely across the state. A World-Herald analysis last month indicated that vaccination rates are significantly lower in the state’s rural counties than in its urban ones.
Meanwhile, both cases and hospitalizations in the state, while still far lower than last fall’s peak, have risen sharply in the past several weeks. Ninety-seven Nebraskans were hospitalized with the virus Wednesday, according to HHS, a figure more than double that of a month ago.
Why some vaccinated people contract the virus while others do not, Tierney said, probably comes down to two factors: how well a person responded to the vaccine, which can vary by factors such as age and immune status, and the amount of virus to which they’re exposed.
A person who knows that she doesn’t respond well to vaccines, she said, might want to consider wearing a mask when out in public.
Some scientists have also begun to suggest that even vaccinated people consider masking indoors in crowded spaces, particularly if they’re in places where cases are high and the delta variant is prevalent. But the CDC recommends only that unvaccinated people mask in public.
Tierney said it’s important for people to be understanding if they see someone wearing a mask.
“If somebody’s wearing a mask, they might be wearing it for a reason,” she said.
Bryant, a former reporter and copy editor at the Grand Island Independent, said she only recently stopped masking in public. She didn’t wear one in Colorado.
She said she has no regrets about getting the vaccine or complaints about its effectiveness. She said she knows that her symptoms could have been much worse if she hadn’t received the shots.
Bryant also recognizes that no vaccine is 100% effective. A couple of years ago, she got influenza, despite being vaccinated against flu every year.
On Monday, feeling a little under the weather but not suspecting COVID-19, she visited her 96-year-old father at his assisted living center.
Later, she developed fatigue, body aches and other symptoms. By Friday, she was feeling better but still had coldlike symptoms — a congested head, tiredness and a bit of a runny nose.
She remains concerned about her father contracting the virus. But he is vaccinated, and the center where he lives requires residents and visitors to mask during visits, which they did.
“Hopefully, that was enough,” she said.
She also feels badly that he has to quarantine for two weeks after having already been through long periods of quarantine. She and her father also had planned activities with her brother, who is visiting from Houston for a few days for the first time in about 18 months. Instead, he bought groceries for her and left them on her porch.
When she’s done with her isolation, she said, she will probably go back to wearing a mask just to reinforce the notion that they provide protection.
“As far as I’m concerned,” she said, “everybody needs to be wearing a mask, and everybody needs to be vaccinated.”
5 key COVID-19 questions answered
What is a COVID-19 vaccine ‘breakthrough’ case?
What is a COVID-19 vaccine “breakthrough” case?
It’s when a fully vaccinated person gets infected with the coronavirus. A small number of such cases are expected and health officials say they’re not a cause for alarm.
COVID-19 vaccines work by teaching the body to recognize the virus. So if you’re exposed to it after vaccination, your immune system should be ready to spring into action and fight it.
In studies, the two-dose COVID-19 vaccines by Pfizer and Moderna were around 95% effective at preventing illness, while the one-shot Johnson & Johnson shot was 72% effective, though direct comparisons are difficult. So while the vaccines are very good at protecting us from the virus, it’s still possible to get infected with mild or no symptoms, or even to get sick.
If you do end up getting sick despite vaccination, experts say the shots are very good at reducing the severity of the illness — the main reason to get vaccinated.
Most people with breakthrough infections experience mild illness, said Dr. William Moss, a vaccine expert at the Johns Hopkins Bloomberg School of Public Health.
In the U.S., people who weren’t vaccinated make up nearly all hospitalizations and deaths from COVID-19.
It’s difficult to determine why any particular breakthrough case happens. How much of the virus you’re exposed to could be a factor, Moss said. Our individual immune systems will also affect how well we respond to the shots. Some people, for example, have health conditions or take medications that could make their immune systems less responsive to the vaccines.
People might also have been exposed to the virus before the shots took full effect. Though less likely, they may have received a dose that was improperly stored or administered, Moss said.
The Centers for Disease Control and Prevention notes variants could be factors in some breakthrough cases, though evidence so far indicates the vaccines used in the U.S. are protective against them.
Health officials are also watching for signs that breakthrough cases are rising, which could signal that protection from the vaccines is fading and boosters are needed.
Will COVID-19 vaccines work if I have a weak immune system?
Will COVID-19 vaccines work if I have a weak immune system?
Probably not as well as they do in healthy people, but the shots should offer some protection.
It’s why vaccinations are still recommended for people with immune systems weakened by disease or certain medications. It’s also important that your family, friends and caregivers get vaccinated, which will make it far less likely that they pass on the virus.
About 3% of U.S. adults have weakened immune systems. Among them are people with HIV or AIDS, transplant recipients, some cancer patients and people with autoimmune disorders such as rheumatoid arthritis, inflammatory bowel disease and lupus.
COVID-19 shots weren’t studied in large numbers of people with weak immune systems. But limited data and experience with flu and pneumonia vaccines suggest they won’t work as well as they do in others. That means people with weakened immune systems should keep taking precautions like wearing masks and avoiding large crowds.
“It’s prudent to use all the precautions you were using before you were vaccinated,” said Dr. Ajit Limaye, a transplant expert at University of Washington Medicine in Seattle.
Although most cancer patients should get vaccinated as soon as they can, people getting stem cell transplant or CAR T-cell therapy should wait at least three months after treatment to get vaccinated, according to guidance from the National Comprehensive Cancer Network. That delay will make sure the vaccines work as well as they can.
For transplant recipients, researchers are looking at whether an extra dose might make the vaccines more effective.
French guidelines recommend a third COVID-19 dose for the immunocompromised, including organ recipients. Israel recently began giving an extra dose of the Pfizer vaccine to transplant patients and others with weak immune systems. Some U.S. transplant recipients seek out a third dose on their own in hopes of more protection even though the federal government hasn’t authorized extra vaccinations.
Do I need to take precautions at hotels if I’m vaccinated?
Do I need to take precautions at hotels if I’m vaccinated?
Most people won’t need to, but it depends on your situation.
The U.S. Centers for Disease Control and Prevention says the risk of COVID-19 is low if you’re fully vaccinated, and that you can resume indoor and outdoor activities without wearing a mask or social distancing.
But if you have health issues, the CDC says to talk to your doctor about the need to continue taking precautions. Parents of young children may also want to be more careful until their kids are vaccinated. Guidance might vary by country as well, depending on local vaccination and infection rates.
“Hotels are safe, but I think there are individual personal factors that may sway you one way or another,” says Dr. Soniya Gandhi, associate chief medical officer at Cedars-Sinai Marina del Rey Hospital.
To help you decide your comfort level, Gandhi suggests looking at infection and vaccination rates in the place you’re visiting. If cases are low, you should feel more confident about activities that could put you in close contact with others, like dining at a hotel restaurant or using the gym.
Most U.S. hotel chains took measures during the pandemic to reduce the risk of infections, and those changes remain in effect. Many hotels offer contactless check-in, prepackaged breakfast items instead of open buffets and more frequent cleaning of common areas.
Some hotels and inns, including the MGM Resort chain, have also upgraded their air filtration systems and even added individual air purifiers to some guest rooms.
If you’re concerned, call ahead to see what protocols the hotel has in place.
Marriott, Hyatt, IHG Hotels & Resorts and other hotel operators have removed mask mandates for fully vaccinated guests at their U.S. hotels. Hilton’s mask rules vary by location, but employees are still required to wear masks.
Will one dose of a two-dose COVID-19 vaccine protect me?
LONDON (AP) — Will one dose of a two-dose COVID-19 vaccine protect me?
Yes, but not nearly as much as if you had both doses. Experts recommend getting fully vaccinated, especially with the emergence of worrisome coronavirus mutations such as the delta variant first identified in India.
The COVID-19 vaccines rolling out globally were developed to target the original version of the virus detected in late 2019. While they seem to work against newer versions, there’s a concern the shots eventually might lose their effectiveness if variants evolve enough.
With the delta variant, a study by British researchers found people were well protected when they got both doses of either the AstraZeneca or Pfizer-BioNTech vaccines. But with only one dose, protection was significantly reduced.
To stem the spread of the delta variant in the United Kingdom, British Prime Minister Boris Johnson recently delayed the lifting of remaining restrictions to get more people the full two doses.
Health officials are also concerned about the dozens of countries that still don’t have enough supply secured to distribute second doses within the recommended time frame.
World Health Organization chief Tedros Adhanom Ghebreyesus has said vaccinations with only one dose won’t be enough to stop outbreaks fueled by new variants and that people should maintain social distancing and other measures until more of the population is fully vaccinated.
The second dose of a two-dose vaccine is critical because it’s what “really gives a boost to the immune system so that the antibody response is very strong,” says Dr. Soumya Swaminathan, WHO’s chief scientist.