Well, it happened. Amid rapidly rising COVID-19 case numbers, your coworker or roommate or friend just tested positive. You're vaccinated, though, and you’re feeling fine. So, how scared should you be, exactly?
First, you can trust that you do have significant protection against the virus. (Yes, even against the highly contagious Delta variant.) In early tests, the Pfizer-BioNTech, Moderna, and Johnson & Johnson vaccines all proved to be highly effective at preventing symptomatic and asymptomatic disease, and even more effective at preventing death and hospitalization. This hasn't changed: Although some conservative pundits have argued otherwise, the Moderna and Pfizer vaccines are 95% protective against serious illness from the Delta variant. According to recent data from Los Angeles County, unvaccinated people are five times more likely than people who are fully vaccinated to contract COVID and 29 times more likely to be hospitalized.
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That said, with new variants and increasing case numbers in the U.S., breakthrough cases are expected to continue creeping up. Out of context, the numbers look frightening: According to estimates from the Centers for Disease Control and Protection, around 35,000 vaccinated Americans are infected each week. But with over 164 million Americans vaccinated (and many of those people exposed to COVID), there is still a low likelihood of contracting the virus — and a lower likelihood of getting sick. As of July 26, the hospitalization rate among vaccinated individuals was 0.003%, and the death rate was 0.0008%. As a report from MIT Medical put it, this proves the vaccines are still working even better than previously predicted.
Basically, if you think or know that you have a breakthrough infection, there's an extremely high chance you'll be okay; this is why the agency assured fully vaccinated, asymptomatic people that they didn't need to get tested or take any extra precautions after exposure. But newer data shows that you could still pass the disease to others. "Infections happen in only a small proportion of people who are fully vaccinated, even with the Delta variant," the CDC reported in July. "However, preliminary evidence suggests that fully vaccinated people who do become infected with the Delta variant can spread the virus to others."
As of August 10, the CDC recommends that vaccinated people get tested three to five days after their exposure to the virus, and continue masking up indoors until they test negative. After a negative test — or 14 days after exposure — you can rest assured that you probably don't have a contagious viral load. If you do test positive, you'll then want to self-isolate for 10 days, said The Ohio State University Wexner Medical Center's Dr. Iahn Gonsenhauser in an interview with CNBC.
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So, what now? Don't panic, mask up, and get tested as soon as you can (within the three-to-five-day window, of course). PCR tests are more accurate, but you can also start with a rapid antigen test: Just make sure to ask your provider about the specific test's accuracy rate, because they can vary. According to a Cochrane analysis of 64 medical studies, antigen tests can accurately identify 72% of symptomatic infections and 58% of asymptomatic infections, and also accurately rule out infection in 99.5% of people with symptoms and 99.5% of people without.
It's never a bad idea to head to your local urgent care center, even if you don't know whether you were exposed — or even if you think that cough might just be seasonal allergies. "We have seen that many people are actually not getting tested around the country, even though they have symptoms," U.S. Surgeon General Dr. Vivek Murthy told CNN. "And this is particularly happening in areas, unfortunately, where the vaccination rates are low, which is exactly where we want to be testing more.”
Breakthrough cases aren't common, but experts aren't surprised they're happening, either. It's important to remember that the COVID vaccines were never built to make anyone completely impenetrable in the face of the virus — they were meant to drastically reduce the chances of illness. If everyone got the vaccine, experts say, the death rate in the U.S. could fall to zero. But some people won't, and some people can't, and in the meantime, the virus will only continue to mutate.
"The takeaway is that our individual risk is small, but our collective responsibility is great," MIT Medical Director Cecilia Stuopis wrote. "While we are well-protected by vaccination, to keep our community safe, we need to be willing to add additional layers of protection for now — masking indoors, distancing, and avoiding risky situations. The virus isn't going away, and we can't control how it will evolve, but we can control how we respond, and that can change the course of the pandemic."