What are ‘breakthrough infections’ and why should vaccinated folks be worried?

Ever since the Philippine government bellied up to the bar and started rolling inoculating its citizens, health officials have volleyed one disclaimer about the vaccinesthat it does not render us immune to the coronavirus, but rather reduces our risk of being hospitalized or contracting a severe illness.

As the highly transmissible Delta variant is declared as the dominant variant in the country, more and more inoculated individuals are bearing proof of this. These are what we call “breakthrough infections,” a new addition to our pandemic-related parlance. We get it: keeping track of all these jargons has taken its toll, but this one arguably deserves our focus more than most.

What are breakthrough infections?

A breakthrough infection or case is when someone contracts the coronavirus more than 14 days — or the full length of time it takes for your immune system to mount a defense — after they’ve been fully vaccinated.

That time frame is important because contracting the virus anytime before then means that your body has not yet built the immunity needed to fend off an infection. Thus, such cases aren’t considered as a breakthrough.

The infected case may or may not show symptoms of the virus. This means that receiving both jabs will still do its job of keeping the individual from being hospitalized. 

Why do breakthrough infections occur?

Despite tallying high efficacy rates across several clinical trials, these vaccines have been known from the get-go to be “fabulous but imperfect,” as Dr. William Schaffner, an infectious disease specialist at the Vanderbilt University School of Medicine, says. Posting a near-100% efficacy rate means that people will still possibly get the virus.

What are 'breakthrough infections' and why should vaccinated folks be worried?

This isn’t unique to the novel coronavirus, too. Even our regular flu shots can’t guarantee absolute immunity from influenza. “Some people can still get the flu after being vaccinated against influenza, but almost invariably that illness will not cause hospitalization,” Dr. Schaffner says.

Apart from vaccine efficacy, other factors such as immune fitness, virus variant, and overall health condition all contribute to a fully vaccinated person’s odds of getting the virus.

How often do breakthrough infections happen?

While they do happen more often due to the arrival of the more infectious Delta variant, immunologists are still confident enough to claim that these cases are “relatively rare.”

To wit, the United States’ Center for Disease Control or CDC detected more than 10,000 COVID-19 cases in vaccinated people across 46 states during the first quarter of 2021. That’s about 0.01% of the roughly 100 million people who have received complete vaccine doses as of April 30. Of that figure, about 10% were hospitalized. Then, about 2% of that percentage, or 160 patients, died due to the virus.

In the Philippines, the Food and Drug Administration (FDA) claimed last month that only 0.0035% of fully vaccinated folks, or 51 cases out of over 9 million who underwent its study, caught the virus. 

How does an infection in a breakthrough case feel?

Catching the coronavirus after you’ve already been fully inoculated may manifest differently even at its worst. 

Should you feel unwell, the symptoms are often shorter in duration and milder in effect than those who are yet to be vaccinated when they get infected. Most breakthrough cases report being bedbound but didn’t need to go to the hospital.

It’s understandable to develop some sense of confidence after getting both vaccine doses, but inoculated folks undergo the same procedure after catching the virus as the rest of the population.

That includes getting tested, going into quarantine for 10 to 14 days, and continuing to comply with minimum health protocols even in isolation. The CDC also recommends breakthrough cases to get tested 3 to 5 days after their exposure – and isolate until they receive a negative test result.

So, should vaccinated folks be worried?

Looking at the numbers alone should tell fully jabbed folks that breakthrough cases aren’t a cause for concern. Despite that, it serves as a sound reminder that, first, vaccines get the job done one way or another. Also, it serves as a sound reminder to urge unvaccinated people to line up and get their jabs.

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And second, that getting your doses shouldn’t be a cause for complacency either. Vaccinated people should still mask up, avoid crowds, and wash their hands regularly. Remember: we can still be carriers of the coronavirus despite our inoculation. Thus, we can only expect the vaccines to do their part in protecting the population if we do ours.

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