We've written often about so-called "breakthrough" COVID infections among fully-vaccinated Americans, noting that they are both relatively rare and overwhelmingly asymptomatic or mild. I can now personally attest to the latter point, having tested positive for the virus over the weekend. As a vaccinated person, my symptoms are very mild, akin to a minor head cold. More on that in a moment, but first, let's zoom out. While some media outlets and individuals with large platforms continue to needlessly spread fear about these types of infections, using tricks such as excluding crucial context like fraction denominators, the real data reflects the wonderful, miraculous reality:
Of the 164 million vaccinated Americans, less than 0.1% have been infected with the coronavirus, and 0.001% have died, according to data from the CDC.https://t.co/qPAJW35tIJ pic.twitter.com/yCveWpz7jb
— Axios (@axios) July 31, 2021
Of 163 million Americans fully vaccinated as of July 26, there have been 6,239 hospitalizations, including 1,263 deaths in people diagnosed with SARS-CoV-2 infection. In about 25% of cases, patients were asymptomatic or diagnosis appeared secondary to primary cause of the event. pic.twitter.com/fIqQT2Mwdg
— Scott Gottlieb, MD (@ScottGottliebMD) August 1, 2021
People immunized by the three safe and effective US-approved vaccines are remarkably well-protected against infection and are virtually completely protected against severe cases or death. This is a spectacular endorsement of the vaccines' efficacy. That said, it's entirely possible, if not likely, that the number of breakthrough infections within the ranks of the vaccinated is actually higher than reported. Why? It stands to reason that some significant portion of the 164 million Americans who've been vaxxed have been subjected to the now-dominant and highly contagious Delta variant. Some of the (still rare) resulting infections lack the severity to provoke any symptoms at all, or (as in my case) are only mildly symptomatic. Many of the affected people have little-to-no reason to get tested, thus contributing to an undercount of breakthrough infections. But that ultimately doesn't really matter much. "Breakthrough" hospitalizations aren't likely to be significantly undercounted; "breakthrough" deaths certainly aren't. Those incidents are vanishingly rare because the vaccines work.
The only reason I sought out a test on Friday evening was in preparation for an event with Texas Gov. Greg Abbott, along with roughly 200 Lone Star State conservatives. The group skewed older, and given the politics of vaccination, there was a non-zero chance that at least some attendees might be unvaxxed. I was experiencing a slight cough and a runny nose late in the week, nothing more. In fact, I felt good enough to have gone for a run in the Texas heat earlier in the day. But because I recalled that most diagnosed "breakthrough" cases entail minor symptoms, I decided to wear a mask in the presence of others until I got swabbed, as soon as possible, just to be safe. Boom: I was positive. I've been isolating ever since, despite feeling more or less normal, and will continue to do so until I test negative.
To be as clear as I possibly can about this: I absolutely do not view this development as evidence that the vaccines somehow "don't work." To the contrary, I am more grateful than ever to have received my Moderna shots this spring (I shared my thinking behind that decision here, and I believe it stands up rather well). I don't know exactly what I'd be experiencing right now, absent the protection of the vaccine, but I'm quite confident it would be much more unpleasant than a slight sniffle and a partial, temporary reduction of my senses of smell and taste. My vaccine is doing its job. For what it's worth, I also still think it's absurd for fully-vaccinated people to be required to wear masks in nearly any setting (especially if they're lacking any symptoms), for reasons highlighted in the above data and illustrated creatively here:
Pretty damn impressive
— Eric Topol (@EricTopol) July 31, 2021
Thanks Darren Lu @Reddit pic.twitter.com/ST6ueaaoY1
Symptomatic infections among the vaccinated are extremely rare, and even when they do occur (hi there!), people are protected against bad health outcomes. There are counter-arguments in the masking debate, but click through to Jonah Goldberg's latest piece for a series of responses to them. They're compelling. As for my path forward, not only are these types of cases far less severe, they also tend to be shorter in duration:
Study: post-vax delta breakthrough infections are infrequent and when they occur, they're typically shorter in duration (with less potential for spread) than in unvaccinated. "Vaccination is associated with faster decline in viral RNA load." https://t.co/B009fsCPJ6 h/t @EricTopol pic.twitter.com/FmNnIxf1oU
— Scott Gottlieb, MD (@ScottGottliebMD) July 31, 2021
Much has been made of the Provincetown, MA, outbreak, which reportedly impacted the CDC's controversial guidance reversal on masking. Even in a veritable human petri dish that couldn't have been better suited to trigger a super-spreader event (packed indoor dance parties with horrible ventilation and tons of close or intimate contact), the ensuing "breakthrough" outbreak affecting hundreds of fully-vaccinated people was remarkably non-destructive, with only a tiny handful of hospitalizations and zero deaths. It was also contained quickly, with the community case rate rapidly steadying then descending again. This is incredibly good news, as summarized by MSNBC host Chris Hayes, with whom I often disagree:
The headline from the Provincetown CDC study should be
— Chris Hayes (@chrislhayes) July 30, 2021
“Holy Crap Did The Vaccines Hold Up Well In Preventing Severe Illness and Death Under An Intensive Stress Test.”
The decoupling of COVID cases from COVID hospitalizations and deaths is a game-changer that is attributable to widespread resistance to the virus, via vaccines and natural immunity. It looks like the frightening surges in serious cases among unvaccinated Americans have motivated increasing numbers of people to go get their shots. Let's hope that trend continues. And speaking of hopeful trends, for all the heated rhetoric about the Delta variant, Delta cases have plunged in places like India (where it is thought to have originated) and the UK, which augurs well for us:
They have similar vax rates to the US, they didn’t reimpose restrictions, they are dealing with the same Delta variant we are (just a few weeks ahead of us) and their cases are now plunging. https://t.co/mzSmbvxed5
— Guy Benson (@guypbenson) July 31, 2021
That's not a call for complacency or an argument against vaccination. But it is a bit of pushback against over-the-top Delta doom in which far too many people are currently trafficking. I'll leave you with some spot-on observations about America's COVID status quo via stats guru Nate Silver, whose data-driven and sensible analysis is drawing hackles from purveyors of panic:
This is the single most important fact of the current stage of the epidemic. Vaccines are radically reducing fatality rates in counties that have vaccinated elderly and vulnerable people. It's way more important than whether there are slightly more breakthrough infections. https://t.co/y4fWAkNvHB
— Nate Silver (@NateSilver538) August 1, 2021
Honestly as long as you're vaccinated and not in some sort of special circumstance you should choose to live your life ~however you want under COVID but don't mistake overcaution for virtue or wisdom.
— Nate Silver (@NateSilver538) July 30, 2021
UPDATE - I discussed the context of my breakthrough case on today's radio show:
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