Breakthrough cases happen when someone who is fully vaccinated against COVID-19 becomes infected with the coronavirus. Most of these cases tend to lead to less severe symptoms and hospitalization, resembling a common cold more than anything.
Ross Kedl, an immunologist at the University of Colorado School of Medicine, told NPR that the virus that comes from a vaccinated person will look different than one from an unvaccinated person.
Vaccinated people often have antibodies from the vaccine. These antibodies “should be coating that virus with antibodies and therefore helping prevent excessive downstream transmission,” Kedl told NPR.
In fact, Kedl said most vaccinated people appear to be infected by unvaccinated people, at least according to case studies that have come out.
“In all these cases where you have these big breakthrough infections, there’s always unvaccinated people in the room,” he told NPR.
Breakthrough cases are becoming increasingly more common among the fully vaccinated, especially because of the highly transmissible delta variant of the coronavirus.
In fact, breakthrough cases are likely to impact thousands of people in the future. Amesh Adalja, a doctor and infectious disease specialist at Johns Hopkins Center for Health Security, told Roll Call that most people will be infected with COVID-19 at some point in their lives.
“It’s likely that everybody will probably get infected with COVID-19 (at some point) because it’s an endemic respiratory virus. The goal is to make sure that at that time, that infection occurs after you’ve been vaccinated so it’s mild,” Adalja told Roll Call.
Overall, breakthrough cases remain rare. Unvaccinated people are still at the highest risk of getting infected with the coronavirus. In fact, the Centers for Disease Control and Prevention released data that showed unvaccinated people are five times more likely to be infected with the coronavirus and they have more than 10 times higher chance of dying from COVID-19, according to the CDC.
Vials of Moderna’s COVID-19 vaccines sit on a table at the Mountain America Exposition Center in Sandy on Tuesday, May 18, 2021. Scientists with the Food and Drug Administration said Tuesday that Moderna did not meet all the criteria necessary for the FDA to support a booster vaccine.
Scientists with the Food and Drug Administration said Tuesday that Moderna did not meet all the criteria necessary for the FDA to support a booster vaccine.
Per Yahoo! News, FDA scientists released new documents that show the Moderna vaccine’s booster shot created antibodies. But the difference in antibody levels before and after the booster shot wasn’t big enough to warrant a booster shot.
In fact, those who already had high antibody levels from the first two-dose regimen did not show signs of increased antibody levels.
So, in a way, the Moderna shot might be too strong already to warrant a booster shot.
John Moore, a professor of microbiology and immunology at Weill Cornell Medical College in New York, told Yahoo! News that there are still a number of questions about the Moderna booster shot and what the FDA wants from it.
“There was boosting, sure. Was it enough boosting? Who knows? There’s no standard amount of boosting that is known to be needed, and nor is it clear how much boosting happened in the study,” Moore said.
Unnamed sources recently told Bloomberg that the FDA might suggest a half-dose for the coronavirus booster shot since the original doses of the vaccine were so strong.
The original two-dose regimen from Moderna had two 100-microgram doses.
For comparison, Pfizer’s first shots had two 30-microgram doses.
A half-dose for the booster shot would likely reduce the side effects of the shot, according to Bloomberg. And it would allow Moderna to spread the booster shot more widely throughout the world.
The Food and Drug Administration and the Centers for Disease Control and Prevention approved the Pfizer booster shot at the end of September. Questions were immediately raised about what this meant for Moderna and Johnson & Johnson vaccine recipients.
Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said on NBC News’ “Meet the Press” recently that the Moderna booster shot will come soon once the right data comes along.
“The actual data that we’ll get (on) that third shot for the Moderna and second shot for the J&J is literally a couple to a few weeks away,” he said. “We’re working on that right now to get the data to the FDA, so they can examine it and make a determination about the boosters for those people.”
Are You Immune After a COVID Infection?
Arthur Allen, Kaiser Health News – Yesterday 8:15 AM
Dr. Aaron Kheriaty, a University of California-Irvine psychiatry professor, felt he didn’t need to be vaccinated against COVID because he’d fallen ill with the disease in July 2020.
So, in August, he sued to stop the university system’s vaccination mandate, saying “natural” immunity had given him and millions of others better protection than any vaccine could.
A judge on Sept. 28 dismissed Kheriaty’s request for an injunction against the university over its mandate, which took effect Sept. 3. While Kheriaty intends to pursue the case further, legal experts doubt that his and similar lawsuits filed around the country will ultimately succeed.
That said, evidence is growing that contracting SARS-CoV-2, the virus that causes COVID-19, is generally as effective as vaccination at stimulating your immune system to prevent the disease. Yet federal officials have been reluctant to recognize any equivalency, citing the wide variation in COVID patients’ immune response to infection.
RELATED: Sure Signs You May Have Already Had COVID.
Like many disputes during the COVID pandemic, the uncertain value of a prior infection has prompted legal challenges, marketing offers and political grandstanding, even as scientists quietly work in the background to sort out the facts.
For decades, doctors have used blood tests to determine whether people are protected against infectious diseases. Pregnant mothers are tested for antibodies to rubella to help ensure their fetuses won’t be infected with the rubella virus, which causes devastating birth defects. Hospital workers are screened for measles and chickenpox antibodies to prevent the spread of those diseases. But immunity to COVID seems trickier to discern than those diseases.
The Food and Drug Administration has authorized the use of COVID antibody tests, which can cost about $70, to detect a past infection. Some tests can distinguish whether the antibodies came from an infection or a vaccine. But neither the FDA nor the Centers for Disease Control and Prevention recommend using the tests to assess whether you’re, in fact, immune to COVID. For that, the tests are essentially useless because there’s no agreement on the amount or types of antibodies that would signal protection from the disease.
“We don’t yet have full understanding of what the presence of antibodies tells us about immunity,” said Kelly Wroblewski, director of infectious diseases at the Association of Public Health Laboratories. By the same token, experts disagree on how much protection an infection delivers.
RELATED: Dr. Fauci Just Said When to Expect Next Surge
In the absence of certainty and as vaccination mandates are levied across the country, lawsuits seek to press the issue. Individuals who claim that vaccination mandates violate their civil liberties argue that infection-acquired immunity protects them. In Los Angeles, six police officers have sued the city, claiming they have natural immunity. In August, law professor Todd Zywicki alleged that George Mason University’s vaccine mandate violated his constitutional rights given he has natural immunity. He cited a number of antibody tests and an immunologist’s medical opinion that it was “medically unnecessary” for him to be vaccinated. Zywicki dropped the lawsuit after the university granted him a medical exemption, which it claims was unrelated to the suit.
Republican legislators have joined the crusade. The GOP Doctors Caucus, which consists of Republican physicians in Congress, has urged people leery of vaccination to instead seek an antibody test, contradicting CDC and FDA recommendations. In Kentucky, the state Senate passed a resolution granting equal immunity status to those who show proof of vaccination or a positive antibody test.
Hospitals were among the first institutions to impose vaccine mandates on their front-line workers because of the danger of them spreading the disease to vulnerable patients. Few have offered exemptions from vaccination to those previously infected. But there are exceptions.
Two Pennsylvania hospital systems allow clinical staff members to defer vaccination for a year after testing positive for COVID. Another, in Michigan, allows employees to opt out of vaccination if they present evidence of previous infection and a positive antibody test in the previous three months. In these cases, the systems indicated they were keen to avoid staffing shortages that could result from the departure of vaccine-shunning nurses.
For Kheriaty, the question is simple. “The research on natural immunity is quite definitive now,” he told KHN. “It’s better than immunity conferred by vaccines.” But such categorical statements are clearly not shared by most in the scientific community.
RELATED: We’re Virus Experts and Here’s What Happens Next
Dr. Arthur Reingold, an epidemiologist at UC-Berkeley, and Shane Crotty, a virologist at the respected La Jolla Institute for Immunology in San Diego, gave expert witness testimony in Kheriaty’s lawsuit, saying the extent of immunity from reinfection, especially against newer variants of COVID, is unknown. They noted that vaccination gives a huge immunity boost to people who’ve been ill previously.
Yet not all of those pushing for recognition of past infection are vaccine critics or torchbearers of the anti-vaccine movement.
Dr. Jeffrey Klausner, clinical professor of population and public health sciences at the University of Southern California, co-authored an analysis published last week that showed infection generally protects for 10 months or more. “From the public health perspective, denying jobs and access and travel to people who have recovered from infection doesn’t make sense,” he said.
In his testimony against Kheriaty’s case for “natural” immunity to COVID, Crotty cited studies of the massive COVID outbreak that swept through Manaus, Brazil, early this year that involved the gamma variant of the virus. One of the studies estimated, based on tests of blood donations, that three-quarters of the city’s population had already been infected before gamma’s arrival. That suggested that previous infection might not protect against new variants. But Klausner and others suspect the rate of prior infection presented in the study was a gross overestimate.
RELATED: Virus Expert Just Gave “Unfortunate” Warning
A large August study from Israel, which showed better protection from infection than from vaccination, may help turn the tide toward acceptance of prior infection, Klausner said. “Everyone is just waiting for Fauci to say, ‘Prior infection provides protection,'” he said.
When Dr. Anthony Fauci, the top federal expert on infectious diseases, was asked during a CNN interview last month whether infected people were as well protected as those who’ve been vaccinated, he hedged. “There could be an argument” that they are, he said. Fauci did not immediately respond to a KHN request for further comment.
CDC spokesperson Kristen Nordlund said in an email that “current evidence” shows wide variation in antibody responses after COVID infection. “We hope to have some additional information on the protectiveness of vaccine immunity compared to natural immunity in the coming weeks.”
A “monumental effort” is underway to determine what level of antibodies is protective, said Dr. Robert Seder, chief of the cellular immunology section at the National Institute of Allergy and Infectious Diseases. Recent studies have taken a stab at a number.
Antibody tests will never provide a yes-or-no answer on COVID protection, said Dr. George Siber, a vaccine industry consultant and co-author of one of the papers. “But there are people who are not going to be immunized. Trying to predict who is at low risk is a worthy undertaking.”
How much immunity does a prior COVID-19 infection give,
and why isn’t it considered with vaccine mandates?
By Erica Moser Day staff writer
Oct. 9—Here is a FAQ answering that and other questions The Day has been hearing recently.
How much natural immunity against COVID-19 do people get from a prior infection, and why can’t natural immunity be used to opt out of vaccine and testing mandates?
Doctors and researchers generally agree that people who previously were infected with COVID-19 and also got vaccinated are the most protected. But the science is still evolving on how much immunity prior infection confers — which may depend on the severity of the infection and the coronavirus variant circulating — and how long protection lasts.
“It’s been very difficult to ascertain how the vaccine and natural immunity compare to each other,” Dr. Shira Doron of Tufts Medical Center told NBC10 Boston last month. Centers for Disease Control and Prevention spokesperson Kristen Nordlund recently told NBC News, “We hope to have some additional information on the protectiveness of vaccine immunity compared to natural immunity in the coming weeks.”
In a study released Aug. 6, the CDC looked at Kentucky adults who were infected with the coronavirus in 2020, and people who were and weren’t reinfected in May or June of this year. The study found that unvaccinated people were 2.34 times more likely to be reinfected.
One of the limitations the authors listed is that “persons who have been vaccinated are possibly less likely to get tested. Therefore, the association of reinfection and lack of vaccination might be overestimated.”
That is the opposite of a limitation that Emory University biostatistician Natalie Dean shared about a different study: Previously infected people may be less likely to get tested than vaccinated people because they think they’re immune.
She talked to the journal Science about a study Israeli researchers released in August based on the database of a health care organization that enrolls about 2.5 million Israelis.
Comparing more than 32,000 people who either got their second Pfizer dose or were infected in January or February, one model found the risk of developing symptomatic COVID-19 was 27 times higher among the vaccinated than those with a previous infection, and the risk of hospitalization eight times higher. But the latter was just based on eight hospitalizations among the fully vaccinated and one of a previously infected person.
Using a model that included people who were infected in 2020, the researchers found evidence of waning natural immunity, but the risk of symptomatic disease was still seven times higher for vaccinated but never-infected people.
This study hasn’t yet been peer-reviewed, and the preprint server medRxiv cautions that the medical research “has yet to be evaluated and so should not be used to guide clinical practice.”
Dr. Richard Martinello, medical director for infection prevention for Yale New Haven Health, said more studies will need to be done to confirm the findings. He said we’ve always known people develop immunity after infection, but the question is whether it’s good enough.
Researchers from the Yale School of Public Health analyzed data from close relatives of the COVID-19 virus to model the risk of reinfection over time. They said reinfection “under endemic conditions would likely occur between 3 and 63 months after peak antibody response, with a median of 16 months.”
“Those who have been naturally infected should get vaccinated. Previous infection alone can offer very little long-term protection against subsequent infections,” lead author Jeffrey Townsend said. This study was published in The Lancet Microbe in Oct. 1.
A Cleveland Clinic study released in June, which hasn’t been peer-reviewed, found that 99.3% of employee infections between Dec. 16 and May 15 occurred among those who were unvaccinated and not previously infected. In those five months, COVID-19 didn’t occur among any of the 2,579 previously infected individuals, including 1,359 people who were unvaccinated.
Some organizations in Connecticut responded to questions about why they opted not to allow prior infection as an exemption from vaccine and testing mandates.
“The science on immunity from natural infection with COVID is evolving. Some people develop very strong immunity and others don’t,” Department of Public Health Commissioner Dr. Manisha Juthani said in an email. “Vaccination after getting COVID reliably produces immunity which is why we continue to recommend getting vaccinated despite having had COVID. This recommendation may change over time as we evaluate more scientific data.”
Martinello said Yale New Haven Health didn’t consider natural immunity as an exemption, because natural immunity is not as consistently established as immunity conferred by a vaccine.
A University of California Irvine School of Medicine professor challenged the UC system’s vaccine mandate, saying he had immunity from a prior infection, but a federal judge upheld the vaccine requirement in a ruling on Sept. 30.
The Michigan hospital system Spectrum Health said last month it would grant an exemption from its employee vaccine mandate to people who have a positive PCR or antigen test for COVID-19 plus a positive antibody test from the past three months, The Detroit News reported.
Some other countries accept a certificate of recovery in addition to proof of vaccination or a negative test: For both the EU Digital COVID Certificate and the Green Pass in Israel, a certificate of recovery is valid for six months.
Excellent video to share with uninformed people!!! 2030 Unmasked – For those Preparing for what’s Coming After Covid-19 (rumble.com) How do school nurses handle students with COVID-19 symptoms?
School nurses here are relying on guidance from DPH, the state Department of Education and Ledge Light Health District.
Addendum 5 from DPH and the education department, which has been revised multiple times, says an individual who has COVID-19 symptoms but hasn’t had close contact with a coronavirus-positive person should stay home, notify the school immediately and get tested.
If at school, “Students should remain masked, adhere to strict physical distancing, be assessed by the school nurse or school medical advisor (if available), stay in the isolation room (with adult supervision), until picked up to go home. Parents should be instructed to consult a healthcare provider and have the student tested.”
Students who test negative can return to school after 24 hours with no fever, or can return without test results if a health care provider “provides documentation with a specific, confirmed alternate diagnosis.”
The addendum has different protocols for close contacts, which depend on vaccination status and whether symptoms are present.
Annie Ryan, nurse at Nathan Hale Arts Magnet School in New London, said that about two weeks ago, she had to send home 17 kids in two days.
“I explain it to the parents,” she said, “and some of them understand, and some of them are screaming in your face, like, ‘Why did you send my kid home, because they just have a cold?'”
Ryan is president of the union that represents nurses for the Visiting Nurse Association of Southeastern Connecticut, which supplies nurses for schools in New London, Waterford, East Lyme and Groton.
Maria Kostopoulos, nurse at Clark Lane Middle School in Waterford, said one primary symptom or two secondary symptoms is enough for her to second a kid home. She said primary symptoms are fever, chills, loss of taste or smell, uncontrolled cough and shortness of breath.
Secondary symptoms include things like a sore throat, congestion, runny nose, nausea, headache and fatigue.
“The symptoms are very vague, so it’s hard to figure out who to send home and who not to send home,” Kostopoulos said, “so a lot of it goes if you know these children’s medical history.
Are they prone to allergies?”
“It’s multifaceted, and it’s dealing with families when they’re fragile and scared, and you don’t know what their situations are at home,” she said. Sending kids home is a hardship on parents, especially if they have to wait a few days to get a test scheduled and then a few days to get results.
Kostopoulos said what’s striking is that boards of education “can adopt the policies in their own way, with a little bit of discretion,” so protocols vary from town to town.
“I don’t think there’s a one size fits all (approach),” Lyme-Old Lyme Superintendent Ian Neviaser said. He added, “It really depends on the specific situation. We don’t require, per se, the student to provide a negative COVID test in every situation, because that would be in some cases a little ridiculous.
If a kid has one symptom and it goes away immediately, the chances of them having COVID are pretty slim.”
Where can I get tested?
Ledge Light Health District is offering free COVID-19 testing four days a week at four locations, for symptomatic and asymptomatic people, with no appointment required.
Testing is Tuesdays from 3 to 7 p.m. at the City of Groton Municipal Building, Wednesdays from 8 to 11 a.m. at the Waterford Public Library, Thursdays from 4 to 7 p.m. at Stonington Human Services and Fridays from noon to 5 p.m. at the New London Senior Center.
Uncas Health District and UCFS Healthcare are offering free drive-thru testing at Dodd Stadium in Norwich on Mondays, Tuesdays, Thursdays and Fridays from 3 to 7 p.m.
Through Yale New Haven Health, people can get tested at Lawrence + Memorial Hospital in New London or Mohegan Sun. To schedule an appointment, visit covidtesting2.ynhhs.org or call (833) 275-9644.
Martinello said when people get tested because they’re sick, the results come back within 24 hours more than 99% of the time.
CVS test scheduling is available at bit.ly/cvscvdtst, but not every site offers rapid testing or testing for asymptomatic people, and appointments may not be available the same day or the next day.
What do I do if I lose my COVID-19 vaccine card?
There are a few options to obtain proof of vaccination, such as contacting your vaccination provider to request a copy. If you got vaccinated through Yale New Haven Health or Hartford HealthCare, you can respectively log on to MyChart or MyChartPLUS to download your vaccination record.
You can log on to the Vaccine Administration Management System, or VAMS, if you scheduled your appointment that way.
Immunization records also are available from the CT Immunization Information System, or CT WiZ, by visiting bit.ly/ctwizportal or calling (860) 509-7929. e.moser@theday.com
“Social media users are sharing a video from October 2019 and falsely claiming that it shows top U.S. infectious disease doctor Anthony Fauci and others plotting a new influenza virus to enforce universal influenza vaccination.” – Reuters
“This video circulating on social media is not evidence that Fauci and others were plotting a new influenza virus to enforce vaccine mandates.” – Reuters
Rachel Clarke on Twitter: “Over 40k new Covid-19 cases today and 7000 hospitalizations.
In no sense is this pandemic over, no matter how fiercely we yearn for normality.
Please mask up and please have your jab https://t.co/WdbJAP9UTo” / Twitter
“Social media users are sharing a video from October 2019 and falsely claiming that it shows top U.S. infectious disease doctor Anthony Fauci and others plotting a new influenza virus to enforce universal influenza vaccination.” – Reuters
“This video circulating on social media is not evidence that Fauci and others were plotting a new influenza virus to enforce vaccine mandates.” – Reuters
A video of a 2019 health panel discussion, now being shared on social media, is not evidence that Fauci and others were plotting a new influenza virus to enforce vaccine mandates. https://t.co/d0q3QD6fkg https://t.co/9ZV6vX6tly” / Twitter
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