What You Need To Know About Covid
Explore top articles, videos, research highlights and more from the AMAyour source for clear, evidence-based news and guidance during the pandemic.
The three COVID-19 vaccines available in the United Statesfrom Moderna, Pfizer-BioNTech and Johnson & Johnsonare doing exactly what they were meant to do: protect against severe illness and hospitalization. But with the more dangerous Delta variant of SARS-CoV-2 spreading rapidly, the U.S. is seeing more COVID-19 vaccine breakthrough infections.
Nevertheless, the fact remains that getting vaccinated is effective in preventing people from getting severely ill or dying from the disease. Even as new COVID-19 variants appear, vaccines continue to hold their ground. But since no vaccine is perfect, it is expected that we will see some COVID-19 breakthrough infections.
More than 161 million people in the U.S. have been fully vaccinated against COVID-19, according to the Centers for Disease Control and Prevention . Meanwhile, the CDC reports that there have been more than 10,000 COVID-19 vaccine breakthrough cases. However, while the CDC initially tracked all breakthrough COVID-19 infections, as of May 1 the agency shifted to only tracking those linked to hospitalization or death. Over 5,100 patients with COVID-19 vaccine breakthrough infections were hospitalized or died.
Scientists Are Studying How Long Vaccine Immunity Is Likely To Last
Reducing the risk of transmitting the coronavirus relies on developing strong immunity against the virus. But immunity, even from the vaccines, fades over time. Scientists are actively monitoring people whove had COVID-19 vaccines to understand how long vaccine immunity is likely to last, and if and when booster shots will be required.
Variants of the coronavirus are also concerning. These are strains of the SARS-CoV-2 virus that carry changes which make them harder to control by immunisation. Such variants present two major challenges: they can evade vaccine immunity and, in some cases, are also more transmissible.
Although variants have spread widely throughout the world, there are several pieces of good news on this front. Countries with advanced vaccine roll-outs are maintaining good control over the virus. For example, Israel began its mass vaccination campaign during their third wave, and quickly saw a decline in new cases.
Viral Load And Transmission
There is also another considerationthe role viral load may play in transmission. A study published in February 2021 in The Lancet Infectious Diseases found that the viral loadthe amount of virus in a persons body is a critical factor in the transmission of SARS-CoV-2.
Specifically, the study concluded that those with higher viral loads are more likely to transmit the virus to others. In March, another study from Israel found that the Pfizer-BioNTech vaccine, even after just a single dose, significantly reduced viral loadwhich suggests that it may also lower the risk of transmission. But it did not evaluate whether vaccinated people could transmit the virus, even if their viral loads were reduced. Nor did it take into account the Delta variant.
More science will certainly emerge on transmission, as the Delta variant circulates and as more people become vaccinated, and hopefully public guidance will follow the science,” says Dr. Meyer.
A recent study, which has not yet been peer-reviewed, demonstrated that people infected by the Delta variant had viral loads roughly 1000 times higher than those infected by the initial strain of the virus.
“The higher viral loads may play a role in increasing the risk of transmission, because each droplet can be packed with more virus,” says Dr. Meyer.
But the extent to which it does so in unvaccinated and vaccinated people is still unclear.
Also Check: How Much Is Cvs Covid Testing
About Author: Lisa Coon
Lisa Coon is a Writing Coordinator for OSF HealthCare, where she has worked since August 2016. A Peoria native, she is a graduate of Bradley University with a degree in journalism. Previously, she worked as a reporter and editor at several newspapers in Iowa and Illinois.She lives in Groveland with her husband and son. In her free time she likes to cook, bake and read. She freely admits that reality TV is a weakness, and she lives by the quote, The beach is good for the soul.
Organizations That Serve People Experiencing Homelessness
People who experience homelessness may be at risk of more severe disease or outcomes. They may also have a greater risk of exposure to COVID-19 because they may:
- not be able to access or use traditional services or resources
- have limited ability to follow public health measures due to financial or environmental barriers
- stay in shelters or other group settings with many other people
Organizations, community health workers and volunteers play an important role in helping prevent and reduce the spread of COVID-19 among those who experience homelessness.
Learn more about:
You May Like: How Much Are Cvs Covid Tests
What Research Is Being Conducted On Long Covid
Though a handful of studies have already been published in an effort to shed light on long COVID and its ramifications among the vaccinated and unvaccinated, the research is very much still ongoing.
One of the biggest studies underway in the U.S. is the NIH-sponsored RECOVER initiative, which is a nationwide research study investigating the long-term effects of COVID-19, Dr. Geng said. The goals of the study are to better understand the rate, subtypes, risk factors, and pathophysiology of long COVID, as well as ways to treat and prevent the syndrome.
As part of this significant undertaking, several groups, and organizations are working together through a RECOVER Consortium to launch multiple studies that will include diverse groups of patients, caregivers, clinicians, community leaders and scientists from across the nation. Stanford Medicine, for instance, one of 30 research teams participating in the NIH-funded study, received $15 million just for its portion of the research effort and will use that money to study 900 COVID-19 survivors, including those experiencing lingering symptoms of initial COVID-19 infections, over a four year period.
“Long COVID is a major public health crisis,” Dr. Geng said. “Resources and multidisciplinary teamwork are required to tackle this challenging and complex problem. We should remain vigilant about long COVID in vaccinated individuals with breakthrough infections and continue to support clinical care and research in this area.”
What Should I Do If I Test Positive
The Covid advice differs depending on where you live in the UK.
Self-isolation is no longer a legal requirement in England, but the NHS advises that people infected with Covid-19 should stay at home and avoid contact with other people to help reduce the spread of the virus.
In particular, you should avoid being in close contact with people at higher risk from coronavirus, for example if they are elderly or have a weakened immune system, even if they have had the vaccine.
Infected people should try to work from home if they can. If you are unable to work from home, talk to your employer about options available to you, government advice states.
Positive cases should try to stay at home and avoid contact with other people for five days after the day of their test.
Scotlands national health information service also recommends self-isolation for people who test positive for coronavirus, but also advises that they book a free PCR test.
You should then isolate for 10 days from the date your symptoms started. If you have had a positive PCR or lateral flow test result but no symptoms, you should self-isolate for 10 days from the date of your test.
You may be able to end self-isolation early if you have two negative lateral flow test results in a row from day six onwards, taken 24 hours apart.
If you are a fully vaccinated close contact, for example someone who lives with an infected person, you can take daily lateral flow tests instead of self-isolating.
Read Also: Cost Of Cvs Covid Test
Its Still Good To Be Cautious
While this is encouraging news, Dr. Cardona stresses that fully vaccinated people still need to be careful as everything opens up again.
Virus transmission may still occur from those who are infected and asymptomatic, or ill without knowing it, especially in crowded areas with a lack of physical distancing, respiratory precautions and hand washing. Other factors to consider are ongoing community transmission and immunization rates.
If you havent been vaccinated or havent completed the vaccination series, she recommends doing so. And if you have a unique circumstance that delays your ability to complete your series of shots as scheduled, still get the second dose. Dr. Cardona says restarting the series isnt necessary.
The CDC also recommends that fully vaccinated people wear masks indoors in public for maximum protection from the delta variant and to lessen the risks of transmission. You should also wear a mask if you have a weakened immune system, an underlying medical condition or are at high risk for severe disease.
Voluntary Reporting By State Health Departments
When the United States began widespread COVID-19 vaccination, CDC put in place a system where state health departments could report COVID-19 vaccine breakthrough infections to CDC.
On May 1, 2021, after collecting data on thousands of vaccine breakthrough infections, CDC changed the focus of how it uses data from this reporting system.
- One of the strengths of this system is collecting data on severe cases of vaccine breakthrough COVID-19 since it is likely that most of these types of vaccine breakthrough cases seek medical care and are diagnosed and reported as a COVID-19 case.
- Persons with asymptomatic or mild cases of vaccine breakthrough infections may not seek testing or medical care and thus these types of vaccine breakthrough cases may be underrepresented in this system. For this reason, CDC relies on a variety of additional surveillance approaches to ensure that it is collecting information on all types of vaccine breakthrough cases.
You May Like: How Much Is Rapid Testing At Cvs
What Can You Do To Stay Safe
In light of the rapid rise in COVID-19 cases, largely driven by the Delta variant, in late July, the CDC updated its COVID-19 prevention guidance. The CDC is now recommending that everyone, including the fully vaccinated, wear a mask in indoor public spaces in areas where COVID-19 transmission is substantial or high.
The new recommendations emphasize that certain populations should continue masking, for instance those who have or live with someone who has a suppressed immune system or an underlying medical condition that puts them at risk for severe disease.
The agency has also urged universal masking for teachers, staff, students, and visitors in K-12 schools, regardless of their vaccination status and the intensity of community transmission in their area.
Another substantial change to the CDC guidelines is the recommendation that fully vaccinated people who have been exposed to someone who has COVID-19 get tested. These people should also wear a mask when indoors in public areas for two weeks after exposure or until test results are negative.
Importantly, says Dr. Meyer, theyre not recommending quarantine after exposure if youre fully vaccinatedjust to wear a mask and get tested. And thats because we think post-vaccination infections are so rare.
But if fully vaccinated people test positive for COVID-19, the CDC recommends they isolate for 10 days.
Whats Required For A Vaccine To Be 100% Effective At Preventing Infection
In order to entirely prevent infection, vaccines would need to induce whats called sterilizing immunity, a type of immunity that prevents a pathogenin this case the coronavirusfrom infecting any cells. If the virus cannot infect cells, then the host cannot transmit it to others.
In a best-case scenario, all vaccines would provide sterilizing immunity, meaning they would protect against disease and prevent transmission. But in practice, most vaccines dont do this. The influenza, rotavirus, and pertussis vaccines, among others, can prevent serious illness from developing, but they dont reach the level of sterilizing immunity.
…The best thing you can do to prevent infectionand therefore transmission to loved ones and people in your communityis to get vaccinated.Jaimie Meyer, MD, MS, a Yale Medicine infectious diseases expert
The same is true for the three authorized COVID-19 vaccines. But studies of the real-world effectiveness of the Pfizer-BioNTech and Moderna vaccines suggest that they can substantially reduce the risk of infection.
And reducing infection is tied to reducing transmission. If youre not infected, you cant transmit, says Dr. Meyer. Vaccines prevent infection therefore, vaccines also prevent onward transmission.
You May Like: Covid Test Cost Cvs
Get The Brand Available
The federal agencies also have approved the mix-and-match approach to getting a booster for people age 18 and older. This means:
- If Pfizer was your primary two-dose series, you can get a booster six months later of either Pfizer, Moderna or Johnson & Johnson.
- If Moderna was your primary two-dose series, you can get a booster six months later of either Moderna, Pfizer or Johnson & Johnson.
- If you received the one-dose Johnson & Johnson vaccine, you can get a booster two months later of either Johnson & Johnson, Pfizer or Moderna.
Do I Need A Covid Test
Testing is still one of the best ways to know for sure if you have COVID. At-home tests are available and allow you to quickly and safely confirm whether you’ve caught COVID or not. You can also get tested at your doctor’s office, clinics, hospitals, and many pharmacies.
The CDC recommends that you get tested three to five days after exposure, even if you do not have any symptoms. You should also wear a face mask indoors for 14 days or until you get a negative COVID test result.
If you do not get tested for COVID, the CDC says that you need to quarantine for 10 days. You might be able to shorten your quarantine if you get a negative COVID test result.
If you get a negative test result on day five or later, the CDC says that you only need to quarantine for seven days. However, you should continue to monitor yourself for symptoms and wear a mask when you are indoors for 14 days after you were exposed.
Read Also: Coronavirus Test Cost Cvs
Trials Focused On Infection Not On Transmission
How can it be that after conducting clinical trials that involved tens of thousands of people, there was still uncertainty about whether the three authorized COVID-19 vaccinesfrom Pfizer-BioNTech, Moderna, and Johnson & Johnsoncould prevent or reduce transmission?
In large part, its because the clinical trials for these vaccines were primarily focused on determining whether the vaccines protected against symptomatic COVID-19 infection. And though the trials showed that the vaccines are very effective in preventing severe disease, hospitalization, and death, none were found to be 100% protective against infection, meaning that some trial participants had mild or asymptomatic COVID-19 cases, even after vaccination.
With the initial coronavirus strain, or even with the Alpha variant, the post-vaccine immune response is usually fast and potent enough that it clears out the infection quicklybefore the virus can spread far in the body or serious symptoms have a chance to develop. But because infection could technically occur, transmission was still considered a possibilityalbeit a remote one.
The Delta variant is showing every day its willingness to outsmart us, said CDC director Rochelle Walensky, MD, MPH, at a recent news briefing.
Breakthrough Cases And Delta: Background
Until recently, scientists were unsure whether fully vaccinated people who became infected with COVID-19 could transmit it to others. But the CDC report released in late July made it clear that some vaccinated people can get Delta in a breakthrough infectionand may be contagious.
The CDC added that breakthrough infections occur in only a small proportion of vaccinated people and of the breakthrough infections, transmission by the vaccinated appears to only be a small part of overall spread of the virus. But the CDC says it does not yet have data on the likelihood of asymptomatic spread among vaccinated people.
So, where does that leave us?
What we do know, says Dr. Meyer, is that there is less circulating virus in the community as a result of vaccination. When we look at vaccinations compared to cases on a population levelwe see that as the number of people vaccinated rises, the number of cases decreases, she says. This is likely due to the fact that people who are vaccinated are not becoming infected as often, but also that they are not forward-transmitting the virus as often.
But more research is needed. The CDC says that “studies are underway to understand the level and duration of transmissibility from Delta vaccine breakthrough infections.”
Recommended Reading: Hank Aaron Dies After Vaccine
How To Protect Against Long Covid
A recently published report in the journal Cell, identified a handful of factors that may help to predict which people are likely to go on to develop long COVID. The analysis lists various potential risk factors of long COVID including:
- The presence and level of autoantibodies
- Epstein-Barr virus in the blood
- Viral load
- Pre-existing type 2 diabetes.
While being aware of conditions that might cause you to be pre-disposed to long COVID is important, experts continue to point out that getting vaccinated is the best way to prevent a COVID infection in the first place.
“More studies are needed in diverse populations with long-term follow-up to better understand the effect vaccines have on long COVID,” Dr. Geng said, adding: “It is important to remember that vaccines are overall effective at reducing COVID infection, and therefore, long COVID, by not getting COVID in the first place.”
Staying up to date with vaccine boosters and making good judgment calls about masking and social distancing are also important steps to prevent COVID-19, said Boden-Albala.
In order to protect yourself and others from long COVID, Boden-Albala said people must evaluate their risk wherever they go.
To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter.