The shock and reality of catching Covid after vaccination

Robin Hauser, a pediatrician in Tampa, Florida, got excited in February. What sets her apart from the vast majority of the tens of millions of other Americans who contracted the virus is this: She fell ill seven weeks after her second dose of the Pfizer BioNTech vaccine.

“I was shocked,” said Hauser. I thought, ‘What the hell? How did this happen?’ I am now telling everyone, including my colleagues, not to be on guard after the vaccine. “

With more Americans being vaccinated every day, a tiny but growing number struggle with the unsettling experience of getting Covid despite being shot once or even two.

In data released Thursday, the Centers for Disease Control and Prevention reported that at least 5,800 people became ill or tested positive for the coronavirus two weeks or more after completing both doses of the Pfizer BioNTech or Moderna vaccine were.

In total, around 78 million Americans are currently fully vaccinated.

These so-called breakthrough infections have occurred in people of all ages. A little more than 40% were in people aged 60 and over and 65% in women. 29% of those infected reported no symptoms, but 7% were hospitalized and just over 1%, 74 people, died, according to the CDC.

Public health officials said breakthrough infections were expected as manufacturers warned loudly and often that the vaccines are not 100% protective. The Pfizer and Moderna versions have consistently been shown to be over 90% effective, most recently for at least six months. Studies have also shown that they are close to 100% effective in ensuring that the small fraction of vaccinated patients who contract the virus do not have severe cases or have to be hospitalized.

Still, people are usually shocked and confused when they become the infrequent breakthrough victim. After months of fear and taking precautions not to get Covid, once they got their shots they felt safe.

Hauser, 52, had stayed home from work to look after her children, aged 21 and 16, who both contracted the virus. She was confident that she was protected. She also looked after her father, who was suffering from cancer.

“It’s a bit of a miracle I didn’t infect him before I realized I was sick too,” said Hauser. In line with the capricious behavior of the virus, Hauser’s husband Brian, who had not yet been vaccinated, was never infected either.

The New Yorker employee Masha Gessen completed the two-shot trial in mid-February. A month later, Gessen fell ill and tested positive after both Gessen’s son and partner Julia Loktev survived attacks of Covid. The experience was “unsettling, even a little traumatic,” said Gessen. Loktev’s disease appeared six days after her first dose.

“The psychological effect of getting the virus after a year in which I was very, very careful and vaccinated, impressed me,” said 54-year-old Gessen in an interview with KHN. “It took me about three weeks to feel normal again.” Gessen wrote about the experience that month in The New Yorker.

Dr. Kami Kim, director of the infectious diseases and international medicine division at the University of South Florida in Tampa, said doctors are equally concerned when these cases arise.

“All of this, while expected, is definitely confusing and frustrating to people, both doctors and patients. We all learn and judge on the way about what is best for our patients and ourselves, ”said Kim.

Vaccine manufacturers said the number of breakthrough cases reported by the CDC isn’t surprising.

Moderna’s most recent analysis of the data from its clinical vaccine study shows that 900 people got Covid after vaccination, which is 90% or more effective for the vaccine, company spokesman Colleen Hussey said.

Pfizer spokeswoman Jerica Pitts said the company would monitor study participants for two years after their second dose to learn more about the Pfizer vaccine’s protection against Covid.

In its reporting, the CDC defines a breakthrough solely as a disease or positive test two weeks or more after full vaccination. But tens of thousands of people who have had a first shot or are just two weeks after their second shot also become infected.

Pfizer and Moderna report data showing infection protection of up to 80% about two weeks after the first shot. However, most experts believe that the protection ranges from 50% to 80%, depending on the length of time after the shot and the individual variation that exists with each vaccine.

The second shot further boosts immunity, but not for a few days, and then builds up over two weeks. Again, this can vary from person to person.

Leslie Fratkin, 60, a freelance photographer in New York City, received her second dose of Pfizer on March 12th. She was surprised when she saw clear symptoms of Covid on March 24 and she was quite ill at home for three days.

“You can’t print the words I said back then,” she said.

The CDC advises people who become eager after a first shot to receive the second dose soon after recovery, with no minimum wait set in place. This is a change from prevailing advice in December and January when some state health departments advised people to wait 90 days after a bout of Covid to get a first or second shot, and most importantly, a second shot.

This important change is supported by studies and experience which suggest that the immunity conferred by the vaccines against infection is stronger and possibly “more stable” over time than immunity from covid infection.

Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, Minneapolis, said more research and better public health advice was urgently needed. For example, is a second dose even needed for people who get Covid after the first dose, or does the infection itself serve as a sufficient booster for the immune system? And if a second shot is recommended, what is the optimal time to wait before getting it?

“These are important practical questions that need to be prioritized,” said Osterholm. “We’re kind of blind now.”

Other countries have handled the introduction of the second dose differently.

In the UK, health officials have postponed the delay for up to 12 weeks to stretch vaccine supplies and prioritize getting at least one shot in the arms of more people faster. In Canada, on April 7, a state vaccine advisory board recommended postponing the second dose for up to four months.

At two press conferences this month, Dr. Anthony Fauci, director of the National Institute for Allergies and Infectious Diseases and avid advisor to President Joe Biden, said the number of breakthrough cases in the US is not a cause for concern. The administration will continue to monitor these instances closely.

An important line of investigation is the role of variants or mutated versions of the original coronavirus in these breakthrough cases. Research suggests that current vaccines against some new variants may be slightly less effective.

Martha Sharan, a CDC spokeswoman, said the agency is now urging states to use genetic sequencing to test virus samples from patients with breakthrough cases to identify variants. For example, in Washington State, eight genetic sequencing variants were found in nine breakout cases reported by April 3.

The Biden government announced today that it will fund $ 1.7 billion in relief efforts law to help the CDC, states, and other jurisdictions more effectively identify and identify variants by scaling genome sequencing efforts to pursue.

The CDC has also set up a national Covid Vaccine Breakthrough Database that state health departments can use to store and manage data.

“We’re lagging behind on sequencing samples,” said Osterholm. “That will give us valuable information.”

KHN senior correspondent JoNel Aleccia contributed to this story.

Steven Findlay, a KHN reporter, contracted Covid 30 days after his first dose and 24 hours after his second dose.

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