Ken Foggo, owner of Eurekan Art on Main Street, had both Moderna shots for Covid-19, taking the first shot the first day it became available to his age group. As a retailer who has frequent interactions with customers, including many from out of town, he felt relieved he was protected.
“I felt pretty cocky about it,” Foggo said. “I wasn’t wearing masks as much, especially in restaurants. Most of them dropped the mask mandate. I guess we got the idea everything was over. Then I felt a little off at the end of July. I didn’t get very sick, but I tested positive for Covid. The weirdest thing was losing my sense of smell and taste. It was not even as bad as a light case of the flu. It was like a little summer cold. I’ve felt fine ever since. I think because I had the vaccine, it was a light case.”
Foggo’s partner, a fully vaccinated woman who also caught Covid, was more ill, but also recovered. They both quarantined several extra days beyond what was required to make sure they didn’t spread the virus.
Foggo suspects eventually nearly everyone is going to get Covid because of the low vaccination rates locally and the highly contagious nature of the Delta variant.
“You see all the reports of people dying,” Foggo said. “I think everyone knows someone who has passed away because of complications. It is hitting closer to home. Then there are the Covid deniers who deny it right to their deathbed. All I can do is be responsible for myself. Right now, I have the shop open, but there is a sign on the store, ‘Must Wear Mask.’”
Some people have said that not enough attention is being paid to the long-term costs of Covid to the American economy. Delta Airlines recently said that each Covid hospitalization of an employee costs about $50,000. And it is unknown how many people will have “long Covid” or complications that affect their ability to work.
Foggo said he doesn’t look at it economically.
“I just look at it like people should be considerate of others,” he said. “If we were 90 percent vaccinated, we could have ended the pandemic.”
The Arkansas Department of Health (ADH) defines a breakthrough infection as an infection due to Covid-19 in someone fully vaccinated. Recent studies estimate that about 2 out of every 10 people who are fully vaccinated experience symptomatic illness due to the virus, said ADH Public Information Officer Danyelle McNeill.
“Fortunately, very few of those who develop breakthrough illness are severe enough to be admitted to the hospital,” McNeill said. “Since February 1, 91.6 percent of people admitted to the hospital have not been fully vaccinated.”
The Centers for Disease Control and Prevention says that vaccine breakthrough cases are expected.
“Covid-19 vaccines are effective and are a critical tool to bring the pandemic under control,” states a press release from the CDC. “However, no vaccines are 100 percent effective at preventing illness in vaccinated people. There will be a small percentage of fully vaccinated people who still get sick, are hospitalized, or die from Covid-19. More than 161 million people in the United States have been fully vaccinated as of July 19. Like with other vaccines, vaccine breakthrough cases will occur, even though the vaccines are working as expected. Asymptomatic infections among vaccinated people will also occur. There is some evidence that vaccination may make illness less severe for those who are vaccinated and still get sick.”
Vaccinated people can carry similar viral loads with a breakthrough infection, but they are not contagious as long, said Dr. Atul Kothari, Medical Director, Healthcare Associated Infections Program, ADH.
“There is an excellent study from Singapore which helps to answer what happens to viral loads over time in unvaccinated versus vaccinated (breakthrough) infection,” Kothari said. “Based on that study, it seems breakthrough infections have high viral loads, but they decrease very quickly within the first few days, unlike infections in unvaccinated individuals. That’s why the recommendation in vaccinated individuals is to test (prefer PCR) ASAP once symptoms develop, or within 3-5 days of exposure if no symptoms have developed.”
The Singapore study indicated that the chances of a patient requiring oxygen were significantly lower in vaccinated group.
With so many Delta variant breakthrough infections, the FDA has authorized a third vaccine dose and the CDC’s Advisory Committee on Immunization Practices has recommended a third dose for people with moderate or severe immunocompromised who have received Pfizer-BioNTech or Moderna vaccine. People in this category include (but are not limited to) those under treatment for cancer, those with solid organ or bone marrow transplants, those with certain inherited immunocompromising conditions, and those taking certain medications.
Booster doses are controversial, and not all health authorities believe they are necessary. David Leonhardt wrote in The New York Times recently that “vaccine immunity may not really be waning much — which means universal booster shots may do little good.” Leonhardt said the third shot recommendation was based on Israeli data that may have been flawed.
People aged 65 and older represent 74 percent of breakthrough infections. But age by itself is not considered a moderately or severely immunocompromising condition. CDC states the third dose recommended for certain people who are immunocompromised is considered a third dose in the primary series—not a booster shot.
State health departments report vaccine breakthrough cases to CDC. CDC now monitors reported hospitalized or fatal vaccine breakthrough cases for clustering by patient demographics, geographic location, time since vaccination, vaccine type, and SARS-CoV-2 lineage. Reported data include hospitalized or fatal breakthrough cases due to any cause, including causes not related to Covid-19.