Look beyond breakthrough infections to address COVID-19’s core problems


The highly contagious Delta variant has fueled a surge in COVID-19 cases this summer, becoming the dominant strain of the SARS-CoV-2 virus in the U.S. and prolonging what public health officials have called a “pandemic of the unvaccinated.”

And yet, breakthrough infections – mostly mild or asymptomatic cases of COVID-19 in fully vaccinated individuals – continue to capture more than their share of headlines. Hospitalizations from breakthrough infections account for less than 1% of the total number of cases in the U.S. To put that in further perspective:

Breakthrough infections are an unfortunate and frustrating byproduct of the Delta variant surge. They also serve as a reminder that we must address some of the foundational problems that continue to drive the pandemic, such as vaccine hesitancy and resistance to mask wearing in public indoor spaces. Here are five areas to focus on beyond breakthrough infections that could help us put an end to the pandemic:

1. Persuade unvaccinated people to take their shot

Vaccination rates have been increasing again since the Delta variant surge.

We all know somebody who has avoided getting the COVID-19 vaccine – there are 75 million eligible Americans who haven’t – and their reasoning runs the gamut from apathy to conspiracy.

Countering fears and misinformation with scientific facts can help. For instance, tell anyone worried about long-term side effects that vaccines are designed to work quickly. The Pfizer and Moderna vaccines are in and out of your body in a few days. Any side effects typically surface within 48 hours of vaccination. In fact, throughout our long and successful history with vaccines, there has never been a serious side effect recorded more than 45 days after a shot was administered.

We now have data on more than 380 million doses of COVID-19 vaccines administered in the U.S. through early September and 5.7 billion worldwide. The numbers don’t lie: These vaccines are safe and very effective. They’re also free and easily available at retail pharmacies, grocery stores, doctor’s offices, and UT Southwestern.

There are no more excuses. Take the shot. It is the best way to protect yourself and others.

RELATED READING: How to talk to vaccine holdouts

2. Encourage mask wearing, especially in school.

Let’s go back to the basics about COVID-19.

  • The original SARS-CoV-2 virus and the Delta variant are spread through transmission of respiratory droplets, usually from sneezing, breathing, talking, and coughing.
  • One of the most effective ways to reduce your chance of catching the virus or spreading it is to block access to the body’s airways by wearing a mask that fully covers your nose and mouth.

Children and teachers returned to school in August in North Texas, putting them together indoors for extended periods of time. Children under 12 are not yet eligible for COVID-19 vaccines, and the percentage of 12- to 15-year-olds who have been fully vaccinated remains relatively low. Wearing a mask in school is the best way to protect them from the Delta variant and limit breakthrough infections.

Respiratory viruses continue to spread as long as they can find available human hosts. Masks are an effective way to thwart their efforts. COVID-19 hospitalizations are increasing among children and pediatric ICUs are filling up, which is why the CDC and American Academy of Pediatrics (AAP) have strongly recommend everyone wear a mask at school.

3. Don’t be deterred by booster shots. Vaccines work.

UT Southwestern experts answer your questions about COVID-19.

On Sept. 17, the the FDA's Vaccines and Related Biological Products Advisory Committee voted to recommend a third dose of the Pfizer vaccine to Americans 65 and older and those at high risk of severe illness. The panel of experts rejected the idea of offering booster shots to all vaccinated individuals, expressing confidence that the Pfizer vaccine provides ample protection from serious illness, hospitalization, and death.

The FDA, which does not have to follows the panel's recommendation, is expected to decide on the third round of shots soon.

Data continue to show the vaccines are more than 90% effective at preventing severe disease from COVID-19. Offering a third dose is a proactive move to further protect the most vulnerable populations. It is also aimed at helping the country stay ahead of the virus while more people get fully vaccinated.

4. Don’t underestimate the Delta variant

The UTSW forecasting model shows hospitalizations in DFW.

The number of people hospitalized nationwide for COVID-19 in early September was higher than it has ever been – even during last winter’s surge. Most hospitalized patients are younger (under 50) and unvaccinated, and many are experiencing more severe illness because of the Delta variant, which represents 95% of all positive test samples at UTSW. Pediatric hospitals are also reaching record levels.

North Texans can avoid worst-case scenarios, according to UT Southwestern’s forecasting model, if we accelerate the current rate of vaccination. Fortunately, the latest model shows mask wearing in public in Dallas County has increased in recent weeks, which is helping temper the rise of hospitalizations. If that trend continues and vaccination rates go up, the model predicts steep declines in cases and hospitalizations.

5. Remember the pandemic exacts a very real human toll

The vast majority of patients hospitalized for COVID-19 continue to be the unvaccinated.

In recent weeks, we’ve all seen the gut-wrenching accounts of hospitalized COVID-19 patients who wished they’d gotten vaccinated. A 42-year-old mother of four from Galveston made it her dying wish to “make sure my kids get vaccinated.” She died Aug. 16, two weeks after her husband.

Sadly, this tragedy is not unique. COVID-19 deaths continue to climb, along with case counts.

In a pandemic, our personal decisions and behaviors affect many other people, including our families and communities. The collateral damage of not masking or avoiding the life-saving vaccine can be enormous: orphaned children, overwhelmed hospitals, wrecked businesses, unemployed workers, and frayed family ties, just to name a few.

We need more people to do the right thing, right now for themselves, their families, and their communities:

Get vaccinated, wear a mask, and help slow the spread of the Delta variant.

That is the breakthrough we truly need.

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