What should you do if you get a breakthrough infection? Our expert weighs in
Many people have questions about what to do if they are vaccinated but test positive. Should they isolate, and for how long? What about family members — should they all get tested? What kinds of symptoms should make someone concerned that they might have a breakthrough infection? And how to address skeptics who question getting the vaccine if you can still get the coronavirus?
CNN: What should people do if they get a breakthrough infection? Should they isolate from their household members? Does it matter if they have symptoms?
Isolation means that they should not be going in public where they could infect others. They should also isolate from close household contacts. That means, if possible, staying in a part of the house away from others, in their own room. Essentially, once a person is infected with Covid-19, it doesn’t matter for the purpose of isolation whether they were vaccinated — they could be contagious to others and need to follow standard isolation procedures.
CNN: If one person in the household gets a breakthrough infection, should everyone get tested?
On the other hand, those fully vaccinated, when exposed to a close contact who has Covid-19, do not need to quarantine unless they develop symptoms. They should still get tested within three to five days after exposure and wear a mask in public for extra protection.
CNN: Does that mean a vaccinated person with a Covid-19 exposure can still go to work?
Wen: According to the CDC guidance, yes, as long as that person doesn’t have symptoms, and they keep a mask on at all times and still get tested three to five days after exposure.
This CDC guidance is missing needed nuance. Consider this: Would you be comfortable sitting shoulder to shoulder with a work colleague around a conference table if you knew that this person’s spouse was just diagnosed with Covid-19? Even if the CDC guidance says that this can be done, I think we need to use some common sense, too. If your spouse or child has Covid-19 and you’re still waiting for your coronavirus test, I’d urge you to tell your supervisor and see if you could work from home at least until you get a negative test result.
I’d also distinguish between what was the level of your exposure to the person who tested positive. If you were at an outdoor party and standing next to someone who ended up testing positive, you should still get tested yourself, but your risk of having coronavirus is pretty low, and it might be reasonable to continue going to work — masked, of course. But if it’s your child or partner with whom you spend many hours together, in close, indoor quarters, you are at much higher risk of contracting Covid-19 from them and so should try not to expose others if possible.
CNN: What are the symptoms of breakthrough Covid-19 infections?
Wen: The key benefit of vaccination is that it reduces the likelihood of severe illness. Those vaccinated who still contract coronavirus are much more likely to have mild symptoms compared to if they were not vaccinated. An individual who might have been very ill with high fever, severe cough and so much trouble breathing that they need oxygen or a ventilator, could now instead have body aches, fatigue and the sniffles. That’s the power of vaccination — it reduces the severity of illness.
Given how much coronavirus is surging in most parts of the country, keep your radar on high alert. If something doesn’t feel quite right to you, get tested.
CNN: If you find out you’re positive, should you tell your colleagues? What if you were at a party — do you tell the host?
Wen: You should follow procedures at your workplace. Talk to your manager, who may direct you to your company’s human resources department or someone else who can help with contact tracing. Generally, this would include identifying the individuals with whom you had close contact in the time period that you could have been contagious. This typically includes up to 48 hours before the beginning of your symptoms.
You should definitely think through what social activities you were engaged in during that potentially infectious period. If you were at a party, you should tell the host, as well as guests with whom you can remember spending prolonged periods of time with.
This is work that your local health department’s contact tracers should be conducting, but in many places, they are overwhelmed. Remember, too, that the contact tracers depend on you to recall where you were, and you would know best as to who you were with when. It’s important to let those you could have exposed know as soon as possible; we would want the same courtesy ourselves.
CNN: Do you need to test again before you’re cleared to go back to work?
Wen: No. Assuming you haven’t had a fever for more than 24 hours and your other symptoms are improving, 10 days after the beginning of your symptoms is the isolation period as recommended by the CDC. After that, you can end isolation and go back to work and interact with others.
CNN: Would a booster shot help to reduce breakthrough infections?
CNN: Some people might be asking what’s the point of getting vaccinated if breakthrough infections can still happen?
Why do breakthrough infections still happen? We can think of vaccination as a very good raincoat. The raincoat will keep you dry in a drizzle. It might even work in a thunderstorm. But if you are in thunderstorms day after day, and sometimes going through hurricanes, at some point, you may get wet. The problem isn’t that the raincoat isn’t working — it’s that there is too much bad weather all around you.
That’s what is happening now with Covid-19 around the country. The level of virus is so high that the vaccine alone may not be enough to protect you. That’s why a mask can help, as can reducing the number of high-risk environments you’re in. Ultimately, we need to reduce the level of virus around us — and the best way to do that is through all of us getting vaccinated.
