CDC shares 8 new charts that show how powerful Pfizer’s vaccine is against COVID-19 and the Delta variant

Pfizer BioNTech COVID-19 vaccine
Pfizer BioNTech’s COVID-19 vaccine is called Comirnaty.

  • On Monday, independent experts to the CDC voted unanimously to recommend Pfizer’s vaccine to everyone over 16.
  • Their decision was data-driven, and factored in both the risks and benefits of vaccination.
  • They reviewed graphs and tables showing that, while vaccinated people can get mild infections, Pfizer’s vaccine does a great job keeping people alive and out of the hospital.
  • See more stories on Insider’s business page.

Pfizer’s COVID-19 vaccine is now not only approved for everyone over 16 years old, it’s recommended.

On Monday, an independent advisory committee to the Centers for Disease Control and Prevention voted unanimously to support recommending the vaccine.

The decision of those 14 experts was based on overwhelming evidence that Pfizer’s 2-shot immunization, named Comirnaty, which was fully approved by the Food and Drug Administration last week, is not only safe but also works very well at preventing disease.

The independent experts on the CDC panel cheered on the creation of the COVID-19 vaccines in the midst of a pandemic, calling it a “miraculous accomplishment” and “a moment of incredible scientific innovation.”

Here are eight charts and graphs that lay out why Pfizer’s vaccine was given a big thumbs up:

COVID-19 vaccines are doing a great job keeping people healthy, alive, and out of the hospital.

chart showing vaccinated and unvaccinated hospitalization rates (with vaccinated near zero, and unvaccinated yo-yoing up and down, but staying consistently much higher than vaccinated rates)
Centers for Disease Control and Prevention ACIP meeting Aug. 30, 2021

The CDC committee looked at data from across the US showing unvaccinated adults are being hospitalized for COVID-19 at rates roughly 16 times higher than the vaccinated.

As of August 23, 0.006% of vaccinated Americans have had a severe case of COVID-19, according to CDC data

The number of vaccinated people who’ve died from COVID-19 is even smaller. Of the 636,015 American COVID-19 deaths, just 2,063, or 0.3%  have been in vaccinated people, a tiny fraction when you consider that more than 174 million people are fully vaccinated in the US. 

Unvaccinated people under age 50 are getting hospitalized at especially high rates this year.

graphs show breakdown by age of hospitalization rates in unvaccinated (high) versus vaccinated (near zero)

The CDC tracks these rates of COVID-19 hospitalizations through COVID-NET, a system which collects data from 250 hospitals across 14 states (located in different areas of the country) every week.

It’s true that more vaccinated people are now catching COVID-19, due to the Delta variant. But their cases are generally mild and the vaccines are still preventing severe disease well.

chart showing vaccine effectiveness remains high since introduction of the delta variant

This graph was compiled by the CDC for the advisory committee, and it is based on 14 separate studies from independent experts around the world, who all aimed to evaluate how well COVID-19 vaccines work in the face of the Delta variant.

The blue colored circles represent Pfizer-only studies, while the red circles are for studies that evaluated both Pfizer and Moderna. The Y-axis on the left represents vaccine effectiveness, as determined in each study.

As you can see, the effectiveness of Pfizer, Moderna, and Johnson & Johnson’s vaccines against any infection ranges widely in these new studies, from around 40% to 80%.

That’s in line with what we know about Delta — it is more contagious. Delta spreads more easily from person to person than other variants, and thus vaccinated people are now more vulnerable to COVID-19 infections when they are exposed to other people who are contagious.

However, the COVID-19 vaccine remains over 80% effective against severe disease in all of these new studies, suggesting that the vaccines are still doing their primary job of fighting off severe infections in vaccinated people very well, even with Delta here.

Hospitalizations of vaccinated patients remain rare, even with Delta.

2 graphs showing vaccine effectiveness before and after Delta - pre delta VE: 87% or higher, post Delta VE estimates 39-84%

These two graphs, also created by the CDC, pull together findings from six different studies across the US, UK and Israel, which each aim to compare COVID-19 vaccine effectiveness before and after Delta showed up. 

The blue dots represent pre-Delta effectiveness percentages, while the orange dots represent vaccine effectiveness with Delta. 

As you can see in the graph on the left, vaccine effectiveness is reduced for any symptomatic disease with Delta, but the graph on the right adds more nuance to the story, telling us that hospitalizations and severe COVID-19 cases are still rare in vaccinated people.

So instead of getting really sick and landing in the hospital, fully vaccinated people who catch COVID-19 may have more mundane symptoms, like headache, sniffles, or a fever.

In the young and generally healthy 16-29 year old age group, the amount of suffering that could be avoided through more vaccinations is staggering.

chart showing benefits and risks of pfizer vaccine, with benefits including preventing thousands more hospitalizations and deaths, while risks are mainly a few cases of myocarditis (non-fatal)

This graph takes into account a lower vaccine effectiveness with Delta and still shows (in light blue bars) a huge number of hospitalizations that could now be avoided by using Pfizer’s vaccine in young adults from ages 16 to 29.

For every million doses administered of Pfizer’s vaccine, 9,980 people under 29 could avoid hospitalization from COVID-19.

The dark blue bars represent even more severe intensive care unit COVID-19 cases. For every one million doses of Pfizer’s vaccine administered, 1,300 people from ages 16 to 29 will not end up in the ICU, the CDC estimates.

The red bars on the right directly compare how those tangible benefits outweigh the potential risk of myocarditis for every age group.

Myocarditis is a temporary, treatable condition. 

For every million doses of Pfizer vaccine given, roughly 136 teens and young adults, most of them teenage boys, have a risk of myocarditis after vaccination, the CDC says.

The panel said the benefits of Pfizer’s shot outweigh the very small risk of myocarditis, an inflammation of the heart, in teens and young adults.

chart showing the expected myocarditis cases per one million people vaccinated is in the single digits
Myocarditis is more common among young men from 16-24, as shown in the chart.

This chart shows the number of myocarditis cases to be expected after vaccination with Pfizer’s shot, broken down by age and sex, per million doses. 

It’s estimated here that fewer than 150 myocarditis cases in teens and young adults ages 16-29 would materialize, for every 1 million doses of COVID-19 vaccine given to such young people. 

Meanwhile, hundreds of thousands of COVID-19 cases, some of them life-threatening, could be avoided by vaccination in that same age group. 

Myocarditis is both temporary and treatable, and the risk of potentially developing the heart condition is actually far worse after a viral infection like COVID-19 than it is with vaccination.

Allergic reactions after Pfizer’s vaccine are also exceedingly rare, and treatable.

chat showing anaphylaxis cases per million doses of pfizer's vaccine is about 5

In the table above, the line circled in red shows the number of expected anaphylaxis cases per million doses of vaccine administered, for Pfizer, Moderna, and Johnson & Johnson’s shots.

For Pfizer, the expected rate of anaphylaxis after vaccination is now five cases per million shots given, which is less than half of what experts initially thought

Anaphylaxis is generally treatable with epinephrine, which all COVID-19 vaccination sites nationwide are required to have on hand.

“I’m delighted to say that we now have a fully FDA approved, CDC recommended vaccine available,” CDC Director Rochelle Walensky said during a white house briefing on Tuesday afternoon, in a nod to all this new data.

“For anyone who’s been waiting to get vaccinated until we had more evidence on safety and effectiveness, I hope yesterday’s announcement will have you join the more than 170 million people who have decided to protect themselves against COVID 19 by getting vaccinated.”

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The pandemic end game isn’t here yet. But if we play our cards right, things will start getting better in 2023.

A spinning wheel with alternating blue and red vaccine and mask options and a single small yellow option labeled "FREEDOM." The background is purple and smaller coronavirus shapes are scattered around.
“People feel like, ‘Oh, we thought COVID was over.’ Well, no. Half the US population is still not vaccinated. And the world is struggling to get vaccinated,” the epidemiologist Saskia Popescu told Insider.

  • The US hasn’t vaccinated enough people to stop the Delta variant from spreading.
  • It’s possible that by 2023 things might feel safer again, but only if more people get vaccinated.
  • Insider spoke with experts who said we need to better manage expectations for what’s ahead.
  • See more stories on Insider’s business page.

After more than 18 months of living with COVID-19, everyone’s exhausted.

The Delta variant is by some estimates a thousand times as infectious as previous versions of the virus, which means masks are back (even for the vaccinated, in many places). The CDC is stressing that “the war has changed” and not for the better.

But after speaking with half a dozen of America’s leading experts on COVID-19, it’s clear that we still shouldn’t feel defeated.

Right now, we are the tortoise in the middle of a critical race against the virus, which appears to have the winning, twitch-like reflexes of a hare. It’s becoming more contagious, even achieving mild infections and transmission in the fully vaccinated population, prompting new booster-dose guidance from the federal government.

“People are emotionally and mentally drained,” the epidemiologist and infection prevention expert Saskia Popescu said, lamenting how complicated it is to communicate the evolving science of the virus and to combat the novel virus itself.

Even so, the truth is we do still have the upper hand in the long run: Vaccines work and can help us win this war.

It’s just going to take longer than many of us thought – at least a few more years before we can live truly postpandemic.

We’re still headed in the right direction – we just have to be nimble

Young kids in masks walk up the stairs against a red wall at a primary school.
Primary-school students in their face masks.

This may be the most complex part of the pandemic.

Around a quarter of the world is fully vaccinated (including just over half of the US). That is not nearly enough vaccine-induced immunity to end the pandemic, especially with new variants emerging.

Vaccines are doing a very good job keeping people alive, out of the hospital, and healthy. But just because the vaccines work doesn’t mean the pandemic is over.

“I’m very depressed,” the infectious-disease expert Dr. Carlos del Rio, a distinguished professor of medicine at Emory University, said about the sluggish pace of vaccine uptake across the US.

“We didn’t set the right expectations,” said infectious-disease expert Mike Osterholm, the director of the University of Minnesota Center for Infectious Disease Research and Policy. “Most people feel like they don’t need to worry anymore.”

The vaccinated experts I spoke with are still taking lots of precautions and plan to keep doing so.

Dr. Paul Offit, a coinventor of the rotavirus vaccine, said he’s not saying yes to any in-person conferences, even those scheduled for the end of 2022. “I’m waiting,” he said.

So is Dr. Stanley Perlman, who’s been studying coronaviruses for more than three decades. He’s fully vaccinated, but is still double-masking when he goes to the movie theater and socially distancing when he has friends over to his home in Iowa (a state that’s logging more than 700 new COVID-19 cases a day).

“I don’t know anything else you can do on the individual level, except protect yourself and protect the people around you,” he said.

Vaccine protection will likely wane in the months and years ahead. That means mitigation measures like masks in indoor public spaces should still be a part of life while we work out an effective long-term disease-fighting strategy, whether it ends up looking like what we have for flu shots (boosters every year) or tetanus (boosters every decade).

“I am hopeful for the future, but I also know that this is going to be a lot longer of a struggle than people realize.” Popescu said.

Yes, the vaccine goalposts have moved

a cdc vaccine card with an arrow pointing at the line that says 'other' for additional doses of vaccines
CDC vaccine cards already have extra lines on them for “other” doses.

The US did not vaccinate fast enough to build up a strong base of viral protection before Delta took over. Instead, as some people got their shots, we all eased up rapidly on mitigation measures.

And with Delta here, the number of people who must get vaccinated for society-wide “herd immunity” protection to kick in has gone way up.

Offit shared some back-of-the-napkin math on this, based on a well-regarded formula he helped develop for herd immunity.

His calculation comes down to two variables: the infectiousness of a disease (which has gone up considerably for COVID-19 with Delta) and the effectiveness of the vaccines (which has gone down slightly for COVID-19 with Delta).

Estimating generously, Offit expects we need at least 90% of the country protected through some combination of vaccinations and previous infections to develop meaningful herd immunity.

Others agree with his rough calculus, which the US hasn’t come close to achieving.

“One end game would be getting 80 to 90% vaccination and/or previously infected,” Perlman said. “That’s the end game. And vaccination is so much better than having infection, because some people will die from infection.”

COVID-19 vaccines also give your body a stronger, broader form of viral protection than infection, teaching it how to fight back better, even in the face of new variants.

By not considering one another, we’re only prolonging the pandemic

Three London police officers detain a anti-lockdown protestor on a sunny afternoon
An anti-lockdown protest in London.

Whether vaccinated Americans are throwing their masks away or getting booster doses sooner than recommended in the hopes of beefing up personal immunity, they all share one thing in common with those who remain unvaccinated. Each mistakenly thinks they can win this race solo.

We are not in “a pandemic of the unvaccinated.” We’re in a pandemic together, and it isn’t over as long as some of us remain unvaccinated.

New data from an under-vaccinated Colorado county showed how it really does take a village to fend off the virus, especially with Delta at play. Only 36% of vaccine-eligible residents in Mesa County got their COVID-19 shots.

Research subsequently found that the vaccine was less than 80% effective against Delta in that area, while in the rest of Colorado, where more residents were vaccinated, the vaccines were nearly 90% effective. In other words, an investment in your own health is an investment in your child’s health and your neighbor’s health too.

Kids under 12 still can’t get vaccinated, and many others, including cancer patients, organ transplant recipients, and elderly adults don’t get the same protection from their vaccines that everyone else does. Until more people are vaccinated, none of them are safe.

Popescu said some public health professionals have been surprised by the fierce pockets of vaccine hesitancy during a deadly pandemic, when we have strong data showing how effective and safe the vaccines are. At a time when children under 12 can’t even get vaccines yet, eight states are making it all but illegal to protect them from disease and death by banning mask mandates in class.

​​”There was this assumption that because we all experienced this pandemic, everybody would get on board with these interventions, whether they were masks or vaccines,” Popescu said. “The US has been a prime example on how that doesn’t work. We have serious fractures in getting people to understand community health.”

As a result, the viral finish line is being pushed back for all of us, time and time again.

We need to use every tool we have

a sandwich board outside a restaurant reads: please show PROOF of COVID-19 vaccination for indoor dining or bar
A sign at a restaurant on New York’s Upper West Side on August 17, the first day you had to show proof of COVID-19 vaccination to participate in indoor dining in the city.

If we consistently wear masks and vaccinate more eligible Americans, while being smart about ventilation and crowd control, we can beat the pandemic faster.

If we don’t vaccinate more Americans, this virus will continue to surprise us with more terrifying developments.

“People need to understand that Delta is not the end of what the virus can do,” Dr. James Hildreth, president of Meharry Medical College, said. “If we could all get vaccinated – most of us get vaccinated – we not only protect ourselves in our communities, we limit the possibility that a scarier Delta will arise.”

Don’t lose hope or turn to anger. Adjust your timeline expectations.

two restaurant-goers hold up their CDC vaccine cards. proof of vaccination is mandatory for indoor dining in New York City now.
Alton Thibodeaux and his wife, Jean, wait to go into a restaurant on New York’s Upper West Side on August 17.

There will likely be enough vaccines for everyone on the planet by the end of 2023.

“We have got to get vaccines to the low- and middle-income countries, not just for humanitarian reasons, but because strategically that’s where the variants are going to come from,” Osterholm said. He added that fewer than 1.5% of the world’s poorest countries have gotten a single vaccine dose and virus levels globally have waxed and waned in a somewhat unpredictable fashion.

Even after most of the world is vaccinated, the virus won’t disappear. The best that we can hope for is that it will become an infectious nuisance that we can control and prevent, as we do with polio, measles, chickenpox, and other vaccine-preventable contagious diseases.

“We still give a polio vaccine, even though we haven’t seen a case here in 40 years,” Offit said. “The reason is that polio still exists in the world.”

For the next couple of years, though, we must carefully navigate the waters of public life to avoid long-term illness and preventable deaths.

“I often think about what it must’ve been like during war time, or depression, or some other point in our history where resilience had to be the order of the day,” Hildreth said. “We’re tired of the virus and we want to be done with it, but that’s not going to solve the problem.”

The specter of more contagious and dangerous coronavirus variants will remain until almost the entire world is vaccinated. At that point, hopefully we’ll have built up enough immunity to protect ourselves – and one another – well from severe illness and death.

In a decade, the threat the coronavirus poses will likely still feel more imminent than polio, which has been eliminated everywhere except Afghanistan and Pakistan.

But if we vaccinate almost everyone and discover more treatments, a COVID-19 diagnosis may eventually not feel much more dire getting the common cold or flu, meriting a few days of bed rest.

“We will get to a point, I think, where we’re comfortable that the incidence of cases and deaths is low enough that we don’t feel we need to change our life anymore,” Offit said.

It will probably not be this year or next. But at some point in 2023, life may feel like it used to again.

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Dr. Fauci warns ‘things are going to get worse’ due to Delta variant surges, but doesn’t foresee more lockdowns

  • Dr. Fauci warned that “things will get worse” as cases of the Delta variant continues to spike.
  • “We’re looking not towards lockdown, but we’re looking towards some pain and suffering in the future,” Fauci told ABC.
  • Fauci reiterated the efficacy of vaccines and said “the solution to this is to get vaccinated.”
  • See more stories on Insider’s business page.

Dr. Anthony Fauci, the White House’s chief medical advisor, warned Sunday that “things will get worse” with “pain and suffering ahead” in the current surge in COVID-19 cases in the US, primarily driven by the Delta variant.

“Are we headed towards a period once again where we’re going to see lockdowns, businesses shut down, masks routine for everybody, or is this potentially just a temporary setback?,” ABC’s Jon Karl asked Fauci on Sunday morning.

“Jon, I don’t think we’re going to see lockdowns. I think we have enough of the percentage of people in the country, not enough to crush the outbreak, but I believe enough to allow us to not get into the situation we were in last winter,” Fauci said. “But things are going to get worse. If you look at the numbers, the seven-day average has gone up substantially.”

Fauci added that “we are seeing an outbreak of the unvaccinated,” highlighting the efficacy of vaccines against COVID-19 illness.

Vaccines have proven remarkably effective against both symptomatic infections and severe disease. Less than 0.8% of fully vaccinated Americans have tested positive for COVID-19, according to estimates, with CDC Director Rochelle Walensky stating that 97% of those hospitalized for COVID-19 are unvaccinated.

“We’re looking not towards lockdown, but we’re looking towards some pain and suffering in the future because we’re seeing the cases go up, which is why we’re saying over and over again that the solution to this is to get vaccinated, and this would not be happening,” Fauci said.

Nationwide, COVID-19 cases have risen by 148%, hospitalizations by 73%, and deaths by 13% over the past 14 days, according to a New York Times database, primarily driven by the contagious Delta variant.

The spike in cases caused the Centers for Disease Control to formally recommend that even fully vaccinated Americans wear face coverings indoors in communities with substantial or high COVID-19 spread, which now encompasses most of the country.

Currently, 44 US states and the District of Columbia have substantial or high COVID-19 spread, according to CDC data, are thus subject to the CDC’s guidance for fully vaccinated people to wear masks indoors.

The Delta surge is hitting communities with the lowest vaccination rates the hardest, spurring new, urgent efforts to get reluctant Americans vaccinated.

In four of the five states with the highest rate of COVID-19 cases per 100,000 people, (Louisiana, Florida, Arkansas, Mississippi, and Alabama), less than 50% of residents have received even one dose of the COVID-19 vaccine and less than 40% are fully vaccinated, according to The Times.

Expanded Coverage Module: coronavirus-module

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CDC: COVID-19 outbreak among 346 fully vaccinated people shows those ‘infected with Delta can transmit the virus’

commercial street in provincetown draped with flags
Foot traffic along Commercial street in Provincetown on July 20, 2021.

  • A CDC study of a COVID outbreak suggests vaccinated people may spread the Delta variant just as easily as unvaccinated.
  • The majority of vaccinated people in the study had mild symptoms like headaches and sore throats.
  • The study was a major factor in the CDC’s new mask guidance for vaccinated people.
  • See more stories on Insider’s business page.

The Centers for Disease Control and Prevention released a study on Friday which suggests that fully vaccinated people can transmit the Delta variant of the coronavirus just as easily as the unvaccinated – a find that changes the calculus of what’s safe for vaccinated people to do, now that the Delta variant is responsible for more than 80% of US cases.

“Unlike with other variants, vaccinated people infected with Delta can transmit the virus,” CDC Director Rochelle Walensky said in a statement released alongside the new report.

The study is a big part of the reason why the CDC changed its guidance for vaccinated people on Tuesday, saying that where COVID-19 transmission is substantial or high, vaccinated people should mask up again indoors in public.

Delta was responsible for at least 90% of the cases in this outbreak, according to viral sequencing. It didn’t matter much which shots vaccinated people with Delta infections got, but the most common symptoms – including cough, headache, and sore throat – were mild.

An outbreak among a crowd that was 74% vaccinated

woman wearing vaccine costume walks down street with bikers, pedestrians watching
Dressed as Maxine the Vaccine, Poppy Champlin encourages pedestrians to get vaccinated while promoting her comedy show on Commercial Street in Provincetown on July 24, 2021.

The study, released by the CDC on Friday, followed an outbreak that started in Barnstable County, an area of coastal Massachusetts that’s popular for summer vacations and parties, and attracts people from across the US.

According to the report, during the first half of July, multiple large events were held in an unnamed town there (local media coverage makes clear that it’s Provincetown.). The festivities included “densely packed indoor and outdoor events at venues that included bars, restaurants, guest houses, and rental homes.”

The outbreak is noteworthy, as Massachusetts is a state with a relatively high vaccination rate, with nearly three-quarters of adults fully vaccinated.

Among Massachusetts residents tied to the cluster and tracked by the state health department, 74% of the cases (346 infections) were in fully vaccinated people. The vast majority of the vaccinated infections were among men, with a median age of 42.

But the outbreak extends far beyond Massachusetts, with the total number of cases tied to the outbreak now estimated at more than 830 people, Provincetown Town Manager Alex Morse said on Facebook July 28.

Though the study demonstrates that vaccinated people are at greater risk of infection with Delta, the overwhelming majority of the breakthrough cases in the cluster have been mild, with symptoms including coughs, headaches, sore throats, muscle aches, and fevers. At least four vaccinated people were hospitalized, ranging from ages 20 to 70, but no deaths were reported. Two of the hospitalized patients had underlying conditions.

In other words, the vaccines are still achieving what they were designed to do: prevent severe infections and deaths.

Delta will ‘find any gap in our defenses’

provincetown street with people walking, biking, dog walking, all wearing masks
Pedestrians walk down Commercial Street on May 25, 2020 in Provincetown, Massachusetts.

Experts have been saying for weeks now that the Delta variant spreads both faster and more easily than other versions of the coronavirus, but this study provides some of the first clear evidence for why that’s the case.

Not only is the viral load of a person infected with Delta estimated to be about 1,000 times higher than with other versions of the virus, this study shows that a vaccinated person’s load is roughly equal to an unvaccinated person’s, meaning that vaccinated and unvaccinated people likely spread Delta equally well.

Andy Slavitt, a former senior adviser to President Joe Biden’s coronavirus response team, has called Delta “COVID on steroids,” while a leaked CDC slide presentation obtained by the Washington Post late Thursday said “the war has changed,” now that Delta is here.

The CDC slides also say Delta is more contagious than the common cold – on par with the chickenpox in its ability to spread.

“What the Delta variant will do is that it will find any gap in our defenses,” Hilary Babcock, medical director of infection prevention at Barnes-Jewish Hospital and St. Louis Children’s Hospital in Missouri previously told Insider.

“You have to be really more careful about it all the time.”

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CDC: Color-coded map reveals where Americans need to wear masks again, and where you can go maskless, outside of schools

a map of the US from the CDC showing which counties have the highest transmission rates
People in orange and red-colored counties should wear masks indoors in public, the CDC said Tuesday.

  • The CDC is now recommending that fully vaccinated people wear masks when indoors in public in certain areas.
  • A federal, color-coded map shows the red and orange zones where masks are recommended.
  • See more stories on Insider’s business page.

The Centers for Disease Control and Prevention is now recommending that fully vaccinated people put their masks back on when indoors in public, at least in the areas of the country where COVID-19 is spreading fastest.

CDC Director Rochelle Walensky said Tuesday that “the Delta variant behaves uniquely differently” compared to other versions of the virus, and that vaccinated people “may be contagious and spread the virus to others.”

But the CDC isn’t recommending that everyone mask up again.

The agency’s new guidance is limited to places where COVID-19 transmission is deemed “substantial” or “high,” meaning that there are either more than 50 cases per 100,000 people in the area, over a seven-day period, or that the COVID-19 test positivity rate is higher than 5%.

(The one glaring exception to that rule is in K-12 schools nationwide, where the CDC is now recommending everyone mask up to protect kids and teachers.)

The main reason for the change in the CDC guidance is that, in areas where there is a lot of virus circulating, the risk of getting infected, even for vaccinated people, is now very high. And while vaccination helps protect people from heading to the hospital, or eventually, dying from the disease, it is not a perfect shield against COVID-19. Vaccinated people can get sick, and prolong the pandemic too, by spreading their virus around.

“That’s why we are saying, in areas of substantial or high transmission, even if you are vaccinated, that we believe it’s important to wear a mask in those settings,” Walensky added.

“There are some people who are not able to be fully vaccinated, like children, and some people who are not able to be fully protected even though they are vaccinated, like immunocompromised people. So part of the reason for this guidance is to make sure that we can protect those [people].”

Mask guidelines, broken down by county

To find out if you’re in a place where transmission is substantial or high, you can use the CDC’s COVID Data Tracker, which drills down to the county level.

Much of the US is currently seeing “substantial” (orange), or “high” (red) rates of transmission, where masks are now advised indoors. In the few pockets of “moderate” (yellow) and “low” (blue) zones, fully vaccinated people can go mask-free, according to the CDC.

As an example, here’s what it looks like if you search “Dallas County, Texas” on the CDC’s map:

a map of texas color coded in  blue, yellow, orange, and red, showing where COVID transmission is highest
Transmission is high enough in Dallas County to warrant masks indoors in public, according to the CDC’s new guidance.

Transmission is high in Dallas County, meaning people should wear masks indoors in public, according to the CDC.

Only three US states are entirely in red – Florida, Arkansas, and Louisiana – but Missouri and Mississippi are almost there, with only a few scarce orange, yellow, and blue counties.

Even in New York City, where more than 65% of adults are now fully vaccinated, transmission is in the red or orange zone in all five boroughs, meaning all New Yorkers should mask up indoors in public.

“It is not a welcome piece of news that masking is going to be a part of people’s lives who have already been vaccinated,” Walensky said, stressing that medical experts, when shown the data on Delta infections in the US, “have universally said that this required action.”

This “could have been avoided with higher vaccination coverage,” she added.

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The CDC is expected to recommend masks for vaccinated people in some indoor settings as COVID-19 cases soar

covid masks
Sandra Martínez, owner of Raspadesardina, a Spanish brand that makes festival clothes, sews a face mask at her atelier on June 8, 2020 in Madrid.

As COVID-19 cases rise nationwide, the Centers for Disease Control and Prevention is expected to issue a change in mask-wearing guidance.

CDC director Rochelle Walensky is expected to announce the new guidance on Tuesday afternoon.

It’s unclear whether the guidelines will be targeted towards areas of the country where COVID-19 transmission is high, as the New York Times reported, or if it will focus on people living with unvaccinated children and immunocompromised people, as PBS Newshour White House reporter Yamiche Alcindor tweeted.

The CDC said in May that fully vaccinated people could drop their masks indoors at all times.

That was before the Delta variant was so prevalent in the US.

The Delta variant spreads faster and far more easily than earlier versions of the virus. It can make vaccinated people sick, though they tend to be asymptomatic or have mild symptoms. Experts believe vaccinated people can also more easily transmit the Delta variant of the coronavirus than earlier versions of the disease.

By and large unvaccinated people are the ones who get severely ill COVID-19 and land in the hospital with a risk of death.

This is a developing story.

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A fully vaccinated mom caught COVID-19 after her kids went to summer camp: ‘Our kids are Trojan-horsing us’

hilary young in a hat on the beach with her two daughters, 6 and 3.
Hilary Young (right) with her two daughters, who got sick after attending a summer camp. Young and her 6-year-old both tested positive for COVID-19.

  • A fully vaccinated mom tested positive for COVID-19 after a counselor at her daughter’s summer camp went home sick with the coronavirus.
  • The mother developed cold-like symptoms, but never had a fever or shortness of breath.
  • “My symptoms seemed exactly like a cold,” she said. “Our kids are Trojan-horsing us. They are the way in.”
  • See more stories on Insider’s business page.

After more than a year of careful masking, distancing, and worrying about getting COVID-19, Hilary Young was fully vaccinated with mRNA shots, and ready to have some fun this summer with her family.

“We were having a hot vax summer, and it got derailed,” Young told Insider, after both she and her six-year-old daughter tested positive for COVID-19.

She suspects their illnesses could be part of a much wider outbreak, one that may have started at a summer camp. Anecdotal data suggests there may be many others like it now that the more infectious Delta variant is around, and few vaccinated people are getting tested for their mild, cold-like symptoms.

“All of us with young kids, that’s a huge unvaccinated population,” Young said of kids under 12 (who can’t yet get vaccinated in the US). “I think our kids are Trojan-horsing us. They are the way in.”

She considers her story a cautionary tale about the dangers of COVID-19 spreading among vaccinated adults.

“My worst fear happened, we survived it, and I think that’s a direct result of being vaccinated,” Young, who lives in Philadelphia, Pennsylvania, said.

A trip to the beach, where fully vaccinated adults got sick

Beach houses pictured with sand dunes in Ocean City, New Jersey.

The illnesses began after Young’s daughters attended a summer camp the week before the July 4th weekend.

One of the girls’ counselors went home sick early on in the week. It wasn’t until Friday that campers and their parents learned she’d tested positive for COVID-19.

By then, it had already been three days, and Young’s daughters weren’t showing any symptoms, so they went ahead to join extended family at the beach for the holiday.

“We figured, ‘OK, even if the kids are sick, we’ll all be fine, it’ll be fine, we’re all vaccinated,'” she said.

All weekend, her three-year-old was “crazy cranky.”

“Lots of meltdowns, lots of tantrums, very tired, but no discernible symptoms,” she added.

By Monday evening, her six-year-old felt fatigued. She later developed a low-grade fever, headache, runny nose, and some nausea.

Some older adults in the beach house started feeling unwell too, with fatigue, and sore throats.

“There were six [fully] vaccinated adults in the house,” Young said. “Four of us felt symptoms.”

Young got a lab test for her six-year-old at a pharmacy, which came back positive for COVID-19.

“We have tried so hard for the last year and a half to keep our kids safe,” she said. “I think everyone was very complacent, happy to have their lives back, feeling like this is over.”

More like a cold than COVID-19

Sinus infections last longer than colds, last longer, and require antibiotics.

Young did an at-home BinaxNOW rapid test on herself once she developed symptoms.

“I just started sobbing because it was like, ‘oh my God, I have, COVID, I can’t believe this happening,'” she said, phoning her doctor.

“I was like, ‘what should I do?’ And she was like, ‘nothing … you just have to quarantine and you should be fine.'”

For the vaccinated, COVID-19 can appear like a mild illness.

Young’s symptoms started with a sore throat, then “full-on congestion” and some dizziness. She said she used NyQuil to sleep for about a week, and Tylenol Cold & Sinus to relieve the stuffiness.

“I lost my sense of taste and smell, which is just starting to come back a little bit now,” she added, but “I never had chills. I never had any respiratory issues.”

“It wasn’t that bad for me,” Young added, sharing that some of her unvaccinated friends believe her story is another reason why they don’t need to get shots. She could not disagree more.

“I billed out 25 hours to clients last week,” the branding consultant said. “Despite not feeling well, I was functioning. I don’t think it will be that kind to unvaccinated people.”

What we know about kids and COVID transmission

Though it’s hard to know for sure exactly how she and her daughter caught COVID-19, Young says it’s not hard to imagine how the pathogen might’ve traveled from the camp, through the girls, and then to the vaccinated elders in their beach house.

“I don’t know if you have kids, but my kids are just constantly in my face, there’s no personal space,” she said.

Early research suggests it may be easier to catch COVID-19 from unvaccinated kids now than it was months ago. One Chinese preprint study found the viral load of people with Delta is about 1,000 times higher than earlier versions of the virus.

Delta “can glom on stronger, and cause infection easier,” Dr. Hilary Babcock, medical director of infection prevention at Barnes-Jewish and St. Louis Children’s Hospitals in Missouri, said. Babcock said some fully vaccinated staff at her hospital are getting infected through their kids, too.

“People who are infected are spreading more virus around them, because they have more virus in their respiratory tract,” she added.

However, the same disease prevention measures many educators adopted last year can still work to crush transmission in the classroom. One recent UK preprint even suggests that daily, rapid testing of students can work just as well as isolation at preventing future spread in schools.

The CDC is ‘not going to have the right data’

man in a mask helps a kid roll in an inflatable trampoline during COVID-19 pandemic
Summer camp in Culver City, California on June 14, 2021.

Young wanted to let the CDC know about her breakthrough case, but found there was nowhere to report it to the agency. (The CDC is only keeping close tabs on severe breakthrough cases, those requiring hospitalization.)

“My symptoms seemed exactly like a cold,” Young said. “If we hadn’t known about my daughter’s counselor testing positive, we never would have assumed it was COVID. We never would’ve gotten tested. And we would have gone out into the world.”

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Pfizer’s COVID-19 vaccine works very well against the Delta variant – but only after 2 doses

a 13 year old puts his fist in the air, claiming victory after a nurse gave him a COVID-19 shot
A 13-year-old celebrates after being inoculated on May 13.

  • A UK study suggests two-dose Pfizer and AstraZeneca vaccines work well against Delta infections.
  • After one shot, the vaccines were only 30% to 36% effective against symptomatic Delta infections.
  • But with two shots, Pfizer’s and AstraZeneca’s vaccines were 88% and 67% effective, respectively.
  • See more stories on Insider’s business page.

A study of more than 19,000 teens and adults across the UK provides some of the first compelling, peer-reviewed, and large-scale evidence that you need both doses of two-dose vaccines to get good protection from the Delta variant.

The findings from Public Health England suggest that vaccine protection against Delta is very strong when people get both shots.

But the research, published in The New England Journal of Medicine on Wednesday, showed that just one dose of either Pfizer’s or AstraZeneca’s COVID-19 vaccine protected people from symptomatic infections only about one-third of the time.

“It’s clear how important the second dose is to secure the strongest possible protection against COVID-19 and its variants,” Matt Hancock, the UK’s secretary of state for health and social care, said when an unreviewed preprint of the study was released in May.

When patients were fully vaccinated, with two shots both given at least two weeks to take effect, Pfizer’s COVID-19 vaccine became about 88% effective against symptomatic COVID-19 from the Delta variant, while AstraZeneca’s vaccine was 67% effective against it.

That is almost as good as those vaccines performed in clinical trials before the new variant was detected, but it does suggest that breakthrough infections in vaccinated people will become slightly more common now that Delta is here.

One shot was only about 30% effective against COVID-19 symptoms with Delta

man staring at the camera, about to get COVID-19 shot administered by nurse
A man gets his second vaccine dose in Bridgeport, Connecticut, on April 20.

This study was possible because the UK maintains a national vaccination register and the proportion of positive COVID-19 cases that are sequenced in the UK is far higher than in the US (about 60% as of May).

In their comparison of a patient’s vaccination status, their COVID-19 test results, and variant sequencing to determine whether their infection was caused by the Alpha (B.1.1.7) variant or Delta, researchers were able to determine how well the Delta variant evaded vaccine protection.

With only one shot on board, Pfizer’s vaccine was just 36% effective against symptomatic Delta cases, while AstraZeneca’s vaccine was 30% effective, the researchers found.

Other research suggests that the Delta variant is more contagious, and that may be, in part, because people who are infected tend to shed more virus while they are sick.

The researchers did not estimate vaccine effectiveness for severe disease and death in this study, but other research (and hospital data) suggests that COVID-19 vaccines are still extremely good at keeping people alive and out of hospital beds.

Vaccinated people are starting to report getting sick more often now that Delta is around, but their infections are generally milder, with common symptoms including headaches, runny noses, congestion, and sore throats.

Getting two shots of a vaccine gives the body a chance to develop a more robust immune response to COVID-19, which ramps up its attack on the virus.

“That’s the reason why the second dose is much more reactive,” professor Akiko Iwasaki, who studies viruses at Yale, previously told Insider. “This is a sign that your immune system is working because you develop a much worse response the second time, based on these antibodies and T cells that are detecting the viral antigen and attacking your own cells.”

Even with Delta prevalent, all the usual pandemic protocols, including masking, distancing, and limiting exposure, still help.

“Even modest mask use combined with vaccination can really put the brakes on even the Delta variant,” Christopher Murray, the director of the Institute for Health Metrics and Evaluation, previously told Insider.

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What to do if you’re exposed to COVID-19 after being fully vaccinated, according to experts

Californians at farmers market without masks
People make their way down the aisle at the Farmers Market in Irvine Regional Park on Tuesday, June 15, 2021 in Irvine, CA. Restrictions are lifted at most businesses, and Californians fully vaccinated for COVID-19 can go without masks in most settings.

  • If you’re vaccinated and exposed to COVID-19, most of the experts Insider spoke to said you don’t need to worry unless you have symptoms.
  • You should get tested if you’re symptomatic, but some experts say to get tested after any exposure.
  • If you’re sick, stay away from others – even if it’s not COVID.
  • See more stories on Insider’s business page.

So your roommate has a cold.

You both got vaccinated months ago, yet every time you hear a cough from the next room, you can’t help but wonder if you should get tested for COVID.

Most public health experts would say you’re in the clear – probably not sick and probably not infectious – unless you start to feel symptoms. (Your ailing roommate, however, should get tested.)

Although the COVID-19 vaccines are highly effective at preventing severe illness, “breakthrough” infections are occurring in fully vaccinated people. It might feel like a bad cold, or carry no symptoms at all.

The Delta variant has increased the odds of such an infection, but there are plenty of other viruses going around, Amesh Adalja, senior scholar at Johns Hopkins Center for Health Security, told Insider.

The only way to know for sure is to get tested. But if your roommate’s test comes back positive for COVID-19, what do you do?

Get tested if you develop cold-like symptoms

If you develop a cough, congestion, or a loss of taste and smell after a known exposure, you should get tested regardless of your vaccination status.

Start with a rapid antigen test. In studies, rapid tests were about 72% effective at identifying COVID-19 in symptomatic people and correctly ruled out COVID for about 99.5% of people who had symptoms for other reasons.

You can also take a rapid test at home. They’re more accurate if you get tested every few days, so if you’re initially negative, you might want to test again to be sure. You could also follow up with a PCR test that looks for other viruses as well, Adalja added.

“You also have to remember that now that many people are socially interacting, other viruses have come back – things like rhinovirus and seasonal coronaviruses – so there are other causes of cold-like symptoms,” Adalja said.

If you don’t have symptoms, many experts say you’re probably in the clear

The CDC recommend vaccinated people get tested or quarantine only if they have symptoms of COVID-19.

If you’re symptom-free for more than a week after an exposure, you can relax, according to Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

“The only time you should get tested if you’re fully vaccinated is if you’re symptomatic, no matter what the exposure,” Adalja said.

Charity Dean, a former top-tier official at the California Department of Public Health, told Insider she was “very disappointed” the CDC is not seriously tracking mild or asymptomatic infections in fully vaccinated people. Without that information, we risk missing a more dangerous “escape variant,” Dean told Insider’s Hilary Brueck.

So if you’re making your decision with public health in mind, you may want to get tested even if you don’t have symptoms.

Quarantine if you feel sick or test positive for COVID

COVID-19 or seasonal virus symptoms indicate that you could be infectious to others.

“If the virus reproduces itself well enough in you to cause symptoms, I think that means that you’re likely to be contagious,” Offit told Insider.

Vaccinated people who get COVID may be less contagious than unvaccinated infected people, if their reduced viral loads are any indication.

However, other experts recommend using common sense before deferring to CDC guidelines, which “lack nuance,” emergency physician Leana Wen told CNN.

“I don’t want someone coming into work, who then tells me that they just spent the entire night caring for their spouse who’s ill from COVID,” Wen told CNN. “Should that person really be in a crowded conference room with a whole bunch of other people? Does that sound right? It doesn’t meet the common sense test.”

One thing experts generally agree on: stay away from people if you’re not feeling well.

The norms of the pandemic – mask-wearing, quarantining – still apply if you’re sick and it’s not COVID-19. But if you’re vaccinated and feeling fine, there’s no need to worry, Offit said.

“I think we’re going to drive ourselves crazy if we’re expecting this vaccine to prevent asymptomatic or mildly symptomatic disease,” Offit said. “Just use common sense. If you develop respiratory symptoms, I think it’s probably a good idea to wear a mask.”

Read the original article on Business Insider

Vaccinated people: Your odds of a COVID ‘breakthrough’ infection have gone up. That doesn’t mean you need to panic.

Analysis banner
flaming lips bubble concert
The Flaming Lips staged a concert in January 2021 with both the band and the audience inside inflatable bubbles.

  • Vaccinated people are well protected from severe disease that could be caused by the Delta variant.
  • They can catch COVID-19, but their symptoms may be mild, and the risk of transmitting may be low.
  • The US is in a precarious position, with a half-vaccinated population.
  • See more stories on Insider’s business page.

New York Yankees, Texas wedding guests, and Vegas partygoers are part of an unlucky but growing minority.

They are fully vaccinated people who’ve got cases of COVID-19, as the more contagious Delta variant spreads quickly around the world.

Their illnesses are a reminder that this pandemic is not over, and we urgently need more shots in arms – globally.

Vaccinated people: A shot does not catapult you into a post-pandemic dream world. Don’t be shocked if you go out and socialize unmasked and then later test positive for COVID-19.

It’s nothing to fret about too much: If you get a “breakthrough” infection, it may feel like a cold or be completely asymptomatic.

But with the far more contagious Delta variant at play, your odds of infection are up, and you could also hurt others by spreading an infection around.

“Plague amnesia is going to cause a massive crisis in the United States if people want to forget that we are still in the midst of a pandemic,” said Charity Dean, a former top-tier official at the California Department of Public Health and a key character in Michael Lewis’ new book about the pandemic.

Being vaccinated doesn’t mean you’re 100% immune to COVID-19

vaccine passport israel 4
Israelis showed off their “green passes” as they arrived for a concert for vaccinated seniors at Bloomfield Stadium in Tel Aviv, Israel, on March 5.

Fully vaccinated people have been given license to party by the Centers for Disease Control and Prevention, which said that people who are fully vaccinated can go maskless indoors pretty much everywhere, even in public spaces. (Almost half of the US is fully vaccinated, the CDC said.)

“This is becoming a pandemic of the unvaccinated,” Rochelle Walensky, the director of the CDC, said during a White House briefing on Friday.

That is the CDC’s take-home message in a nutshell: If you are vaccinated, this virus is no longer your concern.

But the reality is, now that the Delta variant dominates, everyone’s odds of getting sick have ticked up, especially as more people are mask-free as they mingle with other households.

Fully vaccinated people who’ve recently said that they tested positive for COVID-19 include Miami County Commissioner Jose Diaz (who’d been working alongside first responders at the Surfside building collapse), reporter Catt Sadler, comedian Gabriel Iglesias, six Texas lawmakers, and the UK Health Secretary Sajid Javid.

The good news is that even with the more contagious Delta variant around, COVID-19 appears to be milder in vaccinated people, who may suffer symptoms such as coughs, headaches, temporary loss of taste and smell, and sore throats. Fully vaccinated people also tend to carry less virus in the back of their nose and throat, meaning they are probably less likely to spread COVID-19 to others, compared to unvaccinated people who are ill.

‘It wasn’t that bad’

Hilary Young, a branding consultant in Philadelphia who’s been fully vaccinated for more than two months, is another person who recently tested positive for COVID-19. She said her symptoms included a mild sore throat, congestion, headache, dizziness, fatigue, insomnia, and the loss of taste and smell.

“My worst fear happened, we survived it, and I think that’s a direct result of being vaccinated,” she said. “It wasn’t that bad for me. I didn’t end up in the hospital. I wasn’t totally knocked out.”

Her story tracks with the data. In the US, unvaccinated people now account for 97% of COVID-19-related hospitalizations, the CDC said.

But many fully vaccinated health experts still remain cautious when they’re out and about, knowing they could contract a mild case of the virus.

“I realize I’m not likely to die if infected,” Professor Don Milton from the University of Maryland, a leading expert on airborne viruses, recently told Insider, explaining his choice to wear an N95 mask when he goes shopping in suburban Maryland.

“I could still get ill, miss work, screw up my vacation, and [there’s] a small risk that I’d have long-term effects. Why take the risk?” he said.

Young agreed.

“I will continue to wear a mask indoors,” she said. “I think, at the very least, that’s something that people should be encouraged to do – especially if you’re at CVS, where people are shopping for what they think is cold medication.”

A vaccine doesn’t operate like a magic wand

Harry Potter magic wand
Vaccines are not magic.

No vaccine has ever been capable of preventing every single case of an illness.

We know this already because each year scientists develop new flu vaccines, which are at best about 60% effective at keeping people flu-free.

Like COVID-19 vaccines, flu vaccines are worth getting because they teach your body how to better fight off future infections, likely making a case of the virus milder if you catch it. Ideally, if enough people get vaccines, the amount of virus circulating in a community would be lower, so that fewer vulnerable people would get sick and die.

Conversely, low vaccination rates, coupled with a far more contagious viral variant such as Delta, put everyone at greater risk of an infection. (Delta is about twice as contagious as Alpha, which is in turn about twice as contagious as the original virus identified in Wuhan, China.)

So wearing masks and limiting exposure to people who may be infected should still be critical components of communitywide disease prevention. Though it’s less likely than it would be if they remained unvaccinated, vaccinated people could also spread COVID-19 to immunocompromised people and to children under 12, as well as their families.

“The bottom line is, we are dealing with a formidable variant in the Delta variant,” Anthony Fauci, President Joe Biden’s chief medical advisor, said during a White House briefing on Friday. He added that “the message loud and clear that we need to reiterate” is that the vaccines continue to offer “strong protection.”

We have to accept that the odds of infection have changed for vaccinated people

disney world coronavirus
Wearing masks and limiting exposure to people who may be infected should still be critical components of communitywide disease prevention.

The CDC doesn’t encourage any of the 160 million vaccinated people across the US who are exposed to COVID-19 to get tested for it, unless they go on to develop symptoms.

Instead, the country relies on data from the UK and Israel to figure out how well COVID-19 can dodge our vaccines.

This puts the US at a disadvantage as the virus continues to morph, doing its best to survive. With Delta around, we know vaccinated people are not as well protected as they once were. Now, we risk missing the signals of a more dangerous variant – something that our existing vaccines would barely combat.

Young is frustrated that the data on her own breakthrough case – which was detected with an at-home test – won’t be recorded anywhere by the CDC. Young said her doctor didn’t encourage her to seek out confirmation with a laboratory test. Instead they said, “You just have to quarantine, and you should be fine.”

Dean said, given the low level of testing and sequencing being done on fully vaccinated people right now, there’s no way the US can keep tabs on the virus well enough. If we want to know how decent the vaccine protection of the country really is, Dean said, we need to know when vaccinated people are getting infected, what variant they have, and how severe their case is.

“It’s very concerning to me that we’re 20 months into the pandemic and we don’t have that capability yet,” she said. “The technology has to move faster than the pathogen.”

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