About 125 fully vaccinated people in Louisiana tested positive for COVID-19 more than two weeks after their last dose.
The fact that there are a small number of “discovery cases” is not a surprise. “I think it is in line with what you would expect from trials,” said Dr. Joe Kanter, the state health officer.
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A recent study by the US Centers for Disease Control and Prevention showed that Pfizer and Moderna vaccines are approximately 90% effective against infection once two weeks have elapsed since the second of the two doses. The Johnson & Johnson single-dose vaccine is approximately 72% effective against moderate to severe disease, according to US studies.
State officials are looking for detection cases to understand the transmission of coronavirus among vaccinated people and whether vaccines may not work as well against certain strains of the virus. And while discovery cases are rare – 126 cases out of 568,968 fully vaccinated people in Louisiana amount to about 0.02%, or about 1 case for every 4,500 people vaccinated so far – these are a reminder that people who were shot should however take precautions such as masking and distancing in public.
“The vaccine is not a blank check to do whatever you want,” said Dr. Julio Figueroa, head of infectious diseases at LSU Health New Orleans.
Discovery cases are sometimes identified by mandatory tests before surgery or return to work, not because vaccinated people have symptoms.
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As more people get vaccinated, the rate of new cases should drop, Figueroa said. This is partly due to the fact that research shows that vaccinated people who still get COVID, regardless of their symptoms, have a lower viral load and are less likely to transmit the disease.
“What we want to do is give up the entire population, viral elimination, so that we have less and less transmission,” Figueroa said.
Other states and researchers are also looking at the cases found, with results that also suggest it is rare. A study from the University of Texas Southwestern Medical Center in Dallas found that only four of the 8,121 employees who were at least two weeks above the final dose were infected – about 0.04%. Another found that only seven of the 14,990 employees at two California hospitals were subsequently infected, a similar rate.
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In Washington state, only about 100 out of 1.2 million people who have been completely vaccinated have tested positive for coronavirus. Most mild symptoms have been experienced, according to the results of clinical trials suggesting that vaccines decrease the severity of the disease. But eight of those discovery cases led to hospitalization, and two people who died were being investigated as discovery cases, according to the Washington State Department of Health; both were over 80 with other health problems.
Louisiana officials did not share data on the severity of the disease in the discovery, nor did they say what vaccine the individuals received.
The CDC recommends that vaccinated people continue to wear masks in public and around unvaccinated people. Experts said these guidelines could be relaxed as more people get shot, but large-scale vaccination is needed to provide a protective blanket for vulnerable people.
“You want to vaccinate the population as much as possible so that you can get herd immunity,” Figueroa said. “Those sensitive people, even if they have been vaccinated, will be protected.”
Emily Woodruff covers public health for The Times-Picayune | New Orleans attorney as a member of the Report for America body.