What Happens If You Get Covid After the Vaccine

Covid-19 vaccines and infections

When Tom Frederking, 61, of Plainville, Kansas, became fully vaccinated in February, he recalled that he “felt that I had a security blanket thrown over me.”

Frederking is a cancer survivor and was concerned he’d be at greater risk of problems if he got infected.

When he developed a breakthrough Covid infection in August, he did end up having an infusion of protective monoclonal antibodies to help fight off the infection. However, he didn’t end up in the hospital and was able to recuperate at home.

“Through all of this, the only real thing that I’ve had is the congestion,” he says. “I did not lose my sense of smell. I did not lose my sense of taste. I have not had a headache.”

Although it’s not the case for everyone who gets Covid-19 after being vaccinated, his symptoms where relatively mild.

“I’m most definitely glad that I got [the vaccine],” he says. “In fact, I’m telling other people to get it.”

Now that there are Covid-19 vaccines, people talk about Covid-19 breakthrough infections, defined as a positive test 14 days or more after being fully vaccinated.

But what’s it like to actually have one? We asked experts all your questions about breakthrough infections. Plus, why it’s still important to get vaccinated, wear masks, and socially distance.

(Read about Covid-19 vaccine myths no one should fall for.)

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You belong to a very small club

As of July 26, more than 7,500 people who have been vaccinated have ended up in the hospital or died from a breakthrough Covid infection.

While that may seem high, it’s only a fraction of the 167 million people who, like Frederking, are fully vaccinated. And it’s vastly smaller than the more than 600,000 unvaccinated people in the United States who have died of Covid-19 since the start of the pandemic.

“The current breakthrough numbers for Covid are closer to 0.01 percent, which is amazingly low,” says Beth Oller, MD, Kellering’s family physician, based in Stockton, Kansas.

The reason you hear so much about outbreaks is that the denominator, meaning the overall number of people who have gotten shots, is huge, notes William Schaffner, MD, an infectious diseases expert at Vanderbilt University in Nashville.

The more vaccinated people, the greater the number of breakthrough infections. As a percentage, though, it’s still tiny.

You shouldn’t be surprised

Tori Gleason, 41, got her shots in December and January. As a healthcare provider herself (she is a chiropractor in rural western Kansas), she knew from the get-go that she still had a chance of becoming infected.

Gleason felt “like crud” for five days and says her case was probably moderate rather than mild. She was happy she’d been vaccinated.

“I really believe [that] had I not be vaccinated, they would be planning my funeral,” says Gleason. “It really underscores for me the necessary nature of getting vaccinated.”

In clinical trials, the Moderna and Pfizer mRNA vaccines were a whopping 95 percent effective at preventing illness, especially severe illness. They’re “spectacularly effective,” confirms Dr. Schaffner.

But they’re still not 100 percent. Compare that to the annual flu shot, which hovers around 50 percent and, like all vaccines, also has breakthrough infections.

Clinical trials look at generally healthy people who are not necessarily representative of the “real” world.

“They exclude people who don’t have normal immune systems or who are on immunosuppressant drugs,” says S. Wesley Long, MD, PhD, medical director of diagnostic microbiology at Houston Methodist. “You’re trying to determine the best conditions under which the vaccine will work.”

Once the vaccines get to the general population, the equation can change.

Even if vaccinated, the same exposures are a risk

Whether or not you’ve had the vaccine, the same things that put you at risk at the beginning of the pandemic are a problem now—namely being too close to other people and not wearing masks.

Frederking thinks he was infected during an outing with close family members, two of whom were pregnant and not vaccinated. (The CDC recommends that people who are pregnant get the Covid-19 vaccine. It helps protect both the mother and baby after birth as protective antibodies are passed through the placenta.)

With another grandchild on the way, Frederking and his wife had been careful; they were wearing masks in general and limiting where they go. After all of this, he still got Covid.

Gleason thinks she was infected during a 45-minute meeting with an old friend and member of the community.

“I let my guard down,” she says.

(Here are places you’re more likely to contract Covid-19.)

You may not get that sick

Many people who get a breakthrough infection will only have mild symptoms. This was certainly Frederking’s experience, and although Gleason’s symptoms were worse, she was able to recuperate at home and didn’t end up in the hospital.

Your risk of having more severe symptoms is higher if you have a weakened immune system, are older than 65, have conditions like high blood pressure or diabetes, or are overweight.

As many as a third of patients with breakthrough infections have no symptoms at all, according to the American Medical Association.

Meanwhile, only about 0.004 percent of vaccinated people get breakthrough cases that require hospitalization, and an even smaller percentage of those have died, adds Dr. Oller.

“The key point is that the vaccines are still very very good at preventing hospitalization and severe disease and death,” Dr. Long says.

You may already have been vulnerable

Frederking knew that his Covid-19 vaccine might not give him full protection because he had been treated for cancer, which can weaken your immune system and make you more vulnerable to infections.

He was also on ongoing immunotherapy for cancer, and he did not have as strong of an immune response as others to the vaccine.

“The severe breakthrough infections that we see tend to be in older people and those who are more vulnerable because of their immunocompetence,” says Schaffner.

In one study in the journal Clinical Microbiology and Infection, virtually all patients who landed in the hospital with breakthrough infections had a preexisting condition like hypertension or diabetes.

In a CDC sample of breakthrough infections that were either fatal or involved hospitalization, 74 percent were in people 65 or older.

These same people were already at a higher risk for complications from the virus.

As new coronavirus variants emerge, experts debate whether or not a Covid-19 vaccine booster shot is necessary.

On August 13, the U.S. Food and Drug Administration authorized Covid-19 booster shots for certain immunocompromised individuals, saying a third shot could increase protection.

However, fully vaccinated people who are not immunocompromised aren’t yet eligible for a booster shot.

You may or may not have the Delta variant

Neither Gleason nor Frederking knows if they had the Delta variant, which now causes most Covid-19 cases in the United States.

The existing Covid vaccines are effective against Delta, but the variant spreads so easily that it likely is resulting in more breakthrough infections.

“Delta is that it’s so incredibly contagious it’s running through unvaccinated people, and there will be spillover into people who are vaccinated,” says Dr. Schaffner.

© Ergin Yalcin/Getty Images

You still need to get tested

“If you think you have a breakthrough infection, or even if you think there is a high likelihood you have been exposed, please get tested,” says Dr. Oller. “The best way we can keep this virus from continuing to spread is by knowing if we need to isolate.”

Vaccinated people infected with the virus that causes Covid-19 can still pass it on to others, although “you carry the virus for a shorter period of time,” says Dr. Schaffner.

Both Frederking and Gleason have stayed at home since they learned they had Covid-19. Dr. Oller’s advice is to follow local health department guidelines for quarantining.

Find out how long you can test positive after an infection.

Contact your doctor

Although most people with breakthrough infections won’t get that sick, you should still check in with your healthcare provider.

That doesn’t mean actually going into the office where you could spread the virus even further. Gleason set up a telehealth visit, though a phone call might also be enough.

Your healthcare provider can help you monitor the severity of the infection and, if needed, arrange for hospitalization.

Gleason managed her symptoms at home with over-the-counter medications. Frederking mostly stayed at home but, because of his underlying illness, did go into an office to get an infusion of monoclonal antibodies. These boost your immune system to better fight the infection.

Masks and social distancing can still protect you

In July, the CDC updated its mask guidance to say even fully vaccinated people should wear them indoors in public places where the virus is still widespread.

For Gleason, “it’s going to be a mask everywhere if I’m out in public with others and avoiding large gatherings.”

“With the surge of the Delta variant, and how much easier it is to contract, I absolutely think that we should be wearing masks when we are in public, in large gatherings, or around others who aren’t vaccinated or whose vaccination status we don’t know,” stresses Dr. Oller.

(Learn about five reasons to wear a mask that aren’t Covid-19.)

The vaccine is still worth it

Take it not just from the experts but from two people who actually went through the experience.

Frederking is “a believer in the shot,” as is Gleason.

Vaccination is our best defense against Covid but, the more layers of protection you have in place, the less likely you are to get infected, according to Dr. Oller.

“Vaccination, masking, avoiding large crowds-layering; all of these things together decrease risk,” Dr. Oller says. The decision to get a vaccine, she adds, “can literally be a matter of life or death.”

(Find out what eight people say about what it’s like to get the vaccine.)

Eat a bigger breakfast than dinner

In a study in the journal Obesity, one group of obese women consumed 700 calories at breakfast, 500 at lunch, and 200 at dinner. Another group ate the same foods but had 200 calories in the a.m. and 700 at night (lunch stayed the same). After 13 months, the big-breakfast eaters shed 18 pounds, while the big-dinner eaters lost only about seven.

Jog for junk mail

Turn clutter into a challenge: For every piece of junk mail you pull from the mailbox each day, do one lap around your house or building, or up and down a flight of stairs. You’ll burn between 35 and 140 calories per session. Also, check out these weight loss tricks that nutritionists swear by.

Hang a mirror opposite your seat at the table

One study in the Journal of the Association for Consumer Research found that eating in front of mirrors slashed the amount people ate by nearly one-third. Seems having to look yourself in the eye reflects back some of your own inner standards and goals and reminds you of why you’re trying to lose weight in the first place. Make these 30 tiny diet changes that can help you lose a lot of weight.

Don’t take a whiff

A study published in the journal Cell Metabolism found that, at least in mice, the sense of smell may play a significant role in how the body controls hunger and metabolism. Mice that no longer had a sense of smell burned more calories, lost weight, and showed improved sensitivity to insulin compared to mice who still had an intact sense of smell and ate the exact same amount of food. To further prove that smell impacts obesity, the researchers created “super-smeller” mice that had a stronger sense of smell. These mice gained weight and became obese. More research is needed to understand how humans can use their sense of smell to control weight. Diet or exercise: Which is better for weight loss?

Shoot your food

Instead of writing down every morsel, take a picture of it; a visual account may help curb your intake. “Snapping photos and then looking back at them can make people stop and think before indulging,” says nutritionist Joan Salge Blake, RD, author of Nutrition & You. Even your virtuous salad may “show your extra helping of cheese or deep-fried croutons,” Blake cautions.

Stick to wrapped candy

Yes, this is one of the weird weight loss tricks that involve candy. People ate 30 percent less candy when they had to unwrap it first, a Swiss study found. Peeling off the wrapper requires effort, which can make noshers eat less. For more weight loss tricks, read about these 50 breakthroughs doctors wish you knew.

Think about your plate color

Researchers have found that people may eat less food when served on some plates compared with others. For example, one study found that people who were given a white plate at a buffet ate less food than when given a black or red plate teh same size. Check out 13 weight loss tricks even the pros cheat on.

Eat soup before dinner

You might be accustomed to a pre-dinner salad as a calorie-cutting measure, but if leafy greens aren’t your thing, research suggests you can eat soup before dinner and cut down on how much you’ll eat when the main course is served. Research in the journal Appetite found that people who had a low-calorie, thick soup before lunch ate 20 percent less food during the meal compared to people who ate no soup at all. Plus, people who ate soup didn’t report being hungry or feeling less full at the end of the meal. These are the best and worst soups for weight loss.

Make your smoothies thicker

Smoothies are considered one of the most efficient ways to eat a lot of fruit, even vegetables, at once, but one element of your smoothie may have more impact on your waistline than you realize: the drink’s density. Research in The American Journal of Clinical Nutrition found the thicker the drink is, the more full a person feels, no matter the smoothie’s calorie amount. This “phantom fullness”—or feeling full because a food is thick, not high-calorie—may help people from reaching for even more calories later, which the feeling of fullness is gone.

Sleep in a darker room

Getting a full night’s sleep is one of the best ways to control appetite and reduce your risk for weight gain, but the brightness in the room where you sleep may have an impact on your size, too. According to a study in the Proceedings of the National Academy of Sciences of the United States of America, mice who slept in environments with either bright lights or dim illumination (think: a television flickering across the room) eat more compared to mice that snoozed in total darkness. What’s more, the study found that mice that slept with lights on ate at odd times and had interrupted metabolic signals that influenced how often they were hungry. Cut out all light in your bedroom, or slip on a light-blocking sleep mask to help boost your weight-loss goals.

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