[ This has become a common refrain among the cautious—and it’s
wrong.] [[link removed]]

NO, VACCINATED PEOPLE ARE NOT ‘JUST AS LIKELY’ TO SPREAD THE
CORONAVIRUS AS UNVACCINATED PEOPLE  
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Craig Spencer
September 23, 2021
The Atlantic
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_ This has become a common refrain among the cautious—and it’s
wrong. _

, Katie Martin / The Atlantic

 

For many fully vaccinated Americans, the Delta surge spoiled what
should’ve been a glorious summer. Those who had cast their masks
aside months ago were asked to dust them off. Many are still taking no
chances. Some have even returned to all the same precautions they took
before getting their shots, including avoiding the company of other
fully vaccinated people.

Among this last group, a common refrain I’ve heard to justify their
renewed vigilance is that “vaccinated people are just as likely to
spread the coronavirus.”

This misunderstanding, born out of confusing statements from
public-health authorities and misleading media headlines, is a shame.
It is resulting in unnecessary fear among vaccinated people, all the
while undermining the public’s understanding of the importance—and
effectiveness—of getting vaccinated.

So let me make one thing clear: Vaccinated people are not as likely to
spread the coronavirus as the unvaccinated. Even in the United States,
where more than half of the population is fully vaccinated, the
unvaccinated are responsible for the overwhelming majority of
transmission.

I understand why people are confused. In April, after months of
public-health experts cautiously promoting the merits of vaccination,
CDC Director Rochelle Walensky cited new real-world data
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the shots’ effectiveness to jubilantly proclaim
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“vaccinated people do not carry the virus.” The CDC later walked
back her comment, but headlines such as “It’s Official: Vaccinated
People Don’t Transmit COVID-19
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had already given many the impression that in addition to their
remarkable protection against infection with the coronavirus, the
shots also prevented them from passing the illness on to others.

Scientists and researchers objected
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warning that there weren’t enough data to support such a
proclamation. Their concerns were prescient. As Delta first took hold
early this summer and then quickly spread, our collective relief
turned into dejection.

An outbreak in Provincetown, Massachusetts—in which 74 percent of
the 469 cases were in the fully vaccinated—forced the CDC to update
its mask guidance and issue a sad and sobering warning: Vaccinated
people infected with the SARS-CoV-2 Delta variant can be just as
contagious
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unvaccinated people.

In the aftermath of the Provincetown announcement, many who had gotten
their shots were confused about what the news meant for them,
especially when headlines
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to imply that vaccinated individuals are as likely to contract and
transmit COVID-19 as the unvaccinated. But this framing missed the
single most important factor in spreading the coronavirus: To spread
the coronavirus, you have to _have_ the coronavirus. And vaccinated
people are far less likely to have the coronavirus—period. If this
was mentioned at all, it was treated as an afterthought.

Despite concern about waning immunity
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vaccines provide the best protection against infection. And if someone
isn’t infected, they can’t spread the coronavirus. It’s truly
that simple. Additionally, for those instances of a vaccinated person
getting a breakthrough case, yes, they _can_ be as infectious as an
unvaccinated person. But they are likely contagious for a shorter
period of time
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compared with the unvaccinated, and they may harbor less infectious
virus
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That’s why getting more people their shots is crucial for
controlling the spread of the coronavirus: Every vaccinated person
helps limit the virus’s ability to hide, replicate, and propagate.

Among the unvaccinated, the virus travels unhindered on a highway with
multiple off-ramps and refueling stations. In the vaccinated, it gets
lost in a maze of dead-end streets and cul-de-sacs. Every so often, it
pieces together an escape route, but in most scenarios, it finds
itself cut off, and its journey ends. It can go no further.

This is borne out by recent data from New York City
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show that more than 96 percent of cases are among the unvaccinated.
Only 0.33 percent of fully vaccinated New Yorkers have been diagnosed
with COVID-19.

To highlight what this means in the real world, imagine two weddings
with 100 guests, one where everyone is unvaccinated and another where
all the guests are vaccinated.

In the unvaccinated wedding group, the likelihood that at least one
of the guests has COVID-19
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present is more susceptible, and the virus will likely infect many
others, given the increased transmissibility of the Delta variant.

At the wedding with exclusively vaccinated attendees, however, the
likelihood that anyone present has COVID-19 is minuscule. Even if
someone present is infected, the likelihood that the other guests will
contract the virus is similarly low, given the protection afforded by
their shots.

This is exactly why vaccine mandates are so important—and why going
to events that exclude unvaccinated people is much, much safer than
those that are open to all. Everyone knows that the vaccines help
protect each individual who gets their shots. But when more people get
vaccinated, this helps keep everyone else (including children and
others ineligible for vaccination) safe as well.

It’s worth acknowledging that even though the vaccines are our best
protection—and still do what we need them to do very well
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not perfect. Vaccinated individuals can experience breakthrough
infections, and when they do, they can potentially infect others. Some
may also develop long COVID, although thankfully the
shots dramatically lower this risk
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These reasons are exactly why, in many circumstances, mitigation
measures such as masking and mandates still make sense to help limit
the spread, even for the vaccinated.

As an emergency-medicine physician, I’ve seen firsthand the
vaccines’ dramatic role in reducing severe outcomes from a virus
that flooded my emergency room early in the pandemic. And as a member
of one of the first groups vaccinated in the rollout, I was kept safe
by the shots while I cared for patients, and they prevented me from
bringing the virus home to my family.

But ultimately, a COVID-19 diagnosis in someone close to me is what
highlighted why the assertion that the vaccinated are as likely to
spread the coronavirus as the unvaccinated is so wrong.

Recently my cousin contacted me when her daughter tested positive for
COVID-19. Her daughter fell ill just weeks before her 12th birthday,
when she would’ve been eligible for a vaccine. My fully vaccinated
cousin spent nearly every moment at her side—always indoors and
usually unmasked—yet never fell ill herself.

“The vaccine seems to be working. It’s magic!” she texted me.
Before getting her shots, she would have almost certainly been
infected, and likely passed it on to others. But the vaccine broke the
chain of transmission. My cousin never spread her daughter’s
COVID-19 to anyone because she never caught it.

_Craig Spencer [[link removed]] is
an emergency-medicine physician and director of global health in
emergency medicine at New York Presbyterian/Columbia University
Medical Center._

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