Getting vaccinated is the most surefire way to keep your family safe from COVID-19. The available vaccines are very effective at preventing both infection and serious illness: according to a study cited by the CDC, researchers found that the vaccine was 94 percent effective in preventing hospitalization from COVID-19. This means that people who had "breakthrough" COVID-19 cases (cases that occur in someone after they have been vaccinated) were far less likely to be hospitalized than unvaccinated people. The vaccine reduces the severity of the disease, in addition to reducing your odds of catching it.
The fact of the matter is, no vaccine is perfect. Everyone's body is different, which means we each process both vaccines and viruses in different ways. Sometimes the intensity of an infection can overwhelm a vaccinated person’s immune system. People who are immunocompromised may be at greater risk. In the case of COVID-19, a breakthrough infection happens when a fully vaccinated person gets infected with the virus. People with COVID-19 breakthrough infections may also spread the disease to others.
Any case of COVID-19 that causes a person to test positive, regardless of the severity of symptoms (or even a lack of symptoms), is considered a breakthrough case.
Breakthrough cases aren't a sign that the vaccine doesn't work — a vaccine is designed to reduce the severity of an infection as much as it’s meant to stop an infection altogether. So while there is a chance you could still get sick after being vaccinated, your chances of being hospitalized with serious or life-threatening symptoms are much lower than those of an unvaccinated person.
Nevertheless, when these breakthrough cases do occur, they should be taken seriously, and action should be taken promptly. Even if you are not showing symptoms, you may still be at risk of infecting others, and if you do develop symptoms, they should be monitored for severity. Here are some guidelines for what to do:
Your first step is to ensure that the illness you’re experiencing is actually COVID-19, and not a flu with similar symptoms. This is especially important as we enter flu season and the spectrum of diseases we encounter grows dramatically. (Learn more about the importance of getting the flu vaccine every year: read “5 Reasons to Get the Flu Vaccine.”)
Doctors recommend that people with symptoms of COVID-19 get tested, regardless of vaccination status.
If a vaccinated person becomes infected with COVID-19, they can spread the virus. Even a vaccinated person with no symptoms who tests positive may be at risk of spreading the virus. To protect your neighbors and your community, it's best to self-isolate, even if you are healthy, vaccinated, and not showing symptoms.
If you test positive for COVID-19, follow your healthcare provider’s advice. Avoid unnecessary human contact, rigorously use sanitization materials, and stay indoors and away from others, even other vaccinated individuals, for as long as your doctor recommends.
How long to isolate depends on your condition and your local regulations. Generally, people can expect to stay isolated for 10 days after they've tested positive. Talk to your healthcare provider before you make the decision to leave isolation.
Editorial note: On December 27, 2021, the CDC (U.S. Centers for Disease Control and Prevention) updated their recommendations for quarantining and isolating after exposure to the virus that causes COVID-19. In a statement, the CDC announced, “People with COVID-19 should isolate for 5 days and if they are asymptomatic or their symptoms are resolving (without fever for 24 hours), follow that by 5 days of wearing a mask when around others to minimize the risk of infecting people they encounter. The change is motivated by science demonstrating that the majority of SARS-CoV-2 transmission occurs early in the course of illness, generally in the 1-2 days prior to onset of symptoms and the 2-3 days after.” Read the full announcement.
Isolating is for people who have tested positive for COVID-19. For those who were exposed to COVID-19 but have not yet gotten tested, or who are awaiting test results, CDC recommendations are a little different.
It is recommended that someone who is exposed to COVID-19, regardless of vaccination status, quarantine for 14 days and self-monitor for signs of a fever. A person in quarantine may test themselves and, if the test is conducted on day five or later, may end their quarantine early if they test negative.
With much of the country at least mostly reopened, being quarantined now can be more disruptive than it was earlier in the pandemic. People, especially parents or caretakers, may find it impossible to manage their lives while staying separated from the family members they must care for.
Experts have prepared numerous tips on navigating this stressful situation:
• If you have children or a person under your care, especially if they are too young for or otherwise unable to receive a vaccine, it’s best to send them someplace else if possible, or to have someone stay in your home to care for them. If this is not an option, isolate and reduce contact as much as possible. If contact is necessary, liberally use sanitization and personal protection products (such as masks) before any contact, and avoid any unnecessary touching.
• Rather than going to the store, use food delivery apps for meals, groceries, and home supplies, or ask friends or neighbors to run these errands for you. Be sure to request no-contact delivery to keep your delivery person safe, and use gloves, a mask, and sanitization equipment. A sick person should not prepare food. If you're the only person capable of preparing food at your home, it is strongly recommended that you find someone who can help you.
• Do not eat in the same room, or use the same utensils and dinnerware, as anyone else in the house. If possible, wash your dishes in a different area than where others are washed, or sanitize the washing area vigorously.
• Find an isolated place to use as your quarantine spot — preferably an area that does not ventilate into the rest of the house, or that has good external ventilation. Maintaining good ventilation in the rest of the house can prevent COVID-19 particles in the air from infecting others.
• If possible, allow only one person to act as your caretaker. Do your best to communicate through digital means otherwise, as contact should be avoided at all times.
• If bathrooms are shared, sanitize surfaces before leaving the room. If you are too unwell to do so, one designated individual should take on this job, and they should use a mask and gloves while doing so. They should also wait as long as possible to clean the bathroom, to give particles in the air time to settle.
Carbon Health’s medical content is reviewed and approved by healthcare professionals before it is published. But note that our knowledge and understanding of COVID-19 are developing and changing very rapidly; if you have questions or concerns about COVID-19 precautions, treatments, and vaccinations, please talk to your healthcare provider.