Breakthrough Cases: Is Delta Dangerous To The Vaccinated? : Consider This from NPR The delta variant now makes up an estimated 83% of coronavirus cases in the U.S., a sharp increase over recent weeks. Cases are rising more rapidly in places with low rates of vaccination. Arkansas is one of those places. The state's Republican governor, Asa Hutchinson, tells NPR what he's doing to try to convince more people to get a shot.

Amid those localized surges and reports of breakthrough infections, NPR's Alison Aubrey explains how to think about your own risk.

Find more NPR coverage of breakthrough infections here.

In participating regions, you'll also hear a local news segment that will help you make sense of what's going on in your community.

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Will Delta Surge Sway Unvaccinated? Plus: The Truth About 'Breakthrough' Infections

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To some people listening, this sounded like a change in tone.


SEAN HANNITY: Please take COVID seriously. I can't say it enough. Enough people have died. We don't need any more deaths.

CHANG: Sean Hannity, who early on during the pandemic called it a hoax, made a point to tell his Fox News viewers this week that COVID-19 vaccines do work.


HANNITY: And it absolutely makes sense for many Americans to get vaccinated. I believe in science. I believe in the science of vaccination.

CHANG: Hannity said that on Tuesday, the day we learned that the No. 2 Republican in the House, Steve Scalise, who's had full access to the vaccine for many months now, finally got vaccinated. He told a New Orleans newspaper he made that decision because he was worried about the delta variant. That variant has been spreading rapidly, driving COVID surges in areas with low vaccination rates. It now accounts for an estimated 83% of cases in the U.S., according to the CDC.


STEVE DOOCY: If you have the chance, get the shot.

BRIAN KILMEADE: But if you...

DOOCY: It will save your life.

CHANG: Another Fox News personality, Steve Doocy, also spoke up about vaccines on Tuesday, something that he's done in the past. And Senate Minority Leader Mitch McConnell...


MITCH MCCONNELL: Get vaccinated.

CHANG: ...Said this on the same day.


MCCONNELL: This is not complicated. Ninety-seven percent of the people who are in the hospital now for COVID are unvaccinated. So if there's anybody out there willing to listen, get vaccinated.

CHANG: CONSIDER THIS - the coronavirus is spreading rapidly across the country. That's something we could have said a year ago. But now the virus is more transmissible and possibly deadlier. Could that reality encourage more people to finally get vaccinated? - plus, what you need to know about breakthrough infections. From NPR, I'm Ailsa Chang. It's Wednesday, July 21.


CHANG: It's CONSIDER THIS FROM NPR. There are still a lot of powerful anti-vaccine voices out there. On that same night when Sean Hannity made those comments about believing in science, this is what the Fox audience heard on the program right before.


TUCKER CARLSON: The advice they're giving you isn't designed to help. It's designed to make you comply. And you shouldn't comply mindlessly. You're an American adult.

CHANG: Tucker Carlson attacking pro-vaccine messaging - and this was on the program right after Sean Hannity's.


LAURA INGRAHAM: And what about the efficacy of the vaccine itself among adults?

CHANG: That was Laura Ingraham asking about breakthrough infections, which we'll get to later.


INGRAHAM: Something's going on here. Something's going on here. And all they do is want to, you know, attack people who ask questions. OK, I guess they can do that. But it still...

CHANG: A lot of right-leaning voices on Fox News and elsewhere continue to sow mistrust in vaccines. Here's a clip from a panel discussion at CPAC last weekend. That's the Conservative Political Action Conference.


ALEX BERENSON: They were hoping - the government was hoping that they could sort of sucker 90% of the population into getting vaccinated. And it isn't happening, right? There's a...


BERENSON: Younger people are well aware of what the risks really are, and they're well aware of the side effects...

CHANG: After many months of right-wing vaccine skepticism and misinformation, you can see the impact. Recent surveys by the Kaiser Family Foundation have found that there are mainly two kinds of unvaccinated people. In one group, you have people whose attitude could be described as wait and see - like, people who could be convinced to get a shot eventually. In the second group, you have people who say, definitely not - as in, no one could convince them to get vaccinated. Sixty-seven percent of people in that group identify as Republican.

Like we said, the delta variant is causing a surge in nationwide COVID cases and a corresponding rise in hospitalizations, mostly in areas where there's a low rate of vaccination - places like Springfield, Mo.


UNIDENTIFIED REPORTER #1: There are so many patients that doctors and nurses are arriving from other cities to help.

CHANG: Birmingham, Ala.


UNIDENTIFIED REPORTER #2: The lingering COVID-19 pandemic has put such a strain on our health care providers in our area that they are either quitting or retiring early.

CHANG: And Miami, Fla.


UNIDENTIFIED REPORTER #3: Recently, Jackson Health System updated their COVID threat level to high. That's after a 117% increase in COVID patients in 14 days.

CHANG: Another one of those places with a surge in cases is Arkansas. With a vaccination rate around 35%, the state's Republican governor, Asa Hutchinson, recently hit the road to hold a series of community COVID conversations. Basically, these are town halls designed to convince more people to get a shot.


ASA HUTCHINSON: You've got probably 15- to 25% that's not going to be persuaded to get the vaccine. They are hardcore. They actually start talking about bioweapons. But there's a large segment beyond that that have just been hesitant. They want more information.

CHANG: Governor Hutchinson told me it's those people he's focused on winning over. We spoke this week about how.


HUTCHINSON: That's where these community conversations are very, very effective in educating the community, letting them listen to each other, their medical professionals, their pastors or people with experience with COVID. You know, one objector stood up and went through the reasons he didn't want to get the vax. And I said, do you believe in COVID? And he said, yes, but I'm not afraid of it. And then someone else stood up and said, well, I lost two relatives because of COVID. And so that...

CHANG: And did that change that person's mind to get vaccinated?

HUTCHINSON: No, but it might have changed two or three other people's mind to get vaccinated. And we see the minds change as we have these conversations.

CHANG: What about the conspiracy theories? Like, how do you refute something like a theory about bioweapons? What do you do with that?

HUTCHINSON: Well, the only way you can do it - and this is true through history - is to refute it with facts and the truth. And it works. You can, for those that are open-minded, win that argument. But it usually comes from a doctor in the community or a nurse in the community or someone that the community understands and trusts.

CHANG: And how do you know that these conversations are directly leading people to change their minds about the vaccine? Are people coming up to you afterwards and saying, I'm going to get vaccinated now; I wasn't before this conversation started, but now I am?

HUTCHINSON: Well, we actually have a vaccine clinic at each of the town halls that we have. And so you can see them lined up. And these aren't large numbers, but you can see that minds are changed because of the information they got. More significantly, though, we've seen an increase in the vaccination rates since we started these conversations. Now, part of it can be attributed to the risk factor that's increased. But no doubt part of it is because of the community conversations. But it's also not just - it's beneficial because the community engages in it. And whenever we leave...

CHANG: Yeah.

HUTCHINSON: ...The community, they follow up with more action in the community and particularly getting out in the rural areas. So that's the difference we see.

CHANG: Well, if you don't turn this around, if you don't change enough minds in Arkansas about the vaccine, what's the contingency plan at this point? How are things going to look for your state?

HUTCHINSON: Well, we'll take it a step at a time. We want to get the vaccines out. We're going to do everything that we can. If the delta variant or another variant pops up, we're going to have to do all we can to make sure that citizens are protected. And the challenge will be in our hospitals. The challenge will be in our schools. School's 30 days away. We've got to do everything we can to give a safe environment there. And that's why we're concentrating on the vaccines.


CHANG: That was Asa Hutchinson, the Republican governor of Arkansas. There are also new questions this week about so-called breakthrough infections - cases where fully vaccinated people still test positive for the virus. And we should say this isn't unexpected. While COVID-19 vaccines have been proven highly effective at preventing severe disease and death, they don't offer a hundred percent protection from infection.


JEN PSAKI: Let me confirm that yesterday, a fully vaccinated White House official tested positive for COVID-19 off campus.

CHANG: That was White House Press Secretary Jen Psaki on Tuesday. She later confirmed it wasn't the first breakthrough case among White House staff members. And she said that the most recent person to test positive had not been close to the president.


PSAKI: The individual has mild symptoms. We know that there will be breakthrough cases. But as this instance shows, cases in vaccinated individuals are typically mild.

CHANG: So what more do scientists know about breakthrough cases, especially when it comes to the delta variant? I put those questions and a few others to NPR health and science correspondent Allison Aubrey.


CHANG: OK, so people who are fully vaccinated, like myself, are looking for some reassurance right now that they are still going to be protected against this delta variant. Can you offer any reassurance?

ALLISON AUBREY: Yeah, the vaccines are incredibly effective against serious illness from the delta variant. For example, a recent study from the U.K. found that the Pfizer vaccine is 96% effective against hospitalization from the delta variant after two doses.


AUBREY: Now, I talked to Dr. Marc Boom. He's the CEO of Houston Methodist Hospital. He says 90% of the people hospitalized there now with COVID are unvaccinated, and they have doubled the number of COVID patients they had two weeks ago.

MARC BOOM: Every indicator right now is flashing bright red at us and moving at a very quick rate. We're very, obviously, disappointed in this. And frankly, this was entirely avoidable if everybody had gone and gotten vaccinated.

AUBREY: So clearly, unvaccinated people remain at risk.

CHANG: Right, but what about fully vaccinated people testing positive right now? Like, should we be freaking out?

AUBREY: You know, there is a very big difference between simply testing positive and getting sick enough to end up in the hospital with COVID. The whole promise of the vaccines is that they would protect against serious illness and death, and they do. It was not realistic to think that they'd eradicate the virus entirely. So it is not a surprise to hear about a positive test or even a mild case in a fully vaccinated person. I think what is concerning is that the virus is circulating widely again due to the super transmissible delta variant.

CHANG: Yeah.

AUBREY: And there are some breakthrough cases that have led to serious illness. The CDC has reported about 5,500 patients with breakthrough infections who've been hospitalized or died. That's out of 160 million people fully vaccinated in the U.S. But in most cases, Dr. Boom tells me, these patients are vulnerable.

BOOM: By and large, those individuals have underlying significant health risks, like cancer, like transplant, that probably prevented them from mounting a full immune response.

CHANG: Oh, interesting.

AUBREY: The CDC isn't tracking or sort of keeping count of mild breakthrough cases. So there's a bit of an information gap there. But life-threatening breakthrough cases are very rare.

CHANG: OK, so even though the really serious breakthrough cases are very rare, do I need to change my behavior? As someone who's fully vaccinated, do I need to change the way I'm going about life right now? Do I go back to masking, for example?

AUBREY: Well, with the delta variant, scientists say people who are infected seem to release more virus into the air. That's the way the virus spreads. And even if you are vaccinated, there's still a chance you can be exposed and get infected or maybe even pass it on. Los Angeles County, as you know, has already reinstated a mask mandate.


AUBREY: And many experts say it just makes good sense to mask up right now. I spoke to Dr. Bill Miller of the Ohio State University. He says when you walk into a grocery store and you see all the unmasked people, it's concerning.

BILL MILLER: It doesn't make sense to see 95% of people not wearing a mask when we're nowhere near that target level in terms of vaccination. So I personally continue to wear a mask.

AUBREY: And this is especially true if you have kids or immune-compromised people in your household who may not be fully protected.

CHANG: Right, but do most infectious disease experts agree with Miller?

AUBREY: Many do. I mean, experts say you don't have to cancel vacation plans or lock down, but it is time to be cautious again. And masking is a step that's simple and effective. Here's Dr. Marc Boom again.

BOOM: We've let our guard down too far. And if this keeps going up the way it's going up, we're going to need to have everybody masking just to protect everybody and to make sure that we're not spreading the virus unintentionally.

AUBREY: The American Academy of Pediatrics is recommending all kids two and up and staff be masked when school starts again, vaccinated or unvaccinated. And at least one large company, Apple, has delayed its return to office plans given the rise in cases.

CHANG: That was NPR health and science correspondent Allison Aubrey.



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