Testing positive for COVID, even after full vaccination, is not unique to the delta variant. We saw this in the third wave as well with B117. Oftentimes it was in the context of an outbreak investigation. 1/
Fully vaccinated people who tested positive for COVID were overwhelmingly mild cases or completely asymptomatic. 2/
I am seeing the term "breakthrough infection" being used in context of delta variant a lot lately. People testing positive as part of outbreaks (even if fully vaccinated) is not necessarily a bad thing 3/
Two things to consider: oftentimes these individuals are picked up as part of a larger outbreak investigation. If they weren't working or living in a high risk setting, they'd have minimal (or no) symptoms, not get tested, not be a risk to anyone, and be none the wiser 4/
Secondly, the key is to look at the clinical picture. Are the people with full (or partial) vaccination getting sick enough to be hospitalized, or just mild symptoms like a fever/sore throat? The majority of "breakthroughs" are in the mild category 5/
That said, there are (and will be) people with partial and full vaccination who will get sick with COVID and require hospitalization. Certainly this needs to be monitored. Thankfully this has not been a huge issue. 6/
I propose some further precision on breakthrough infections by coining the phrase "Breakthrough infection of concern" (BIOC). In other words, people fully vaccinated or >2w post 1st vaccine dose, who are getting sick enough with COVID to be hospitalized 7/
With delta, we do know there are more BIOCs with people having only received 1 dose, but numbers are still absolutely small. The answer is still vaccinating. 8/8
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