Vaccination rates across the country are continuing to rise, with nearly 300 million doses given so far. Many sports teams set thresholds to encourage player and staff vaccination as vaccine eligibility criteria expanded in order to get back to in-person games, tournaments, and celebrations.
So the news that nine members of the New York Yankees tested positive for COVID-19 raised some concerns and generated some headlines.
But experts say there is little reason for concern. In fact, this situation shows the vaccines are working as expected, as Brian Cashman, general manager of the Yankees, was quick to note on the Yankees official Twitter account.
In this Q&A, Gopi Patel, MD, Hospital Epidemiologist at The Mount Sinai Hospital, Medical Director for Antimicrobial Stewardship for the Mount Sinai Health System, and Associate Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai, explains why the news about the Yankees provides more evidence that the COVID-19 vaccines are helping to end the pandemic by reducing the number of people who get very sick from the infection.
Many people may have been surprised or concerned when they heard that in one week, nine cases of COVID-19 were found in fully vaccinated members of the New York Yankees organization. Is that a concern to you?
It was a concern in the way it was first presented, which was that even though vaccinated, nine individuals contracted COVID-19. What really should have been emphasized is this: among those nine individuals, one had very mild disease, and the other eight were completely asymptomatic, meaning they did not show any symptoms of infection.
We have to remember that the practices of professional sports teams and the entertainment industry are very different from what we do in day-to-day life. They are tested frequently, in some cases daily, and these cases may not have detected if they didn’t have those protocols in place. What is especially important is, if we go back months ago, these individuals with COVID-19 may not have been asymptomatic. They may have been sick or even hospitalized with severe disease, and maybe in some settings they may have passed away.
Gopi Patel, MD
Although it’s not great for anybody to have COVID-19, what is very encouraging is that this situation with the Yankees shows that these vaccines work. They all received the Johnson and Johnson vaccine. We know vaccines prevent severe disease, hospitalizations, and people passing away from COVID-19. However, no vaccine is 100 percent, so it does mean that we need to emphasize the other things that we recommend: Wear masks and practice social distancing as appropriate. Make sure everybody around you is vaccinated, and practice behaviors that we’ve been asking people to practice if you don’t know the vaccination status of your colleagues or the individuals in your surroundings.
What are asymptomatic infections?
An asymptomatic infection is one where you don’t have symptoms that have been associated with COVID-19. You don’t have fever, you don’t have runny nose, and you don’t have a cough. You don’t feel what we call flu-like. You don’t have aches or pains; you haven’t lost your sense of smell. You don’t really feel sick.
What are breakthrough infections?
Breakthrough infections are infections that have been diagnosed in individuals who are two weeks or more out from their last dose of a COVID-19 vaccine. That’s 14 days or more out from one dose of the Johnson and Johnson vaccine, and that’s 14 days out from the second dose of either the Moderna or the Pfizer vaccines.
Since there is a possibility, albeit small, of a so-called breakthrough infection, should I continue masking and social distancing even though I am fully vaccinated?
It depends on who you’re around. You should feel confident that everyone is “safe” if you’re around a lot of people in your herd or your bubble who are fully vaccinated; if your whole family is vaccinated, and you’re aware of what kind of things they do, your risk of being infected if vaccinated is low. However, people could be immunocompromised, and vaccines are not 100 percent. Those are the patients we worry about with vaccines, because we don’t know how well vaccines will work in that population, although we are learning more, and we still encourage them to get vaccinated after speaking to their providers. If you have someone you’re visiting and they are vaccinated but they have some underlying immunocompromising condition, it’s probably best for you to mask and for them to mask too. If you’re at the grocery store or on public transportation, I would still recommend masking, because you don’t know what’s going on around you, and you don’t really know right now who’s vaccinated and who’s not.
If I am fully vaccinated, should I worry that I could pass the infection along to others?
We still are exploring and learning more about how this infection is transmitted among vaccinated individuals, so in the case of the Yankees, we don’t know how that happened. They did get the Johnson and Johnson vaccine, which is not as highly effective as the Pfizer or Moderna vaccine in preventing symptomatic infections but still very effective at preventing serious infections, hospitalizations, and death. We need to know in the case of the Yankees, was this a specific variant of concern? Was there a “super-spreader event” like an indoor gathering or an outing? We hope to learn more. I’m sure this is being investigated fully. I can’t really tell you if you personally should be worried about a breakthrough infection, but I do think you are less likely to have a severe infection if you are fully vaccinated.
What about spreading the infection to my unvaccinated children?
We always need to be concerned about our kids, depending on how old they are. If they’re less than 12, they may not be eligible to be vaccinated for a little bit longer, so we need to make sure we keep them safe. Those who are vaccinated may still be coming home to someone who is not vaccinated or interacting with someone who can’t be vaccinated at this time, such as those who may be immunocompromised or have other medical problems. It’s best to model the behavior you want kids to model. I’m the parent of a seven year old, so when she is wearing her mask, I’m wearing mine.
Should I be concerned about other people not getting vaccinated?
This is a global pandemic, and we all need to do our part. It’s important that if you have a vaccine story, if there’s a reason that you elected to get vaccinated, you share that story with others. We need to help people get to the place where they’re ready to be vaccinated. Some people have personal concerns about their medical condition; we ask that they speak to their health care provider.
I usually ask people if they can have conversations with at least two other people who are skeptical about vaccines or have concerns about vaccines, in a nonjudgmental way, and try to figure out what their concerns are. At least turn them to the right information, whether it be our website or the Centers for Disease Control or the New York City Department of Health and Mental Hygiene or the New York State Department of Health. I think it’s helpful to get people the information that they need to make the decision that’s best for them. It is one of the things that’s going to help this world get back to normal.