If the vaccinated person feels unwell, should a COVID-19 test be required?


Imagine you had a runny nose and sore throat last night. When you woke up this morning, you started coughing and fever. In the past year, your thoughts will immediately jump to COVID-19. However, if you have been fully vaccinated, you may be thinking: should I still be tested for COVID-19?

As an infectious disease doctor, I am often asked this question. The answer is yes. If you have symptoms of COVID-19, you should be tested for COVID-19 even if you are fully vaccinated.You will not have a high risk of hospitalization or serious illness, but if you are infected May transmit the virus to people who have not been vaccinated, Who may be very sick.

The vaccine is effective, but not 100% effective

Researchers have developed some The amazing COVID-19 vaccine in the past yearThe high efficiency of these vaccines in a tightly controlled clinical trial environment matches their effectiveness in real life.The mRNA vaccines produced by Pfizer and Moderna still exist More than 90% effective in preventing hospitalization or death.

However, this does not mean that you have the same degree of protection from infection.

The latest research estimates that mRNA vaccines provide 70% to 85% protection from infection. It is impossible to know if a person is adequately protected or if they will still develop a mild case if exposed to the coronavirus.

If you are indeed infected, you can still spread the virus. This is why testing is still important.

What is a breakthrough case?

When a person becomes infected with the coronavirus after being fully vaccinated, this is called a breakthrough case. The breakthrough case demonstrates a basic principle of infectious diseases-whether a person is infected depends on a balance between two factors: exposure intensity and immunity.

Exposure intensity It is related to how close an uninfected person is to a highly infectious individual who spews the virus while speaking, and the length of time the two people have been in contact. Immunity is related to the body’s inherent protection against COVID-19. Unvaccinated people who have never been infected with the coronavirus have no protection-after all, this is a brand new virus-and fully vaccinated people will be more protected.

According to the CDC, as of April 30, a total of 10,262 known COVID-19 vaccine breakthrough infections In the U.S. states and territories. These are usually asymptomatic or mildly symptomatic cases, and most do not lead to hospitalization.Breakthrough cases will continue to happen, although these people Unlikely to spread the coronavirus to others Compared with unvaccinated people, They might still be.

What about the coronavirus variants?Well, the world is very lucky, especially the mRNA vaccine Provides important protection against all major variants So far it has appeared.But it is entirely possible that at some point Coronavirus strains may mutate with Partial or complete evasion of vaccine protectionIf you feel uncomfortable, this is another good reason for testing.

As vaccination rates in the U.S. and other countries have risen and the number of daily cases has fallen, It is important to pay close attention to the coronavirusThe COVID-19 test allows officials to track how many viruses are in the community, and a positive test result can help people isolate themselves before they unknowingly spread the virus to others. So yes, if you have related symptoms, please get tested, even if you are fully vaccinated.


Arif R. Savari, Physician, Associate Professor of Infectious Diseases, Head of the Department of Medicine, West Virginia University

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