CDC: COVID-19 Vaccine Breakthrough Case Investigation and Reporting

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As of October 12, 2021, more than 187 million people in the United States had been fully vaccinated against COVID-19.

During the same time, CDC received reports from 50 U.S. states and territories of 31,895 patients with COVID-19 vaccine breakthrough infection who were hospitalized or died.

There were 7,178 breakthrough deaths, with 6,104 of people aged 65 or older.

The 7,178 deaths are 0.0038% of the 187 million vaccinated.

People aged ≥65 years6,104(85%)

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COVID-19 Vaccine Breakthrough Case Investigation and Reporting

This page provides information and resources to help public health departments and laboratories investigate and report COVID-19 vaccine breakthrough cases.

  • Vaccine breakthrough cases are expected. COVID-19 vaccines are effective and are a critical tool to bring the pandemic under control; however, no vaccine is 100% effective at preventing illness. Some fully vaccinated people will get sick, and some will even be hospitalized or die from COVID-19. However, there is evidence that vaccination may make illness less severe for those who are vaccinated and still get sick. The risk of infection, hospitalization, and death are all much lower in vaccinated people compared to unvaccinated.
  • More than 187 million people in the United States have been fully vaccinated as of October 12, 2021. CDC is monitoring these cases among vaccinated persons and evaluating trends in order to better understand who is at risk for severe COVID-19 following vaccine breakthrough infection. Vaccinated people have also experienced asymptomatic infections.
  • Current data suggest that COVID-19 vaccines authorized for use in the United States offer protection against most SARS-CoV-2 variants circulating in the United States.

What CDC is doing

CDC is leading multiple vaccine effectiveness studies and monitoring vaccine breakthroughs from a network of states to understand how COVID-19 vaccines are working and to identify patterns or trends in:

  • Patients’ characteristics, such as age or underlying medical conditions
  • The specific vaccine that patients received
  • Which SARS-CoV-2 variants are causing the infection

Defining a vaccine breakthrough infection

For the purpose of this surveillance, a vaccine breakthrough infection is defined as the detection of SARS-CoV-2 RNA or antigen in a respiratory specimen collected from a person ≥14 days after they have completed all recommended doses of a U.S. Food and Drug Administration (FDA)-authorized COVID-19 vaccine.

Identifying and investigating hospitalized or fatal vaccine breakthrough cases

CDC monitors reported hospitalized or fatal vaccine breakthrough cases for clustering by patient demographics, geographic location, time since vaccination, vaccine type, and SARS-CoV-2 lineage. Reported data include hospitalized or fatal vaccine breakthrough cases due to any cause, including causes not related to COVID-19.

To the fullest extent possible, respiratory specimens that test positive for SARS-CoV-2 RNA are collected for genomic sequencing to identify the virus lineage that caused the infection.
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Hospitalized or fatal COVID-19 vaccine breakthrough cases reported to CDC as of October 12, 2021

As of October 12, 2021, more than 187 million people in the United States had been fully vaccinated against COVID-19.

During the same time, CDC received reports from 50 U.S. states and territories of 31,895 patients with COVID-19 vaccine breakthrough infection who were hospitalized or died.

DeathsHospitalized, non-fatal*
TotalN=7,178N=24,717
Females3,066(43%)11,655(47%)
People aged ≥65 years6,104(85%)16,509(67%)
Asymptomatic or not COVID-related**951(13%)3,647(15%)

*This table separates all reported vaccine breakthrough infections that resulted in hospitalization and/or death into two columns.  While most deaths were also among hospitalized individuals, a small number were not.

**Includes cases in which the patient did not have symptoms of COVID-19, or their hospitalization or death was not COVID-related. For example, people may be hospitalized for reasons other than COVID-19, such as an auto accident, and test positive when screened upon hospital admission.

Previous data on all vaccine breakthrough cases reported to CDC from January–April 2021 are available.
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COVID-19 vaccines are effective

  • To date, no unexpected patterns have been identified in the case demographics or vaccine characteristics among people with reported vaccine breakthrough infections.
  • COVID-19 vaccines are effective. CDC recommends that everyone 12 years of age and older get a COVID-19 vaccine as soon as they can.
  • A vaccine breakthrough infection happens when a fully vaccinated person gets infected with COVID-19. People with vaccine breakthrough infections may spread COVID-19 to others.
  • Even if you are fully vaccinated, if you live in an area with substantial or high transmission of COVID-19, you will be better protected if you wear a mask when you are in indoor public places.
  • Currently, CDC is recommending that moderately to severely immunocompromised people receive an additional dose of mRNA COVID-19 vaccine at least 28 days after a second dose of Pfizer-BioNTech COVID-19 vaccine or Moderna COVID-19 vaccine.

https://www.cdc.gov/vaccines/covid-19/health-departments/breakthrough-cases.html

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