Vaccine Breakthrough Questions and Answers

What is a COVID-19 vaccine breakthrough infection? 

A COVID-19 vaccine breakthrough infection is when a person tests positive for SARS-CoV-2 (the virus that causes COVID-19) 14 days or more after their second dose of Pfizer or Moderna COVID-19 vaccine or a single dose of the Janssen (Johnson & Johnson) COVID-19 vaccine. 

How does the Virginia Department of Health (VDH) classify cases that are fully vaccinated? 

VDH ensures a COVID-19 case reported to the Virginia Electronic Disease Surveillance System (VEDSS) matches correctly to that person’s vaccination history in the Virginia Immunization Information System (VIIS). VDH checks that a person’s COVID-19 vaccine was given following the CDC’s Advisory Committee on Immunization Practices’ (ACIP) recommendations. If the second dose of the COVID-19 vaccine was given too early, or too late, it does not meet the ACIP recommendations and the person’s illness would not be counted as a vaccine-breakthrough case. 

Is COVID-19 common in persons who have been fully vaccinated? 

When levels of COVID-19 community transmission are high, the risk of getting COVID-19 is higher for everyone, including people who are vaccinated.  However, COVID-19 infections in people who are fully vaccinated represent a small percentage of reported cases. Because no vaccine is 100% effective, some breakthrough cases are expected.  As the number of people who are vaccinated increases, so will the number of vaccine breakthrough cases, but this does not mean the vaccine is not working. Vaccines are designed to reduce the risk of severe illness and death.  In most cases, vaccinated people who become infected and get sick have mild illness and may be sick for a shorter period of time. Asymptomatic infections among vaccinated people may also occur.  Hospitalizations and deaths among vaccinated people are rare as you can see here.   

If a case’s vaccination records are not found through the Virginia Immunization Information System (VIIS), how else is vaccination status confirmed? 

VDH also uses information provided by the case patient to confirm vaccination status. Case investigators ask that the person provide a copy of their vaccination card or contact the COVID-19 Vaccination Record Request Portal to obtain a copy. 

Does the Virginia Department of Health have vaccination information for Virginians who were vaccinated in other states, at a federal facility, or a FEMA-run vaccine clinic?

VDH has a data-sharing arrangement with the state of Tennessee and recently received vaccination information for Virginians who received their vaccine in Tennessee. VDH is working to implement similar data-sharing arrangements with other adjacent states, including the District of Columbia and Maryland. VDH knows the total number of people vaccinated by federal entities such as the Department of Defense and the Veterans Administration, but their immunization records are not in VIIS. Virginians who received their vaccination at a FEMA-run site are included in VIIS.

For more the most currently reported information on Vaccine Breakthrough Cases, please follow this link to the Case Rates by Vaccination Status dashboard.