WEBVTT 00:00:00.000 --> 00:00:03.241 align:middle line:90% [MUSIC PLAYING] 00:00:03.241 --> 00:00:05.556 align:middle line:90% 00:00:05.556 --> 00:00:07.720 align:middle line:84% ROCHELLE WALENSKY: [INAUDIBLE] on the Delta variant 00:00:07.720 --> 00:00:10.430 align:middle line:84% from several states and other countries 00:00:10.430 --> 00:00:13.620 align:middle line:84% indicate that, in rare occasions, 00:00:13.620 --> 00:00:17.000 align:middle line:84% some vaccinated people infected with the Delta variant 00:00:17.000 --> 00:00:20.390 align:middle line:84% after vaccination may be contagious 00:00:20.390 --> 00:00:23.060 align:middle line:90% and spread the virus to others. 00:00:23.060 --> 00:00:27.060 align:middle line:84% In areas with substantial and high transmission, 00:00:27.060 --> 00:00:31.370 align:middle line:84% CDC recommends fully vaccinated people wear masks 00:00:31.370 --> 00:00:34.340 align:middle line:84% in public indoor settings to help 00:00:34.340 --> 00:00:38.526 align:middle line:84% prevent the spread of the Delta variant and protect others. 00:00:38.526 --> 00:00:41.540 align:middle line:84% MONICA GANDHI: So I think that, essentially, part of the reason 00:00:41.540 --> 00:00:43.310 align:middle line:84% they made that decision is because 00:00:43.310 --> 00:00:44.960 align:middle line:90% in a Provincetown outbreak. 00:00:44.960 --> 00:00:48.800 align:middle line:84% And this was about 60,000 people that descended on Provincetown 00:00:48.800 --> 00:00:52.100 align:middle line:84% at a time that we didn't need to wear masks inside, 00:00:52.100 --> 00:00:55.170 align:middle line:84% happened to be raining that weekend, really 00:00:55.170 --> 00:00:58.070 align:middle line:84% high kind of stress environment for the vaccines, 00:00:58.070 --> 00:01:01.550 align:middle line:84% lots of inside time, no masks, closed windows, 00:01:01.550 --> 00:01:05.030 align:middle line:84% mixed population, some unvaccinated, and really 00:01:05.030 --> 00:01:06.440 align:middle line:90% a lot of intimacy as well. 00:01:06.440 --> 00:01:07.940 align:middle line:84% All of that put together, there was 00:01:07.940 --> 00:01:09.650 align:middle line:84% a high rate of symptomatic breakthroughs 00:01:09.650 --> 00:01:11.360 align:middle line:90% in that outbreak study. 00:01:11.360 --> 00:01:14.090 align:middle line:84% About 3/4 of people had some symptoms. 00:01:14.090 --> 00:01:16.310 align:middle line:84% But luckily, what we really need to do 00:01:16.310 --> 00:01:18.440 align:middle line:84% is quantitate breakthrough infections 00:01:18.440 --> 00:01:22.220 align:middle line:84% under more normal circumstances, not a high stress situation. 00:01:22.220 --> 00:01:24.080 align:middle line:84% Just what are people doing every day? 00:01:24.080 --> 00:01:28.340 align:middle line:84% And really what the data gathered from Virginia 00:01:28.340 --> 00:01:30.560 align:middle line:84% and from Washington state and from Utah, 00:01:30.560 --> 00:01:33.230 align:middle line:84% putting it all together, the real risk is about one 00:01:33.230 --> 00:01:34.250 align:middle line:90% in 5,000. 00:01:34.250 --> 00:01:36.140 align:middle line:84% In more high incidence regions, in 00:01:36.140 --> 00:01:38.030 align:middle line:84% places like San Francisco, where I live, 00:01:38.030 --> 00:01:41.600 align:middle line:84% lower event, so probably even lower in Vermont about one 00:01:41.600 --> 00:01:54.990 align:middle line:90% in 10,000. 00:01:54.990 --> 00:01:56.950 align:middle line:84% The question is, how much can you 00:01:56.950 --> 00:01:58.540 align:middle line:90% spread if you're vaccinated? 00:01:58.540 --> 00:02:01.370 align:middle line:84% And I think there's two ways to think about it, 00:02:01.370 --> 00:02:03.920 align:middle line:84% If you have symptoms and you don't have symptoms. 00:02:03.920 --> 00:02:06.730 align:middle line:84% So if you have symptoms and you have 00:02:06.730 --> 00:02:09.649 align:middle line:84% like a cold or a flu or mild symptomatic breakthrough, 00:02:09.649 --> 00:02:10.449 align:middle line:90% can you spread? 00:02:10.449 --> 00:02:13.390 align:middle line:84% Well, the Provincetown study was just one study, one point 00:02:13.390 --> 00:02:15.820 align:middle line:84% in time, looked like the viral load was the same in vaccinated 00:02:15.820 --> 00:02:17.050 align:middle line:90% and unvaccinated. 00:02:17.050 --> 00:02:19.750 align:middle line:84% But again, it didn't do serial viral loads. 00:02:19.750 --> 00:02:23.200 align:middle line:84% There was a study from Singapore that showed us that among Delta 00:02:23.200 --> 00:02:25.670 align:middle line:84% symptomatic breakthroughs, for one point in time, 00:02:25.670 --> 00:02:27.250 align:middle line:90% the viral load may be the same. 00:02:27.250 --> 00:02:29.200 align:middle line:84% But then the viral load comes down very quickly 00:02:29.200 --> 00:02:32.500 align:middle line:84% in vaccinated individuals, as compared to unvaccinated 00:02:32.500 --> 00:02:33.760 align:middle line:90% that it takes a while. 00:02:33.760 --> 00:02:36.070 align:middle line:84% And that makes sense because your immune system 00:02:36.070 --> 00:02:38.690 align:middle line:84% is going to fight that virus, bring down the viral load. 00:02:38.690 --> 00:02:41.410 align:middle line:84% So you're likely not as transmissible. 00:02:41.410 --> 00:02:44.140 align:middle line:84% There are some people who have had severe breakthroughs 00:02:44.140 --> 00:02:47.330 align:middle line:84% and have needed to be hospitalized after vaccination. 00:02:47.330 --> 00:02:49.940 align:middle line:84% The CDC actually does track this data. 00:02:49.940 --> 00:02:52.660 align:middle line:84% And one thing a lot of people are asking the CDC to do 00:02:52.660 --> 00:02:54.970 align:middle line:84% is please tell us all the characteristics 00:02:54.970 --> 00:02:57.610 align:middle line:84% of those severe breakthroughs because those 00:02:57.610 --> 00:03:00.040 align:middle line:84% are likely the people who are going to need a third shot. 00:03:00.040 --> 00:03:02.440 align:middle line:84% Immunocompromised is definitely going to be on the list. 00:03:02.440 --> 00:03:04.180 align:middle line:84% I think it's really important for the CDC 00:03:04.180 --> 00:03:07.120 align:middle line:84% to give us the demographic data of those severe breakthroughs. 00:03:07.120 --> 00:03:09.610 align:middle line:84% And I actually think our messaging for the last month 00:03:09.610 --> 00:03:11.500 align:middle line:90% has been really not positive. 00:03:11.500 --> 00:03:15.340 align:middle line:84% And really, what's going on is that vaccinated people are 00:03:15.340 --> 00:03:19.090 align:middle line:84% really very protected from severe disease, really high, 00:03:19.090 --> 00:03:23.440 align:middle line:84% over 96% in many studies, and that this risk 00:03:23.440 --> 00:03:26.020 align:middle line:84% of these mild breakthroughs depends on how much community 00:03:26.020 --> 00:03:29.830 align:middle line:84% transmission is in your area but is really quite low if you're 00:03:29.830 --> 00:03:31.370 align:middle line:90% just doing your normal things. 00:03:31.370 --> 00:03:33.550 align:middle line:90% And so one in 10,000. 00:03:33.550 --> 00:03:35.980 align:middle line:84% And so because of that, I think we may have been giving 00:03:35.980 --> 00:03:37.450 align:middle line:84% a message that sounds like the vaccines 00:03:37.450 --> 00:03:39.370 align:middle line:84% aren't working very well, which, to me, 00:03:39.370 --> 00:03:40.720 align:middle line:90% could scare the vaccinated. 00:03:40.720 --> 00:03:43.370 align:middle line:84% And actually doesn't make the unvaccinated 00:03:43.370 --> 00:03:44.630 align:middle line:90% think they should get a vaccine. 00:03:44.630 --> 00:03:48.040 align:middle line:84% So I have been, yes, very upset by the messaging 00:03:48.040 --> 00:03:50.910 align:middle line:84% and think we need to be way more positive. 00:03:50.910 --> 00:03:53.000 align:middle line:90%