In early July, as COVID-19 case numbers fell across most of the nation and the end of the pandemic almost seemed at hand, Justin Robinson, 40, flew from San Francisco to New York City to visit a friend. The city was alive and Robinson and his friend “were having a blast.”
This was the closest he’d come to anything like pre-pandemic living, and he remembers, very specifically, the thrill of once again sitting at a bar with a drink before him. “It’s random that that was exciting, but to actually be in a bar, at a bar ...” he says. Simple things, long deferred, sometimes have an unexpected weight.
After his time in New York was up, Robinson flew home to the Bay Area and noticed his allergies seemed to be acting up. That tended to happen any time he traveled, though. So, he went about business as usual, until a few mornings later he woke up feeling like “I’d swam on my side for a while, and my head had filled with water.”
Later that day, Robinson found out he was one of the now tens of thousands of fully vaccinated Californians to experience a breakthrough COVID infection. He cycled through all of the emotions one might expect — frustration that it happened to him, fear he might wind up hospitalized, anger that so many still refused to get the vaccine. In the end, he, like most who have dealt with post-vaccination infections, mostly experienced COVID as a series of cold symptoms — loss of energy and a congestion that seemed to come and go — for about a week.
“I think that a lot of people incorrectly assumed-slash-hoped that we were kind of coming out of the pandemic,” Robinson says. “And I think we’re being consistently proven that that’s not the case yet.”
In California, out of more than 21 million fully vaccinated individuals, the state has counted about 41,000 breakthrough infections. That number, less than 0.2%, is almost certainly low, says Dr. Peter Chin-Hong, an infectious disease specialist at UCSF. It doesn’t account for minor infections that people dismiss as colds or those infections caught through at-home testing and never reported. Indeed, anecdotally, a growing number of people know at least one friend, family member or co-worker who has tested positive despite being fully vaccinated.
What is better known, though, is how few fully vaccinated people have been admitted to the emergency room (1,379 at last count) and how many have died (119). And it should be noted that not every hospital admission or death was necessarily due to the COVID infection. Also worth noting: More than 99% of COVID-related deaths in California are now occurring in the unvaccinated population.
All of this taken together, Chin-Hong says, is proof that, so far, the “vaccine has done its job.” The prospect of breakthrough infections can still be disorienting, he says, and “COVID still has a lot of stigma and meaning.” But, for the vaccinated, this is not 2020 all over again.
“The most important silver lining is you’re not going to get really sick, in general,” he says. “You’re not going to go to the intensive care unit and have a breathing tube. And you certainly have a really, really low chance of dying.”
Chin-Hong likes to compare being vaccinated to having an umbrella during a thunderstorm: There’s still a chance of getting wet, you just won’t have to change your clothes.
JR Miller of Oakland is one of the unlucky folks to have a breakthrough COVID infection.
Nick Otto/Special to The ChronicleFor the most part, JR Miller, 32, says he’s been living a “pretty basic life,” even as Bay Area counties relaxed their rules. If he’s not working at his Oakland home, then he’s working at outdoor cafes. He goes to the gym a few times a week, but hasn’t been out to a club in a year. When friends — all vaccinated — have visited from out of town, they’ve mostly spent their visits hiking or in wine country.
So, two weeks ago, when he started to feel sick, he was caught off guard. “We had literally started to return to life as normal, so the idea I could get infected was hard to accept,” he says.
It felt like “a bad cold,” which was still worse than he had expected. “I’m double vaxxed and I’m a vegetarian and I go to the gym and I drink lots of water,” he says. “By no means did I think I needed to go to the hospital, but I was uncomfortable for a couple days.”
He’s since bounced back, and last weekend, he went on a hike outside Redwood City.
The top five symptoms of breakthrough COVID infections, according to the ongoing ZOE COVID Symptom Study done in conjunction with King’s College London, are headache, runny nose, sore throat, loss of smell and sneezing, something not previously associated with the virus. Essentially, Chin-Hong says, the virus seems to be staying localized in patients’ noses and throats. (Those with breakthrough cases can still transmit the virus, and research is ongoing as to what percentage of breakthrough cases may lead to long-lasting illness also known as long COVID.)
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For the past couple weeks, Jessica Lefebvre, 50, a homeless outreach coordinator who lives in West Oakland, has been working from bed. It wasn’t until she coughed for the first time that it occurred to her she might have COVID. Getting a test was a challenge — it’s easier, she says, to find a vaccine. Finally, though, she came across a Walgreens with at-home tests in stock.
Her breakthrough infection has hit her in waves. It started as allergies and then grew into headaches and trouble sleeping. For a while she thought she was on the mend, only for the body aches — worse even than her recent recovery from a surgery — to start up again. “It’s just been a roller coaster.”
The whole experience has her, like so many others, feeling frustrated. She’s been extra careful — “June 15 didn’t mean anything to me,” Lefebvre says, referencing the state’s date of reopening. She was still careful, she still wore a mask everywhere. “I guess the part that makes me feel — hopeless is the wrong word — defenseless is I’ve done everything right.”
Still, she’s thankful for the vaccine. “I’m convinced if I weren’t vaccinated, I’d be in the hospital right now,” she says. Her body may ache, but “I don’t think what I’m going through is serious. I’m not in the hospital. I’m not on a ventilator, I’m not going to die.”
JR Miller says his breakthrough COVID infection felt like a bad cold. He’s feeling better now, exercising again as he rebounds from the infection.
Nick Otto/Special to The ChronicleAgain and again, those with breakthrough cases say that if they had to get COVID, they’re happy to have gotten it after the vaccine was available.
Lois Hirsch, 78, a retiree living in Noe Valley, doesn’t know how she caught COVID. Maybe it was the baseball game she went to. Whatever the case, getting sick wasn’t ideal — she wound up with a fever and cough. Her doctor prescribed her an antibiotic for “a little bit of pneumonia.” And, in the end, she had to miss a wedding full of family and friends, something she’d been looking forward to.
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But more importantly, she says, the vaccine kept her alive. “I just can’t believe there are people who won’t get a vaccine,” she says. Hirsch remembers when the polio vaccine came out, how one night, after dinner, her mother gathered everybody together and “we went and got shots right away.
“I don’t remember anybody saying they weren’t going to get the polio shot.”
If Carter Gibson, 31, had to guess where he caught COVID, it would be the dance party he went to a couple weeks ago for a friend’s birthday. There were about 100 people there, but it was all outdoors and felt safe enough given that he was vaccinated and case numbers were low.
A couple days later, though, he started to feel tired and an at-home test confirmed he and his partner were positive. “I was bummed, but I was prepared for it,” he says. They’d been talking about risk tolerance a lot, Gibson says. “We had already sort of understood that if we went out we could get it.”
Gibson, who lives in San Francisco, came down with a sore throat and fatigue; his partner had a cough, too. That’s all since passed.
“I don’t think we would change anything we did,” he says. “We just got unlucky.”
Ryan Kost is a San Francisco Chronicle staff writer. Email: [email protected] Twitter: @RyanKost
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