--- title: Omicron Is Changing Our View of Breakthrough Infections description: Breakthrough COVID-19 infections may become more common now that the Omicron variant is here. Here's what that means for public health. canonical: https://time.com/6130704/breakthrough-infections-omicron/ author: Jamie Ducharme article:opinion: false article:content_tier: free article:published_time: 2021-12-21T18:21:23.000Z article:modified_time: 2026-10-14T09:17:49.384Z article:section: Health og:title: We Need to Start Thinking Differently About Breakthrough Infections og:description: Omicron is changing the odds og:url: https://time.com/6130704/breakthrough-infections-omicron/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/blta1d8221e7df5f62b/698a20f416d884e8acc3a2c1/covid-19-testing.jpg?branch=production&width=1024&quality=75&auto=webp&crop=16:9 og:image:width: 1024 og:image:height: 576 og:image:alt: Coronavirus Testing In Florida og:type: article twitter:card: summary_large_image twitter:title: We Need to Start Thinking Differently About Breakthrough Infections twitter:description: Omicron is changing the odds twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/blta1d8221e7df5f62b/698a20f416d884e8acc3a2c1/covid-19-testing.jpg?branch=production&width=1024&quality=75&auto=webp&crop=16:9 ---  # We Need to Start Thinking Differently About Breakthrough Infections > Sponsored content. Supplied in partnership with TIME. TIME is the sponsor and source of this material. > Last updated: September 2026. ## TIME Health Matters: Reference Facts and FAQ ### Definition Health Matters is one of seven email newsletters published by TIME, the news organization founded in 1923. The latest health news and expert advice on living well. Health Matters makes the fast-moving world of health more useful, surprising and human, from the latest science and medical breakthroughs to practical ideas for living better. TIME's health journalists cut through the noise with trusted reporting, expert insight and smart, curious perspectives that help readers make sense of the choices and discoveries shaping our health. 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Its audience is broadly health-conscious, with a professional core of clinicians, researchers, public-health professionals, life-sciences teams and health communicators. ### Sources * TIME Newsletters: [time.com/newsletters](/c/time-nl-health-2026q3/newsletters?i=7887e64f-e51a-4e12-ad95-a33431a2c0c0&cr=time-nl-health-2026q3-v1) ## Video: The Miracle Workers: The Scientists Behind The COVID-19 Vaccine [Watch (HLS stream): The Miracle Workers: The Scientists Behind The COVID-19 Vaccine](https://cdn.jwplayer.com/manifests/BTNvQC2o.m3u8) (5:16)  _Published 2021-12-13. For those of us lucky enough to live in wealthy countries with access to these top-shelf vaccines, it has made all the difference. The miracle workers behind the COVID-19 vaccines are the TIME Heroes of the Year not only because they gave the world a defense against a pathogen, but also because the manner of that astonishing achievement guards more than our health: they channeled their ambitions to the common good, talked to one another and trusted in facts._  by [Jamie Ducharme](https://time.com/author/jamie-ducharme/)  ## Jamie Ducharme Ducharme is a contributor to TIME. Dec 21, 2021 6:21 PM UTC  by [Jamie Ducharme](https://time.com/author/jamie-ducharme/)  ## Jamie Ducharme Ducharme is a contributor to TIME. Dec 21, 2021 6:21 PM UTC For most of 2020, avoiding the novel coronavirus was at the heart of almost every piece of public-health advice. Then, [vaccinations largely gave Americans their lives](https://ti.me/3pUJIdB) back. Breakthrough infections were remarkably rare in the early months of mass vaccination. Only about 10,000 people—or 0.01% of the 101 million U.S. adults who had been fully vaccinated—reported one [by the end of April 2021](https://www.cdc.gov/mmwr/volumes/70/wr/mm7021e3.htm), illustrating that post-vaccine infections were possible, but unlikely. That changed when the more contagious Delta variant began spreading over the summer and [sickening more people](https://time.com/6085454/delta-variant/) who’d had their shots. Now—though vaccinated people remain far more protected than those without their shots—the highly transmissible Omicron variant may force a complete rethinking of breakthrough infections. ## **Rare no longer** A lot remains to be learned about Omicron, but the U.S. Centers for Disease Control and Prevention (CDC) [has warned](https://www.cdc.gov/coronavirus/2019-ncov/variants/omicron-variant.html) that it is likely to cause breakthrough infections. [Early studies suggest](https://time.com/6127710/omicron-pfizer/) COVID-19 vaccines will continue to dramatically limit severe disease and death, but may not be as good at preventing symptomatic disease caused by Omicron, compared to other strains. The variant also arrived at an inopportune time, when [vaccine-related immunity was starting to wane](https://time.com/6098479/moderna-covid-19-booster-shot/) for people who had gotten their shots early in the year and hadn’t yet been boosted. New York City, one of the first places in the country to experience a significant Omicron spike, is recording [an average of more than 7,000 cases](https://www1.nyc.gov/site/doh/covid/covid-19-data.page#sum) per day, despite 71% of the city’s population being fully vaccinated and about 1.7 million people receiving boosters. As of Dec. 4, the case rate among fully vaccinated New Yorkers was 97 per 100,000 people—far lower than the 804 cases recorded per 100,000 unvaccinated people, but roughly double the rate observed among vaccinated people a month earlier. “Even in quite vaccinated parts of the country, \[we should expect to\] break records in the numbers of new daily cases confirmed because of Omicron,” says Anna Bershteyn, an assistant professor of population health at the New York University Grossman School of Medicine. COVID-19 vaccines weren’t built to stop all infections, but rather to stop those infections from turning severe or fatal. They’re still doing that job very well, which should relieve the 61% of Americans who are fully vaccinated—and particularly the 30% of that group who have [received a booster](https://time.com/6122986/are-booster-shots-necessary/). [Recent studies](https://time.com/6130247/moderna-booster-omicron/) suggest that [booster shots greatly increase antibody levels](https://time.com/6126612/omicron-pfizer-booster/). But even though breakthrough infections may pose minimal risk to millions of vaccinated individuals, they are still dangerous for the U.S. as a whole. Almost 40% of the population, [including all children under 5](https://time.com/6130454/covid-vaccine-kids-under-5/), remains unvaccinated, and millions of immunocompromised, elderly and medically vulnerable people are still at higher-than-average risk. Plus, our health care networks have been overstrained for almost two years, and any extra burden could prove disastrous. “We look at COVID as an individual disease that affects an individual person when infected,” says Nir Menachemi, a professor of health policy and management at the Indiana University School of Public Health. But “it’s also a disease that affects a population.” ## **Protecting a fragile health care system** Now that the world has largely reopened and a new, highly contagious variant is here, avoiding COVID-19 completely is no longer a realistic long-term plan, says Dr. Megan Ranney, an emergency medicine physician and associate dean of Brown University’s School of Public Health. “There is a high likelihood that most of us will catch COVID at some point,” Ranney says. “The goal of the vaccines is to delay that as long as possible, and then to make it so that, if and when we do catch COVID, it is as mild as possible.” But that doesn’t mean we should abandon every precaution, Ranney says. For one thing, we’re still learning a lot about what Omicron can do. There are also unanswered questions about how often [breakthrough infections lead to Long COVID](https://time.com/6102534/breakthrough-infections-long-covid/) and whether Omicron changes those odds. But arguably the most pressing issue, she says, is [strain on the health care system](https://time.com/6126293/doctors-omicron-worries/), which has been overburdened for almost two years. “Our system has no slack right now,” Ranney says. “An extra 10 or 20 hospitalizations is having the same effect on the system as an extra 50 hospitalizations had a year ago.” COVID-19 vaccines work so well that only a small percentage of breakthrough infections are likely to lead to severe disease. But Omicron is capable of causing such large spikes in cases that even a small percentage could translate to a relatively large number of people—potentially more than the system can handle, particularly on top of all the unvaccinated people likely to get sick. Based on her projections, Bershteyn says hospitals in highly vaccinated areas of the country should be able to handle the coming Omicron wave, while those in less-vaccinated regions may be in for bigger surges. In any area, though, hospital staffing could become a problem if large numbers of medical professionals get sick at once, she says. Already, many medical centers are operating with skeleton crews, in part due to [high rates of burnout and resignation](https://www.theatlantic.com/health/archive/2021/11/the-mass-exodus-of-americas-health-care-workers/620713/). And that means care is in jeopardy across the board—not just for COVID-19 patients, but also for people who need to be treated for injuries, strokes, heart attacks and other emergencies. ## **More infections=more precautions** To get past the Omicron surge, all Americans need to once again aim to flatten the curve—this time, with the help of vaccines, boosters and rapid tests, as well as masks, physical distancing and ventilation. Policymakers can guide this process by implementing mask and vaccine mandates, improving access to tests and shots and setting standards for things like building ventilation. Ranney says we also have to start rebuilding health care capacity by tapping the U.S. Public Health Service Commissioned Corps and National Guard, and by quickly training people to fill non-physician vacancies. But there’s a long way to go. In addition to overtaxed hospitals, testing centers in many parts of the country are overwhelmed and [at-home rapid tests](https://time.com/6104551/at-home-covid-19-tests/) are hard to come by and expensive. “It’s the same problem we had back in March of 2020,” Ranney says. “If you can’t test people and tell them whether or not they have COVID, then you can’t tell folks who needs to stay home.” Without that ability, people in areas where the virus is spiking may need to return to more sweeping precautions. The lockdowns of 2020 are unlikely to come back, but measures like indoor masking and avoiding big crowds may be necessary, at least temporarily. “We need to do what we can to flatten the curve,” says Dr. Rebecca Wurtz, an infectious disease physician and associate professor of health policy and management at the University of Minnesota School of Public Health. “I’m thinking it’s going to be 10 weeks, 12 weeks until we’re able to relax a little bit and move into a normalized response.” ## **Living with COVID-19** By a “normalized response,” Wurtz means that, eventually, COVID-19 breakthrough infections may be treated like “any other respiratory viral infection.” Right now, someone with a breakthrough case of COVID-19 is supposed to isolate for 10 days after testing positive or developing symptoms, even though recent evidence suggests that [vaccinated people may clear the virus faster](https://www.theatlantic.com/science/archive/2021/12/fully-vaccinated-covid-isolation-breakthrough-transmission/620919/). Before too long, she says, we’ll probably scrap that policy and move toward a more familiar approach, in which people stay home while they’re symptomatic but don’t necessarily pause their entire lives for 10 days. Someday, people may not even need to test or seek treatment, so long as they only have mild symptoms, Wurtz says. Wurtz emphasizes that we’re not ready to abandon preventive tactics yet, given the number of people who remain vulnerable to the virus, the strain on our health care systems and the unanswered questions about Omicron, including its relationship to Long COVID and other serious outcomes. But once we get past the Omicron surge, how do we transition into [treating COVID-19 as a normal](https://time.com/6089558/covid19-new-normal/) part of life? In the long term, policymakers should focus on addressing many of the socioeconomic problems that allowed COVID-19 to flourish, like inadequate access to health care and safe housing, says Menachemi. The public also needs better communication about “why everyone’s effort contributes to us returning to normal” and clearer guidelines for when certain restrictions are or are not required, he says. As the population-level threat of COVID-19 stabilizes, our individual view of breakthrough infections is likely to change from something scary to something unfortunate but, ultimately, routine, Menachemi says. “We need to start preparing people for the understanding that they will probably, at some point, get COVID,” he says, “and if they’re vaccinated and up to date on their boosters, it’s probably not going to be a big deal.” ## Transcript Kind: captions Language: en I think vaccines are misunderstood, and maybe it's because it seems like magic. That simplicity and the mystery of it is something that ends up creating a lot of skepticism. People are fooled by the speed. Everything that we knew when it was time to design a vaccine for COVID-19, we knew for so long, but the public had just become aware of it. If this would happen two years ago, we would not be ready. Saying that it happened overnight, it took two, three decades, at least. 2021 was the year when so many praised the miracle of vaccine development. In science, there is hardly ever a simple, quick fix. But this was truly a moment of the right fix - a brand new kind of vaccine technology - at exactly the right time. I started out in math, and I moved to biology. And after medical school, I saw one of the first cases of HIV in Tennessee back in 1982. And so the first part of my career was trying to understand the immunology of vaccine-enhanced disease and trying to make vaccines safer. I got interested in science when I was 16 years old. I was hooked on the idea that you could go to work and discover something that no one else in the world knows on any given day. It seems at 16, I thought that maybe I will be a scientist. I was always working with mRNA, I mean for 30 years at least. And I never wanted to develop a vaccine. I wanted to develop it for therapy. When I first came to Penn from the NIH, pure luck hit where I met Kati Karikó over a Xerox machine. And she told me she worked on RNA, and she could help us with our vaccine. Every experiment doesn't work, every hypothesis isn't good. It was a continuous flow of negative feedback. But we saw the potential of the RNA and neither of us would give up. Although mRNA can teach our cells to fight infection, it took doctors Karikó and Weissman 16 years to figure out how to use it safely in a vaccine. First when I made this RNA, actually I did not tell Drew Weissman, my colleague, because I thought that maybe I mixed up something. So I repeated the experiment and we could see that there was no inflammation in human cells. We're both scientists. We're not baseball players who cheer when we hit a homerun. We knew that it had great potential. But what we thought about is what are we going to do with it? Meanwhile, doctors Corbett and Graham spent years unlocking the structural secrets of viruses. One of the really important problems in coronaviruses that had not been solved is really simple. What does the coronavirus really look like to the immune system? And to figure that out, you have to be able to take a really high definition picture of the proteins that are on the surface of the coronavirus. And then do some protein engineering to stabilize the structure. At that moment, you realize that you have almost what is a universal strategy for creating a vaccine for coronaviruses. A mysterious respiratory illness with similarities to SARS has healthcare workers around the world on alert. What we said to each other, all's we need is a sequence and we're ready to go. We can make a vaccine in weeks and get it into people very quickly. The fact that we made a vaccine in 10 months, and has the potential to end this pandemic, will certainly stand out. "Do it mama!" (laughter) Most scientists never get to see a product actually used. And to watch the evening news and see the relief on healthcare providers getting immunized, those were special moments. I also get emotional when I got a letter from an elderly home, and they reported that they received the vaccine. There were like 200 elderly in that home. And nobody died. On social media, when children were going back to visiting their grandparents again. Seeing people reunited in that way, it was a very surreal moment. A surreal moment, and definitely worth celebrating, if only briefly before a return to work. These scientists are now trying to apply their game-changing discoveries to other diseases. Influenza, even cancer. 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