"Even if you are vaccinated, if you're living in an area with high rates of Covid-19 spread -- and with the Delta variant surging -- there is a chance that you could become infected," said emergency physician Dr. Leana Wen, visiting professor at George Washington University's Milken Institute School of Public Health.
The Delta strain is the most transmissible coronavirus variant identified so far, the head of the World Health Organization said. It's about 40% to 60% more transmissible than the highly contagious Alpha (B.1.1.7) variant, according to the European Centre for Disease Prevention and Control.
In the United States, the Delta variant has spread to every state and is now responsible for more than 50% of Covid-19 cases, the US Centers for Disease Control and Prevention said.
"In some parts of the country, this percentage is even higher, especially in areas with low vaccination rates," the CDC said. "This rapid rise is concerning and threatens the progress the United States has made toward ending the pandemic."
As the Delta variant keeps spreading, "we know that there is a risk of breakthrough infection" among fully vaccinated people, Wen said. "So even if you are vaccinated, you could still get infected. The safest thing is for everyone around you -- even if you are vaccinated -- to also be vaccinated as well."
But even when people do get breakthrough infections, the vaccines are still "very, very high in effectiveness" when it comes to preventing severe illness or hospitalization -- well into the 90% range, said Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases.
There are some doctors who have expressed interest in giving a booster dose of vaccine to some patients, such as those who might be immunocompromised, Fauci said Sunday.
But the CDC and the US Food and Drug Administration say those who are fully vaccinated don't need a booster shot right now.
"There will always be people, well-meaning people and well-meaning companies will say, 'You know, the way we look at the situation, it looks like you might need a booster, so let's go ahead and give a booster.' But that's not a formal recommendation," Fauci said.
"Data evolves. You get more information as the time goes by. So when you get to the point where you have enough information to make a firm recommendation, that is not flip-flopping. That is making recommendations as the data evolve."
In low-vaccination states, more young people are getting hospitalized
Nationwide, 48% of all Americans have been fully vaccinated, according to CDC data Sunday. But a third of all eligible Americans -- those ages 12 and older -- haven't received a dose of vaccine yet.
In Missouri, only about 40% of the population is fully vaccinated. Doctors there say hospital rooms and equipment are running low, especially as more young people get hospitalized with Covid-19.
"We are seeing more people 30 years and older getting sicker and requiring hospitalization," said Dr. Mayrol Juarez at Mercy Hospital in Springfield.
"Also, we have seen that in this wave, each person is getting sicker faster."
Missouri's state health department estimates more than 70% of the virus circulating in the state is the Delta variant.
About 91% of the patients in the intensive care unit at Mercy Hospital in Springfield are on ventilators, Chief Administrative Officer Erik Frederick said.
"That is shocking to us, to have that kind of number," Frederick said Saturday. "These are young patients -- you have them in their 20s, 30s, 40s -- again, it's alarming, (and) a direct line to the vaccination rates."
In Arkansas, where about 35% of the population is fully vaccinated, the state recently surpassed 1,000 new Covid-19 cases a day, state health officials said.
"Arkansas is on the upward surge of a third wave of Covid-19 here in our state, and it's tilting towards younger people," said Dr. Cam Patterson, chancellor of the University of Arkansas for Medical Sciences.
"We're also seeing breakthrough infections in individuals who are immunocompromised."
And in Mississippi, where only a third of the population is fully vaccinated, "we've seen almost an entire takeover in the Delta variant," said State Health Officer Dr. Thomas Dobbs.
New Covid-19 cases and hospitalizations are fueled primarily by unvaccinated people, State Epidemiologist Dr. Paul Byers said.
"Due to the rapid rise of Delta variant cases and outbreaks, combined with the low overall immunization rate in the state," Mississippi is advising seniors 65 and older to avoid mass gatherings until July 26, regardless of vaccination status, the state health officer tweeted.
When might we need a booster?
"Americans who have been fully vaccinated do not need a booster shot at this time," the CDC and FDA said in a joint statement Thursday.
"We continue to review any new data as it becomes available and will keep the public informed. We are prepared for booster doses if and when the science demonstrates that they are needed."
Some Americans were confused when Pfizer said immunity has partially waned for some of its vaccine recipients as the Delta variant spreads around the world. Pfizer said it's working to develop a booster dose to protect people from variants.
"We see declining efficacy of the vaccine in Israel against the Delta variant, but that declining efficacy seems to be clustered among people who are older and who were vaccinated a while ago," Dr. Scott Gottlieb, a former FDA commissioner and current board member at Pfizer, told CBS' "Face the Nation" on Sunday.
"With respect to the boosters, what we're talking about is a third dose of the existing vaccine," Gottlieb said.
"Anyone who gets vaccinated right now will not need a booster. If you go out and get vaccinated right now, that vaccine is going to carry you through the fall and the winter. What we're really talking about right now is people who were vaccinated a while ago, where there may be some declining efficacy."
Thursday, Pfizer said it would soon publish data about a third dose of vaccine and submit it to the FDA, the European Medicines Agency and other regulators. Pfizer said it would seek FDA emergency use authorization for a booster dose in August.
Dr. Jerome Adams, the US surgeon general during the Trump administration, said he agrees with the CDC and the FDA that fully vaccinated people don't need a booster shot right now.
"Vaccinations are your best bet right now," Adams said Friday. "They're still incredibly effective. And if we have to get a booster, we just have to get a booster. We do that for the flu every single year, so people shouldn't get too worked up about that."
The CDC encourages in-person learning -- with safety precautions
With millions of students returning to classrooms in the coming weeks, the CDC said schools should prioritize in-person learning combined with safety measures.
Students, teachers and staff who are fully vaccinated don't need to wear masks at school, the CDC said. But those who aren't fully vaccinated, including children younger than 12 who are not yet eligible, should wear masks while indoors, the CDC said.
The CDC suggests schools offer Covid-19 vaccines on site, provide paid sick leave for employees to get vaccinated and excuse absences for students 12 and older to get vaccinated.
If Covid-19 cases are low in a community, and local schools want to transition away from pandemic precautions, they should do so gradually, the CDC said in a draft of the guidance obtained by CNN.
"If localities decide to remove prevention strategies in schools based on local conditions, they should remove them one at a time and monitor closely (with adequate testing) for any increases in COVID-19 cases before removing the next prevention strategy," the guidance says.
Getting more people vaccinated will assist in that effort, many experts say.
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