Can you spread COVID-19 after vaccination? Here’s what we know
by Kate Baggaley
December 28, 2020
On December 18, the U.S. Food and Drug Administration granted Moderna’s COVID-19 vaccine emergency use authorization. The vaccine is the second to win approval in the US, and the first doses were administered on Monday.
This milestone is impressive both because the vaccines from Moderna and Pfizer were developed at record-breaking speed and because they appear to be more than 90 percent effective (at least in clinical trials) at protecting people from developing symptomatic COVID-19. But one thing that isn’t clear yet is whether COVID-19 vaccines will also prevent vaccinated people from carrying the novel coronavirus without feeling sick and unwittingly spreading it to others. This means that for now, it’s important to keep wearing masks, socially distancing, and taking other precautionary measures even if you have been vaccinated.
“It would not be so far-fetched to have a vaccine that protects you from developing the worst COVID disease, but you could be infected and you could be spreading it [without] getting really sick,” says Jeffrey Bethony, a professor of microbiology, immunology, and tropical medicine at the George Washington University School of Medicine and Health Sciences who works on vaccines for parasitic diseases and HIV. “There is hope that they prevent transmission, but we simply don’t know enough about them yet.”
One reason that this novel virus—officially called SARS-CoV-2—has spread so rampantly is that people can be contagious several days before they feel ill, and in some cases never develop symptoms. Such a high rate of asymptomatic spread is “just not all that common in other infections,” says Susanna Naggie, an associate professor of medicine in the Duke University School of Medicine who specializes in infectious diseases. “With flu there is asymptomatic disease, but not at the level we see with SARS-CoV-2.” This makes it particularly important to understand whether COVID-19 vaccines will prevent asymptomatic infections, she says.
Many vaccines—including those for hepatitis A and B, measles, chickenpox, and human papillomavirus—do prevent people both from becoming ill and from passing the pathogen to others. “Generally, we believe that if you have a vaccine that prevents disease, you’re likely preventing infections as well, but you can’t assume that that’s 100 percent [the case],” Naggie says.
Some pathogens can infect and reproduce in vaccinated people for short periods of time without making them sick, including the bacteria that cause meningitis and pertussis, or whooping cough. This is also a problem for vaccines under development for parasitic illnesses such as malaria, schistosomiasis, and hookworm infection, Bethony says. “The vaccine protects people against the most serious clinical manifestations of the disease but it doesn’t entirely stop infection,” Bethony says. “You still might have a person who is mildly infected, and they’re still able to spread the disease.”
Whether an inoculation will prevent infection partly depends on the vaccine’s mechanism of action. Many COVID-19 vaccines, including those by Moderna and Pfizer, target the spike-shaped proteins on the surface of SARS-CoV-2 that help it bind to and enter host cells. “We’re talking about developing antibodies and immune response directly to the spike protein,” Naggie says. “So the hope would be that you could truly prevent infection.”
Several developers have reported early data hinting that their COVID-19 vaccines will reduce asymptomatic infections. During late-stage trials for the vaccine developed by the University of Oxford and AstraZeneca, some participants were given weekly COVID-19 tests. One group accidentally was given a low first dose of the vaccine followed by the intended full second dose. Asymptomatic infections were less common in this vaccinated group than they were among those who received a placebo. Researchers are still investigating why that low-dose group fared better than the full-dose group in that regard.
In Moderna’s clinical trials, researchers swabbed participants before they received each of their two doses of the vaccine. On December 15, the drugmaker reported that 38 volunteers who received the placebo tested positive without showing COVID-19 symptoms before their second dose, compared with only 14 from the group that received the vaccine.
“Presumably that means it also decreases the risk of transmission, although to prove that will take a lot more work,” Naggie says. “Maybe the vaccine completely prevents infection, or maybe it really shortens the period of infection and someone sheds for only a couple of days … these would all be very critical pieces to answer that.”
Investigating this question may become easier as at-home COVID-19 testing kits become more common. In follow-up clinical trials, researchers could ask people to swab themselves daily and track how often vaccinated people test positive and whether they pass the virus to other members of their household, Naggie says.
Several vaccine developers, including Moderna and Pfizer, are planning to test the blood of trial participants for antibodies that recognize a part of the virus that wasn’t targeted by the vaccine. Such antibodies would indicate whether a person became infected after being vaccinated.
Another way to find out how well COVID-19 vaccines prevent transmission is to monitor areas where vaccination is prevalent to see if infections also drop among the remaining unvaccinated people, Bethony says. This type of situation occurred after the first polio vaccine was introduced in 1955; the following year, scientists saw fewer cases even than they were expecting because enough kids had been immunized that the virus had trouble reaching those who hadn’t.
In the US, COVID-19 vaccines have only become available within the past several weeks and aren’t expected to be distributed to the general public before next spring. It’s going to be a while before we reach herd immunity. It’s also still unclear what percent of Americans need to be vaccinated for us to reach this stage as herd immunity depends on many factors including how quickly the virus spreads within various communities, and how effective the vaccines are at preventing the spread of the novel virus.
“We are just getting access to the vaccine and so for some months to come … we probably are still looking at questions about the role of the vaccine in transmission and the need to continue all these public health measures,” Naggie says. “For the time being, until we have adequate immunity in our communities and until we know better about transmission, the answer is yes.” So get vaccinated when you are able and keep masking up.
Strong on vocals
The group Mirage is very much alive, and kicking, as one would say!
Their lineup did undergo a few changes and now they have decided to present themselves as an all male group – operating without a female vocalist.
At the helm is Donald Pieries (drums and vocals), Trevin Joseph (percussion and vocals), Dilipa Deshan (bass and vocals), Toosha Rajarathna (keyboards and vocals), and Sudam Nanayakkara (lead guitar and vocals).
The plus factor, where the new lineup is concerned, is that all five members sing.
However, leader Donald did mention that if it’s a function, where a female vocalist is required, they would then feature a guest performer.
Mirage is a very experience outfit and they now do the Friday night scene at the Irish Pub, in Colombo, as well as private gigs.
Dichotomy of an urban-suburban New Year
Ushered in by the ‘coo-ee’ of the Koel and the swaying of Erabadu bunches, the Sinhala and Tamil New Year will dawn in the wee hours of April 14. With houses to clean, preparation of sweetmeats and last-minute shopping, times are hectic…. and the streets congested.
It is believed that New Year traditions predated the advent of Buddhism in the 3rd century BC. But Buddhism resulted in a re-interpretation of the existing New Year activities in a Buddhist light. Hinduism has co-existed with Buddhism over millennia and no serious contradiction in New Year rituals are observed among Buddhists and Hindus.
The local New Year is a complex mix of Indigenous, Astrological, Hindu, and Buddhist traditions. Hindu literature provides the New Year with its mythological backdrop. The Prince of Peace called Indradeva is said to descend upon the earth to ensure peace and happiness, in a white carriage wearing on his head a white floral crown seven cubits high. He first plunges, into a sea of milk, breaking earth’s gravity.
The timing of the Sinhala New Year coincides with the New Year celebrations of many traditional calendars of South and Southeast Asia. Astrologically, the New Year begins when the sun moves from the House of Pisces (Meena Rashiya) to the House of Aries (Mesha Rashiya) in the celestial sphere.
The New Year marks the end of the harvest season and spring. Consequently, for farming communities, the traditional New Year doubles as a harvest as well. It also coincides with one of two instances when the sun is directly above Sri Lanka. The month of Bak, which coincides with April, according to the Gregorian calendar, represents prosperity. Astrologers decide the modern day rituals based on auspicious times, which coincides with the transit of the Sun between ‘House of Pisces’ and ‘House of Aries’.
Consequently, the ending of the old year, and the beginning of the new year occur several hours apart, during the time of transit. This period is considered Nonegathe, which roughly translates to ‘neutral period’ or a period in which there are no auspicious times. During the Nonegathe, traditionally, people are encouraged to engage themselves in meritorious and religious activities, refraining from material pursuits. This year the Nonegathe begin at 8.09 pm on Tuesday, April 13, and continues till 8.57 am on 14. New Year dawns at the halfway point of the transit, ushered in bythe sound of fire crackers, to the woe of many a dog and cat of the neighbourhood. Cracker related accidents are a common occurrence during new year celebrations. Environmental and safety concerns aside, lighting crackers remain an integral part of the celebrations throughout Sri Lanka.
This year the Sinhala and Tamil New Year dawns on Wednesday, April 14, at 2.33 am. But ‘spring cleaning’ starts days before the dawn of the new year. Before the new year the floor of houses are washed clean, polished, walls are lime-washed or painted, drapes are washed, dried and rehang. The well of the house is drained either manually or using an electric water pump and would not be used until such time the water is drawn for first transaction. Sweetmeats are prepared, often at homes, although commercialization of the new year has encouraged most urbanites to buy such food items. Shopping is a big part of the new year. Crowds throng to clothing retailers by the thousands. Relatives, specially the kids, are bought clothes as presents.
Bathing for the old year takes place before the dawn of the new year. This year this particular auspicious time falls on April 12, to bathe in the essence of wood apple leaves. Abiding by the relevant auspicious times the hearth and an oil lamp are lit and pot of milk is set to boil upon the hearth. Milk rice, the first meal of the year, is prepared separate. Entering into the first business transaction and partaking of the first meal are also observed according to the given auspicious times. This year, the auspicious time for preparing of meals, milk rice and sweets using mung beans, falls on Wednesday, April 14 at 6.17 am, and is to be carried out dressed in light green, while facing east. Commencement of work, transactions and consumption of the first meal falls on Wednesday, April 14 at 7.41 am, to be observed while wearing light green and facing east.
The first transaction was traditionally done with the well. The woman of the house would draw water from the well and in exchange drop a few pieces of charcoal, flowers, coins, salt and dried chillies into the well, in certain regions a handful of paddy or rice is also thrown in for good measure. But this ritual is also dying out as few urban homes have wells within their premises. This is not a mere ritual and was traditionally carried out with the purification properties of charcoal in mind. The first water is preferably collected into an airtight container, and kept till the dawn of the next new year. It is believed that if the water in the container does not go down it would be a prosperous year. The rituals vary slightly based on the region. However, the essence of the celebrations remains the same.
Anointing of oil is another major ritual of the New Year celebrations. It falls on Saturday, April 17 at 7.16 am, and is done wearing blue, facing south, with nuga leaves placed on the head and Karada leaves at the feet. Oil is to be applied mixed with extracts of Nuga leaves. The auspicious time for setting out for professional occupations falls on Monday, April 19 at 6.39 am, while dressed in white, by consuming a meal of milk rice mixed with ghee, while facing South.
Traditionally, women played Raban during this time, but such practices are slowly being weaned out by urbanization and commercialisation of the New Year. Neighbours are visited with platters of sweetmeats, bananas, Kevum (oil cake) and Kokis (a crispy sweetmeat) usually delivered by children. The dichotomy of the urban and village life is obvious here too, where in the suburbs and the village outdoor celebrations are preferred and the city opts for more private parties.
New Year games: Integral part of New Year Celebrations
Food, games and rituals make a better part of New Year celebrations. One major perk of Avurudu is the festivals that are organised in each neighbourhood in its celebration. Observing all the rituals, like boiling milk, partaking of the first meal, anointing of oil, setting off to work, are, no doubt exciting, but much looked-forward-to is the local Avurudu Uthsawaya.
Avurudu Krida or New Year games are categorised as indoor and outdoor games. All indoor games are played on the floor and outdoor games played during the Avurudu Uthsava or New Year festival, with the whole neighbourhood taking part. Some of the indoor games are Pancha Dameema, Olinda Keliya and Cadju Dameema. Outdoor games include Kotta pora, Onchili pedeema, Raban geseema, Kana mutti bindeema, Placing the eye on the elephant, Coconut grating competition, Bun-eating competition, Lime-on-spoon race, Kamba adeema (Tug-o-War) and Lissana gaha nageema (climbing the greased pole). And what’s an Avurudhu Uthsava sans an Avurudu Kumari pageant, minus the usual drama that high profile beauty pageants of the day entail, of course.
A salient point of New Year games is that there are no age categories. Although there are games reserved for children such as blowing of balloons, races and soft drinks drinking contests, most other games are not age based.
Kotta pora aka pillow fights are not the kind the average teenagers fight out with their siblings, on plush beds. This is a serious game, wherein players have to balance themselves on a horizontal log in a seated position. With one hand tied behind their back and wielding the pillow with the other, players have to knock the opponent off balance. Whoever knocks the opponent off the log first, wins. The game is usually played over a muddy pit, so the loser goes home with a mud bath.
Climbing the greased pole is fun to watch, but cannot be fun to take part in. A flag is tied to the end of a timber pole-fixed to the ground and greased along the whole length. The objective of the players is to climb the pole, referred to as the ‘tree’, and bring down the flag. Retrieving the flag is never achieved on the first climb. It takes multiple climbers removing some of the grease at a time, so someone could finally retrieve the flag.
Who knew that scraping coconut could be made into an interesting game? During the Avurudu coconut scraping competition, women sit on coconut scraper stools and try to scrape a coconut as fast as possible. The one who finishes first wins. These maybe Avurudu games, but they are taken quite seriously. The grated coconut is inspected for clumps and those with ungrated clumps are disqualified.
Coconut palm weaving is another interesting contest that is exclusive to women. However men are by no means discouraged from entering such contests and, in fact, few men do. Participants are given equally measured coconut fronds and the one who finishes first wins.
Kana Mutti Bindima involves breaking one of many water filled clay pots hung overhead, using a long wooden beam. Placing the eye on the elephant is another game played while blindfolded. An elephant is drawn on a black or white board and the blindfolded person has to spot the eye of the elephant. Another competition involves feeding the partner yoghurt or curd while blindfolded.
The Banis-eating contest involves eating tea buns tied to a string. Contestants run to the buns with their hands tied behind their backs and have to eat buns hanging from a string, on their knees. The one who finishes his or her bun first, wins. Kamba adeema or Tug-o-War pits two teams against each other in a test of strength. Teams pull on opposite ends of a rope, with the goal being to bring the rope a certain distance in one direction against the force of the opposing team’s pull.
Participants of the lime-on-spoon race have to run a certain distance while balancing a lime on a spoon, with the handle in their mouths. The first person to cross the finish line without dropping the lime wins. The sack race and the three-legged race are equally fun to watch and to take part in. In the sack race, participants get into jute sacks and hop for the finish line. The first one over, wins. In the three-legged race one leg of each pair of participants are tied together and the duo must reach the finish line by synchronising their running, else they would trip over their own feet.
Pancha Dameema is an indoor game played in two groups, using five small shells, a coconut shell and a game board. Olinda is another indoor board game, normally played by two players. The board has nine holes, four beads each. The player who collects the most number of seeds win.
This is the verse sung while playing the game:
“Olinda thibenne koi koi dese,
Olinda thibenne bangali dese…
Genath hadanne koi koi dese,
Genath hadanne Sinhala dese…”
Six nabbed with over 100 kg of ‘Ice’
Happy New Year!
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