• My parents, spouse, siblings, and children won’t get COVID-19 from me.
  • My friends won’t get COVID-19 from me.
  • My coworkers won’t get COVID-19 from me.
  • My patients won’t get COVID-19 from me.

To the best of my knowledge, no data suggest that vaccinated individuals who have breakthrough COVID-19 infections can’t transmit COVID-19 to others, as the above text implies.

Sterling Wood, DO

Oceanport, New Jersey

1 Shafer SL How to Explain Vaccination to Your Unvaccinated Patients


ASA Monitor November 2021

Dr. Wood is correct. Vaccinated patients with breakthrough infections can readily transmit COVID-19 to others. I did not anticipate that my text would be interpreted as he did, and I apologize for not being more precise. Point 2 of the editorial says, “I have reduced the risk of my passing COVID-19 to others.” In bullet points a, b, c, and d, I wanted to point out the many individuals who would not get COVID-19 if I didn’t get COVID-19. I did not mean to imply that vaccinated individuals with breakthrough infections are unable to transmit COVID-19. While the secondary attack rate from vaccinated individuals with breakthrough infections (25%) is less than for unvaccinated individuals with COVID-19 (38%), it is still significant.1 I appreciate Dr. Wood bringing this to my attention and providing an opportunity to clarify this potential misunderstanding of my editorial.

1 Singanayagam A, Hakki S, Dunning J. et al.

Community transmission and viral load kinetics of the SARS-CoV-2 delta (B.1.617.2) variant in vaccinated and unvaccinated individuals in the UK: a prospective, longitudinal, cohort study

Lancet Infectious Disease 2021

Steven L. Shafer, MD, FASA


ASA Monitor