About ten days after Billy went with his partner and a friend to Provincetown, Massachusetts, a Cape Cod tourist hub popular with the LGBTQ+ community affectionately known as “PTown,” to celebrate the Fourth of July weekend, he started to feel sick.
Despite getting his second jab of the Moderna vaccine in April, the 26-year-old grocery store worker from Boston—who asked his last name be withheld for professional reasons—said his symptoms mirrored all the indicators of the novel coronavirus that has plagued the United States for over a year. He had a headache, fatigue, nausea, congestion, diarrhea, and a slight cough.
To make matters worse, Billy told The Daily Beast, his partner was also experiencing symptoms—along with other PTown visitors and residents, some of whom were going online to report a positive diagnosis after the holiday weekend.
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“I left work and got tested,” Billy told The Daily Beast, noting that only he—and not his partner—tested positive for COVID-19. It was just one of “several” cases that have been reported over the past few days among visitors who spent time in the Massachusetts town, according to Outer Cape Health Services, a local group of community health centers.
“Going to PTown [and] being around so many young people from all across the New England region and NYC, I knew it was a risk,” he said Tuesday, adding that he was starting to feel better already. “However, all the symptoms I’ve had, if we were in a pre-COVID world, I would’ve probably gone to work. They haven’t been debilitating at all.”
In other words, the vaccine is working. In fact, local officials, health experts, and people who passed through Provincetown during what appears to be a modest spike there almost universally say the new cases are no cause for grave alarm, at least not yet.
The reason is simple: Provincetown currently has one of the highest vaccination rates in the state, and the shots are helping prevent summer vacations from turning into a disaster.
According to the Barnstable County Department of Health, at least 30 people have tested positive in the last week—and a majority of those cases are from “fully vaccinated” individuals. That represents an uptick for the county that consists of all of Cape Cod and the associated island, which saw about 20 cases two weeks prior.
It is not clear how many of the positive individuals in Barnstable are breakthrough cases—meaning they are exhibiting symptoms despite getting shots. But Provincetown Health Department and Outer Cape Health Services both told The Daily Beast they were monitoring the situation.
The numbers also do not account for people who visited the county and later tested positive in their hometowns—and, of course, likely fail to capture some vaccinated people who became infected and never had symptoms. Some of those people, even vaccinated ones, could theoretically have gone on to infect others—including young kids who cannot get vaccinated—though the evidence suggests that is unlikely.
A spokesperson for Outer Cape Health Services, meanwhile, told The Daily Beast that no hospitalizations have been recorded associated with these potential breakthrough cases.
“Bottom line: we are not seeing anything we didn’t really expect,” Provincetown Town Manager Alex Morse told The Daily Beast, confirming that the town was monitoring positive COVID cases among people “in PTown over the last few weeks.”
“If anything, it confirms the vaccine is working, we always knew it was not 100 percent effective. And from what we are seeing, everyone who has tested positive has a mild case,” he added.
The slight spike in cases in Barnstable County, however, is a microcosm of an ongoing national problem—one that almost entirely falls on unvaccinated people.
According to Johns Hopkins University, 34 states—including Massachusetts—have seen a 50 percent spike of new cases in the last week as the highly transmissible Delta variant sweeps the nation. The vast majority of those cases, hospitalizations, and deaths stem from unvaccinated residents.
Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security and a specialist in infectious diseases, explained that while breakthrough cases are going to occur, all cases would be decreased if everyone just got the vaccine already.
Perhaps most important, mini outbreaks like this one do nothing to dent the clear reality that the vaccines are safe and effective.
“These people somehow believe that COVID is going to magically disappear,” he told The Daily Beast. “We are going to be having COVID cases ten years from now. And breakthrough cases will occur no matter what.”
In Provincetown, almost all part-time and permanent residents are fully inoculated with one of three COVID-19 vaccines. Further, many bars and clubs in the Cape Cod town require vaccination cards for entry—and three past visitors told The Daily Beast that some establishments still have a mask policy.
For Jeremy Cox, a 39-year-old program manager, the ongoing threat of the coronavirus and the Delta variant has not yet made him pause on his frequent trips to Provincetown. He told The Daily Beast that since Memorial Day weekend, he has gone multiple times—and has never had a moment of uneasiness because “people are required to be vaccinated to get into places” and mask-use is still encouraged.
“I think the panic comes from people expecting the vaccine to be magic and also thinking it wouldn’t be them in terms of being a breakthrough case,” he said, adding that he knew while at the tourist spot that “if I went anywhere without a mask, then I am responsible for my actions.”
Cox, however, did admit that he was surprised when he learned that three of his friends who were with him during the July 4th weekend had tested positive for COVID-19 despite being fully vaccinated. He said he was even more shocked when he saw on social media that a slew of people who went to Provincetown—and could have been around him at holiday events—were speaking out about how they had tested positive, with symptoms, despite their vaccination status.
“I was a bit surprised, but only because it likely means that someone sharing houses weren’t vaccinated and then hung out with others who hung out with others,” he said, noting that while he shared a house with three other people, he said he was “always with other people, whether it
was at their houses, dinner or dancing.”
Local health officials cautioned that they have not yet determined the origins or cause of the Provincetown uptick.
“I think everyone just needs to accept the science and look at the symptoms the newly infected are having,” Cox told The Daily Beast. “My friends who have it are saying it’s just a head cold—if that. Those who are saying they’re having stronger symptoms are the outliers here in terms of the body’s reaction to becoming infected while vaccinated.”
Adalja also stressed that the vaccine “essentially defangs the coronavirus,” and warned against social-media hysteria about spikes in resort towns.
Worried that overtesting could have a chilling effect on those who may have been on the fence about getting the vaccine, the doctor stressed that it is important for only people who are not vaccinated or people who have symptoms to get tested for the coronavirus.
“Fully vaccinated people with no symptoms should not be tested. Period,” he added.
Still, Dr. Graham Walker, an emergency physician in San Francisco who has treated COVID-19 patients, believes that the uptick in cases should encourage people to use “slightly more caution… as we find some new normal after vaccinations.”
“Some people think they may be more protected than they are,” Walker said. “Nobody in the PTown group has been hospitalized, but we don’t know how many people will have long-term effects from the virus.”
While Walker stresses that those who went to Provincetown vaccinated “did nothing wrong” and should not be “blamed for following the CDC guidelines and going out to celebrate the holiday,” the cluster should be a wake-up call.
“This was not a superspreader event, this is just a numbers game,” he said. “Even if there wasn’t a Delta variant, we would still get breakout cases. The vaccine isn’t 100 percent effective. Do the math. Someone had to get it.”
