A Physician’s Point of View: Managing a COVID-19 exposure post vaccination

Plus, patients want to know when they can shake hands again.
  • Dr. Jeffrey Weaver, Clinical Medical Director, Texas MedClinic
  • March 2021

Today a patient received the rapid antigen test curbside, sharing that he was testing out of concern of exposing his parents, since they stayed with him due to the power outage during “Snovid” last week.

His COVID-19 rapid test was positive, and he shared that he didn’t have symptoms.

Could this be a false positive?  He also had a high-risk COVID-19 exposure 6 days prior. In 2 days, he would be 7 days out from his second dose of the Pfizer COVID-19 vaccine.

Medical recommendation: People are considered fully vaccinated 14 days after receiving the second dose of the Pfizer or Moderna vaccines and do not have to quarantine after an exposure. They will have to quarantine if exposed after 90 days post vaccination.

He asked if the vaccine could have caused his positive test.  The answer is no.

I offered him a COVID-19 PCR test, but he had just had one at CVS that morning and was waiting for results (up to 3 days).  He needed a quick answer because his parents had risk factors and they wanted him to be tested. He know he has to be in isolation until the PCR comes back.

If the PCR COVID-19 test is negative, he should begin quarantine since he had been exposed. He asked if quarantine was necessary, since he just had the vaccine.  The answer is yes. He must isolate now and then quarantine if the PCR is negative.  If the PCR is positive, he should isolate for 10 days.

If the exposure would have been after his second vaccine dose + 14 days, then he would not have to quarantine after an exposure for up to 90 days. He would still need to follow isolation recommendation if the PCR is positive. If he tests positive with the PCR test, should this be reported?  Would this be an asymptomatic spreader who is doing so despite being vaccinated, which can happen as seen with other vaccines?  This is not considered to be a significant concern at this time with these vaccines.

I explained these complicated details to the patient. He wanted to know when it was safe to shake hands with someone. The short answer; not for a while.

I talked to several patients who contracted the virus after attending a large wedding on Valentine’s Day; 10+ persons tested positive for COVID-19.

COVID-19 is not behind us. Encourage patients to be considerate to the concerns and safety of others when it comes to mask wearing, social distancing and hand-washing.  There is no guarantee that a person will not contract COVID-19, even with a vaccine or using all precautions.

P.S. I do not live in fear of COVID, and I love to spend time outdoors without my mask!

Texas MedClinic - Dr. Jeffrey Weaver, Clinical Medical Director
Dr. Jeffrey Weaver, Clinical Medical Director, Texas MedClinic
Dr. Weaver has been treating patients well at Texas MedClinic for 14 years. Trained in family medicine, he received his medical degree from Howard University College of Medicine in Washington D.C. As chief medical officer, Dr. Weaver oversees clinical protocol and teaching of fellow Texas MedClinic staff. His clinical expertise focuses on emergency medicine and management of complex urgent medical needs.
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