Abstract
SummaryAn outbreak of over 1,000 COVID-19 cases in Provincetown, Massachusetts (MA), in July 2021—the first large outbreak mostly in vaccinated individuals in the US—prompted a comprehensive public health response, motivating changes to national masking recommendations and raising questions about infection and transmission among vaccinated individuals. To address these questions, we combined viral genomic and epidemiological data from 467 individuals, including 40% of outbreak-associated cases. The Delta variant accounted for 99% of cases in this dataset; it was introduced from at least 40 sources, but 83% of cases derived from a single source, likely through transmission across multiple settings over a short time rather than a single event. Genomic and epidemiological data supported multiple transmissions of Delta from and between fully vaccinated individuals. However, despite its magnitude, the outbreak had limited onward impact in MA and the US overall, likely due to high vaccination rates and a robust public health response.
Highlights
On July 10th, 2021, the Massachusetts Department of Public Health (MADPH) received reports of an increase in COVID-19 cases among people who resided in or had recently visited Provincetown, a tourist town on Cape Cod, MA
MADPH notified of an increase in cases of COVID-19 in individuals who recently visited or reside in Provincetown, MA
0.5 from residual diagnostic specimens collected between July 9th and August
Summary
On July 10th, 2021, the Massachusetts Department of Public Health (MADPH) received reports of an increase in COVID-19 cases among people who resided in or had recently visited Provincetown, a tourist town on Cape Cod, MA. Provincetown had attracted thousands of visitors, many of whom reported attending multiple large public and private gatherings—often. Cell 185, 485–492, February 3, 2022 a 2021 The Authors. MADPH notified of an increase in cases of COVID-19 in individuals who recently visited or reside in Provincetown, MA. Number of sequenced cases Collection Date B Mean Rt 95%CI. 1,098 cases of COVID-19 associated with the outbreak identified by case investigation between July 6th and July 31st. 638 residual diagnostic specimens from unique cases collected between July 9th and August 2nd with associated metadata
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