Outbreak of COVID in Fully Vaccinated and Tested Cruise Ship Passengers and Crew

by TVR Staff, Dec 5, 2021 | Published by the National Vaccine Information Center

Updated: Dec. 6, 2021 | At least 17 cases of COVID-19 have been detected among the fully vaccinated crew and passengers aboard a Norwegian cruise ship that docked in New Orleans, Louisiana on Dec. 5, 2021. The Louisiana Department of Health noted that the Breakaway, owned by Norwegian Cruise Line Holdings Ltd, departed New Orleans with about 3,200 people on a weeklong cruise on November 28 with stops in Belize, Honduras and Mexico.¹

100 Percent COVID Vaccinated Crew and Guests Promised “Freedom” and “Confidence”

Norwegian assures customers they can “cruise with the ultimate freedom and confidence” due to their Sail Safe Health and Safety Program that requires all guests and crew to be 100 percent fully vaccinated “so you can do what you’ve always wanted to do on a cruise—EVERYTHING. No masks.  No social distancing.”² “Let’s get back to living life to the fullest, together. Sail Safe. Feel Free.” With 100 percent vaccination, they assure guests they can “surround yourself in safety” and “get up close and personal.”³

In addition to vaccination, all passengers are required to take a rapid COVID-19 antigen test at embarkation and are encouraged to take a PCR test within 96 hours of sailing.

The reputation of the cruise industry was badly tarnished in February 2020 after 20 percent (712 persons) of those aboard Carnival’s Diamond Princess were found to be infected with SARS-CoV-2, which resulted in a two week quarantine off the coast of Yokohama.⁴ The “COVID issue” is now considered by travel industry experts to be “well managed“ and they maintain cruises are now as safe as ‘safety’ can ever be guaranteed in these times.”⁵

Everyone onboard will be tested for COVID before leaving and will be provided with post-exposure and quarantine public health guidance by the U.S. Centers for Disease Control and Prevention (CDC). People who test positive for COVID will either travel to their homes or self-isolate according to CDC guidelines, the Louisiana Department of Health said.⁶

COVID Vaccination Offers False Sense of Security

Anna Durbin, MD, director of the Center for Immunization Research at Johns Hopkins Bloomberg School of Public Health, stated at a press briefing in September 2020, “Vaccines are designed to prevent serious illness, not to prevent infection or prevent any symptoms.”⁷

“The vaccinated are not as protected as they think,” said Eric Topol, MD, director of the Scripps Research Translational Institute. “They are still in jeopardy.”⁸

A study⁹ published in The Lancet in October 2021 found that the vaccine effect on reducing transmission was “minimal” in the context of Delta variant circulation Another study¹⁰ also published in October found that while people who become infected with the Delta variant are less likely to pass the virus to their close contacts if they have already had a COVID vaccination, that protective effect is relatively small and dwindles alarmingly at three months after the receipt of the second shot.

Absence of Breakthrough Data Puzzling

On May 1, 2021 the CDC abruptly stopped tracking COVID in vaccinated people, also known as “breakthrough cases,” unless the illness was severe enough to cause hospitalization or death.¹¹ “I was shocked,” said Leana Wen, MD, a physician and visiting professor of health policy and management at George Washington University. “I have yet to hear a coherent explanation of why they stopped tracking this information.” While vaccines reportedly continue to shield vaccinated people against the worst outcomes, those who have gotten COVID vaccine and still become infected with the virus are, in fact, often miserably sick and may chafe at the notion that their cases are not being accurately counted.¹²

While the true number of COVID breakthrough cases in vaccinated persons is unknown, infectious disease experts hint that breakthrough cases are more likely than the current data suggest. “I think that if we started to test people just randomly on the street, we would find a lot more people who test positive,” noted Abraar Karan, MD, an infectious diseases fellow at Stanford.¹³

Journalist David Wallace-Wells, who spoke to scientists at Harvard and Scripps, said public health officials may be “overstating the vaccine effect on transmission and understating the scale and risk of breakthrough infections.”¹⁴

“The message that breakthrough cases are exceedingly rare and that you don’t have to worry about them if you’re vaccinated—that this is only an epidemic of the unvaccinated—that message is falling flat,” Harvard epidemiologist Michael Mina, MD, PhD told Wallace-Wells.¹⁴

Cruise Lines One of Biggest Losers in COVID Pandemic Response

The global cruise industry has been growing for years, culminating in a preliminary peak of 30 million passengers worldwide in 2019 with major cruise companies seen as the frontrunners in tourism. Shutdowns associated with the pandemic have had a devastating effect on the cruise industry.¹⁵

According to the Cruise Lines International Association (CLIA), the number of cruise passengers fell by more than 80 percent to 5.7 million in 2020, almost all of which were generated in the first two months of the year. The (almost) complete standstill brought the cruise industry a cumulative loss of around U.S. $77 billion last year.¹⁵

¹ Lemos G. 17 Covid-19 cases identified on New Orleans-bound cruise ship. CNN Dec. 6, 2021.
² Norwegian Cruise Line. Pre-Cruise Need to Knows.
³ Norwegian Cruise Line. Sail Safe.
⁴ Tokuda Y et al. COVID-19 outbreak on the Diamond Princess Cruise Ship in February 2020. Wiley Online Library July 29, 2020.
⁵ Hausold A. Cruise Industry Facing the Biggest Challenges in Its History. Tourism Review Nov. 29, 2021.
⁶ Reuters Staff. COVID cases found on Norwegian Cruise ship returning to New Orleans. Reuters Dec. 5, 2021.
⁷ Stieg C. There’s a major thing people are missing about Covid boosters—and it’s really important. CNBC Sept. 16, 2021.
⁸ Deam J, Fortis B. The CDC Only Tracks a Fraction of Breakthrough COVID-19 Infections, Even as Cases Surge. TPM Aug. 21, 2021.
⁹ Wilder-Smith A. What is the vaccine effect on reducing transmission in the context of the SARS-CoV-2 delta variant? The Lancet Oct. 29, 2021.
¹⁰ Mallapaty S. WCOVID vaccines cut the risk of transmitting Delta — but not for long. Nature Oct. 5, 2021.
¹¹ U.S. Centers for Disease Control and Prevention. COVID-19 Vaccine Breakthrough Infections Reported to CDC — United States, January 1–April 30, 2021. Morbidity and Mortality Weekly Report May 28, 2021.
¹² Deam J, Fortis B. The CDC Only Tracks a Fraction of Breakthrough COVID-19 Infections, Even as Cases Surge. TPM Aug. 21, 2021.
¹³ Miltimore J. What is the True Vaccine Breakthrough Rate? The CDC Doesn’t Want You to Know. The Vaccine Reaction Oct. 11, 2021.
¹⁴ Ibid.
¹⁵ Hausold A. Cruise Industry Facing the Biggest Challenges in Its History. Tourism Review Nov. 29, 2021.

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