Q&A: Why are groundbreaking COVID cases on the rise in Maine? And what’s the latest on the recall?

The number of COVID-19 infections in Maine has jumped 35% since July 1 as the delta variant swept across all corners of Maine, resulting in a record number of hospitalizations and an increase in the death toll.

While Maine has one of the highest vaccination rates in the country, some fully vaccinated people still contract the coronavirus – and some have been hospitalized or have died.

This Q&A examines groundbreaking cases, what’s behind the numbers, and how booster shots fit into this latest chapter of the pandemic.

What is a case of rupture? And why does this happen?

A defining case is when a fully vaccinated person – someone who has received a final dose for at least two weeks – tests positive for COVID-19. As of Oct. 1, there had been at least 4,167 breakthrough infections in the state, according to the latest data from the Maine Center for Disease Control and Prevention.

As to why they are happening, groundbreaking cases are both expected and inevitable amid an ever-developing pandemic caused by an ever-evolving virus. This is because vaccines do not prevent infection with the coronavirus. Instead, vaccines are designed to teach the body how to fight infection by triggering an aggressive immune system response that will hopefully prevent serious illness.

In other words, vaccines are akin to army training for an invasion: the virus can still make landfall, but vaccines are the training that helps prevent invaders from going beyond. beyond the beach.

Why is the number of revolutionary cases increasing in Maine?

It’s all about the numbers, according to health officials. About two-thirds of Maine’s 1.3 million people are fully immunized, which is one of the highest rates in the country. Those 4,167 groundbreaking cases represent just 0.5% of the more than 880,833 fully vaccinated Mainers, based on the latest data from the Maine CDC.

The 4,167 cases also represent 7.5 percent of the 55,489 new infections reported in Maine since the earliest date in late January, when Maine residents could be fully immunized. In other words, the vast majority of new cases of COVID come from the minority who are not vaccinated.

Dr Nirav Shah, director of the Maine CDC, seized on the fact that more than 99.5 percent of fully vaccinated Mainers have not reported breakthrough cases.

“So I just want to note that although they do occur, they are generally rare compared to the substrate level of fully vaccinated people in the state,” Shah said Wednesday. “And it depends on the remarkable quality of the vaccines. “

Do revolutionary cases show that vaccines are not effective?

No, and the hospitalization figures illustrate this point.

Again, vaccines help prevent serious illness – and death – but don’t block infection. Depending on the week, 65 to 75% of people hospitalized with COVID-19 have not been vaccinated, even though only a third of the population is not vaccinated.

Calculating these numbers further, the approximately 160,000 children in Maine who are too young to be vaccinated fortunately represent very few hospitalizations. Thus, two-thirds to three-quarters of hospitalizations in Maine in recent weeks are among the approximately 22% of Mainers (approximately 300,000 people) who are eligible but not yet vaccinated.

However, the effectiveness of the vaccine decreases over time, which is why most vaccines require periodic booster shots. It can be every ten years for a tetanus vaccine, while doctors recommend annual flu shots because new strains of the flu virus emerge. And, as we’ve seen with the highly contagious delta variant, this coronavirus can mutate quickly.

Recent medical studies have suggested that some of the COVID vaccines may become less effective over time.

A study released by the US CDC in mid-September found that the Pfizer vaccine was 77 percent effective at preventing hospitalizations after four months in people without a weakened immune system, compared to 91 percent effective initially. But another study, published a month earlier, found no loss of effectiveness in preventing serious illness six months after a last dose of Pfizer or Moderna.

“Protection against severe COVID-19 resulting in hospitalization was maintained for 24 weeks after vaccination with COVID-19 mRNA vaccines,” the authors wrote in the study released by the US CDC in August. “To reduce their risk of hospitalization, all eligible people should be offered the COVID-19 vaccination. “

Asked Wednesday about the decrease in efficacy, Shah summed up the research: “There has been a bit of waning immunity for infections, but luckily all three vaccines continue to show high efficacy when it comes to them. serious outcomes like hospitalizations and ventilators. What this actually means, according to the US CDC, is that what is behind many groundbreaking hospitalizations is more the fact that there are more people vaccinated and less the fact that the vaccine is losing its strength. efficiency. “

But exceptional hospitalizations occur and their number is increasing. Why?

Officials say this is likely the result of the large number of fully vaccinated people in Maine, combined with complicated health factors in specific individuals.

As of Wednesday morning, 18 of 51, or 35%, of Northern Light Health Network COVID hospital patients were fully vaccinated. Those vaccinated represented eight of 20 intensive care patients in Northern Light’s network, which includes Eastern Maine Medical Center in Bangor and Mercy Hospital in Portland.

Dr James Jarvis, COVID-19 Incident Command medic for Northern Light, said while this is not true for every person, most people fully vaccinated in hospital or intensive care have problems underlying health issues. The same is not true for many unvaccinated patients.

“What I can say is that when we look at our unvaccinated population, they become a host of younger, healthier people who require hospitalization,” Jarvis said. “And this has been the case for a few months. “

How does Maine’s rate of breakthrough infections compare to other states?

That’s hard to assess because states track and report breakthrough cases differently – and some don’t report them publicly at all, unless requested.

Neighboring New Hampshire reported 1,809 COVID infections among fully vaccinated people as of September 15, or about 3.3% of the total cases since mid-January, according to the WMUR television channel. Massachusetts, meanwhile, reported a total of around 40,500 breakthrough infections this week, including 3,741 since last week, according to a Boston Globe report. This translates to less than 1% of Massachusetts’ fully vaccinated population, the journal reported.

But the US CDC does not require states to report breakthrough infections, and there is no federal standard to track them. The federal agency, for example, regularly reports only the total number of hospitalizations and deaths among fully vaccinated people. Nationally, those numbers were 16,889 hospitalizations and 5,226 deaths as of Sept. 27, according to the most recent data.

Incomplete and inconsistent data is frustrating for researchers and groups tracking COVID-19.

“States are significantly hampering efforts to define the national landscape of groundbreaking COVID-19 cases by failing to report data, or by rarely reporting it in atypical formats,” wrote Beth Blauer, deputy vice-president at the Johns Hopkins University who helped run this institution. closely monitored COVID tracking program. “The Delta variant is already ravaging the United States, and other variants may arise in the future. We need detailed, real-time information on breakthrough cases to monitor vaccine effectiveness and defend against further outbreaks. “

How do booster shots fit into this discussion of breakthrough cases?

The US CDC has recommended booster shots for people 65 years of age or older who have received the Pfizer vaccine, and for younger people with underlying health conditions that could put them at a higher risk of serious illness. or death from COVID. Federal authorities have also authorized booster shots for people with more exposed jobs or living conditions, such as healthcare workers and teachers or daycares, as well as grocery store workers and people living in informal settlements. homeless shelters.

Federal regulators are also assessing the need for Moderna or J&J boosters.

Booster injections are now widely available for eligible populations in Maine. In addition to some doctor’s offices, retail pharmacies like CVS and Walgreens, as well as most major healthcare networks, including MaineHealth and Northern Light Health, offer free booster shots.

As of Wednesday, 35,569 boosters or additional doses of vaccine had been administered in Maine.

The state averages about 2,700 booster shots per day this week, up from about 1,000 per day last week. Shah said those numbers, along with the number of first and second doses given, show that vaccines are still widely and readily available throughout Maine.

The main objective of the state remains to put these first and second blows in the arms, which, according to Shah, will provide the “biggest blow” from a point of view of public health on the scale of the population, because unvaccinated people are more likely to contract and spread the virus.

“Getting the recall is important. You should walk and not run there, ”Shah said. “What motivated the decision on the recalls was that they were starting to see more breakthrough cases, but not necessarily more breakthrough hospitalizations after adjusting for population and time since vaccination. But in a sense, part of the rationale for the boosters was to prevent the vaccine from losing that effectiveness. “

Information on vaccination sites is available at maine.gov/covid19/vaccines/vaccination-sites or by calling the state vaccination hotline at 888-445-4111.

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