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The proportion of serious and fatal COVID-19 infections among vaccinated Tennesséens is increasing, but experts warn against using data on ‘breakthrough’ infections – which occur when fully vaccinated people are infected with the coronavirus – to draw general conclusions about the efficacy of the vaccine.
Unvaccinated Tennesséens continue to account for the majority of hospitalizations and deaths related to COVID-19 in the state.
But the proportion of fully vaccinated patients has tripled or more, according to the Tennessee Department of Health’s latest COVID-19 Critical Indicator report:
– Vaccines accounted for 13% of all COVID-19 cases in Tennessee in August, up from 4% in May.
– Among people hospitalized with COVID-19, 14% were vaccinated in August, up from 5% in May.
– Vaccines accounted for 17% of deaths from COVID-19 in August, up from 3% in May.
Dr Jason Andrews, associate professor of medicine in the division of infectious diseases at Stanford University School of Medicine, said that although vaccine protection against symptomatic COVID-19 infections has waned since the release of initial data from vaccine trials, there are many other factors. resulting in increased cases of rupture, and the ability of vaccines to protect against hospitalization and death remains strong.
The new variants of the coronavirus and the decrease in immunity over time are likely contributing to the decrease in the effectiveness of the COVID-19 vaccine, he said. But breakthrough infections are also more likely during times of high community spread, which has increased dramatically since early July due to the summer surge.
Unlike large-scale studies, crude case reports do not take into account factors such as age and medical conditions, and the elderly and those with underlying illnesses are the groups with the lowest vaccination rates. higher. These same groups are at higher risk of serious illness and death from COVID-19, regardless of their vaccination status.
“So if we just look at the [COVID-19] deaths and hospitalizations and if you look at the proportion of people vaccinated, you may see a higher proportion than you would expect among those vaccinated. But it is very likely because most of the deaths are from people [older] or have health issues, ”Andrews said.
Vaccines are also generally less effective in adults and people with weakened immune systems.
“This is probably the case that we are seeing decline [immunity] more in the elderly and in people with weakened immune systems, ”he said.
“Vaccines aren’t perfect – it’s reality. Very few things in life are perfect,” Andrews said. “We do things because they reduce our risk, even though they’re not perfect, and we know very clearly that vaccines reduce our chances of hospitalization and death by at least 90%.”
The Tennessee Department of Health also notes that COVID-19-related hospitalizations in vaccinated people are more rigorously investigated than unvaccinated people, so the number of hospitalizations in unvaccinated people is probably underestimated.
Real-time breakthrough case data is not available, and breakthrough case summary data for Tennessee is only available until August, as it takes weeks to properly investigate cases.
The department links its vaccination registry to its testing data to calculate the number of general breakthrough cases, which should be considered an undercount given that not all people positive for COVID-19 seek testing.
Andrews said mRNA vaccines, Pfizer and Moderna, set the bar very high when initial data showed vaccines were around 95% effective in preventing symptomatic infections, whereas historically virus vaccines respiratory systems such as influenza aim for an efficiency of about 60 to 70%.
Now, the scientific community is trying to determine how the efficacy of the COVID-19 vaccine is changing in order to determine who may need boosters and when.
“These are the debates going on right now,” Andrews said. “Since we have been able to achieve such high efficiency, we continue to strive to achieve this goal, as our goal as the medical and public health community is to reduce disease, including transmission, as much as possible. “
Although the breakthrough cases are a concern, he said the biggest concern is that a large portion of the population remains unvaccinated.
A total of 296 deaths and 769 hospitalizations have been reported throughout the pandemic, according to the latest Critical Indicators report, and more than 6.4 million Tennessians have been fully vaccinated, according to the Department of Health.
Contact Elizabeth Fite at [email protected] or follow her on Twitter @ecfite.
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