May 18, 2021

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In rare cases, even the vaccinated can get COVID-19 and die

In rare cases, even the vaccinated can get COVID-19 and die

Carey Alexander Washington, 80, a practicing clinical psychologist, called her daughter in January as soon as she received her first dose of the Pfizer COVID-19 vaccine.

“He was so excited to get it,” said Tanya Washington, 49, an Atlanta resident who works at an investment firm.

Carey received her second shot in February. 4. A little over a month later, the South Carolina resident suffered from shortness of breath. His internist didn’t test him for the virus. Carey, after all, was fully vaccinated. The doctor instead sent him to a cardiologist, who was also not tested for coronavirus.

Carey died on March 25 after nearly two weeks in hospital, his last days in intensive care. COVID-19 had destroyed his lungs.

Carey was one of a small percentage of people who had been vaccinated against COVID-19 and then contracted the virus. The Centers for Disease Control and Prevention reported that about 0.008% of the vaccinated were fully infected and about 1% of them died. Public health officials said such cases were expected and their number is reassuring.

“No armor is 100% effective,” said Dr. John Swartzberg, an infectious disease expert at UC Berkeley.

But so-called breakthrough infections remain worrying and the reported figures are likely lower than actual cases. They serve as warning tales for fully vaccinated people to get tested if they develop symptoms for the infection and to continue following health guidelines.

In Carey Washington’s case, her daughter wondered if he could survive if he was first tested for coronavirus after his symptoms appeared. Has his vaccination status dissuaded his doctors from testing him?

As the pandemic continues, researchers want to learn more about these cases, including the role different strains of the virus can play and whether infected people share traits or behaviors that have made them more vulnerable. The information could lead to changes in the vaccine or the way it is given to certain people.

Stacia Wyman, a UC Berkeley scientist who is sequencing the virus’s genome in groundbreaking cases, said there should be a centralized place to collect innovative genomic sequences so that patterns can be detected and information shared.

The virus will continue to evolve and sequencing detects whether the virus is one of the variants already identified or if a new one has emerged.

“This is the information we need to fight the pandemic,” said Wyman. a computational biologist at UC Berkeley’s Innovative Genomics Institute. “It’s really frustrating that there isn’t a lot of organization around this. I don’t think we will have to wait a year to put our acts together with the revolutionary cases “.

As of April 20, the CDC reported 7,157 infections among 87 million Americans who had been fully vaccinated. Almost half of the cases involved people aged 60 and over, and about a third of those infected had no symptoms. Nearly 500 have been hospitalized, two-thirds due to COVID-19. Eighty-eight people died, 13% of them from causes other than COVID-19.

The CDC warned that the cases were likely underreported.

In California, the State Department of Public Health has identified 1,379 cases of the infection among 10.7 million residents who have been fully vaccinated, occurring 14 days after the second dose of Pfizer or Moderna or a single dose of Johnson & Johnson. The department said it still has no information on the number of vaccinated Californians who have been hospitalized or died from the disease.

To better understand the breakthrough infections, the researchers said it was important to know whether the vaccines were properly stored, the underlying conditions and behavior of the “hosts” that were infected, and the nature of the virus that infected them.

Were people taking certain medications that dulled the effectiveness of the vaccines? Were they vaccinated at a time when they slept little or drank excessively? Swartzberg asked. Could these factors interfere with the vaccine? “It’s pure speculation,” he said.

He said the amount of exposure to the virus may also play a factor, outweighing the immunity you get from the vaccine.

“The dose makes the poison,” he said. “In many cases with infectious diseases, the more viruses you are exposed to in a setting, the more likely you are to get infected.”

Dr. George Rutherford, an infectious disease expert at UC San Francisco, said it’s not surprising that some people who were fully vaccinated have died from COVID-19. Vaccines are known not to offer 100% protection, he said, and frail and elderly people are particularly sensitive.

“Remember we vaccinated the oldest of the oldest in nursing homes first, so if there had been revolutionary cases there, there would have been mortality,” Rutherford said.

A CDC study released last week found that Pfizer and Moderna vaccines were 94% effective in preventing adults aged 65 and over from getting sick enough to require hospitalization. The study looked at patients in 24 hospitals in 14 states from January to March 2021. “Vaccination is a key tool for reducing severe COVID-19 in high-risk groups,” the study says.

Two more CDC studies of groundbreaking cases in nursing homes showed that vaccines protected residents, even when the virus spread to homes.

In a qualified nursing home in Kentucky, 18 residents and four staff members who had been fully vaccinated were infected during an outbreak caused by an unvaccinated employee. The culprit was a variant that had never been detected in Kentucky, a rare strain that is not on the CDC’s list of variants of concern.

The study found that vaccinated residents and staff were 87% less likely to have symptoms of COVID-19 than unvaccinated. Three residents died, two of whom were not vaccinated.

In the second specialized nursing home study, in Chicago, 22 possible breakthrough infections occurred among fully vaccinated people. Two thirds of the infected were asymptomatic. The others had mild to moderate symptoms and one person died.

Dr. Art Reingold, professor of public health at UC Berkeley, noted that the Biden administration has provided $ 1 billion to expand genome sequencing of the virus, which should make it easier to detect new variants and their role in infections. .

“The concern is that some of the variants could eventually develop in a way that vaccines no longer protect you,” he said. If that happens, booster shots or reformulated vaccines would be needed, he said.

So far, he said, the small fraction of breakthrough infections means “people shouldn’t panic.” In fact, he said, the numbers in California look so good that people may be able to take their masks off at home by the summer.

A person is more likely to be struck by lightning than a breakthrough infection, Swartzberg said. Dr. Carlos del Rio, an infectious disease and vaccine expert at Emory University School of Medicine, said someone was more likely to be hit by a car at a busy intersection than to develop a groundbreaking COVID-19 infection.

“It’s really important for the public to put this into perspective,” Swartzberg said. “The chances of you having a breakthrough of any kind are slim. And the chances of that twist making you even slightly sick are even more minuscule.

But Tanya Washington wants people to remember that breakthroughs are possible. He believes his father was infected by an unvaccinated employee in the offices he shared with other doctors. His father contracted the Californian variant of the virus, as did at least one other person in the office.

“He’s been on all these doctor appointments and no one has ever heard of COVID,” he said. “He was vaccinated twice. He was in what he thought was the safe environment of his office. “