Those who get more serious illnesses due to breakthrough cases of COVID-19 are more likely to be older and have preexisting conditions, a new study from the Yale School of Medicine found.
Dr. Hyung Chen, who led the study, told SF Gate in an email that "overall, older population with underlying heart or lung disease or with weakened immune systems were the most highly represented in those with breakthrough cases with symptoms."
Vaccines have shown robust efficacies, according to the researchers, with a greater than 85% success rate at preventing severe symptomatic disease. Breakthrough cases of COVID-19 infections in fully vaccinated people remain possible, although still quite rare, and the Yale team used real results from the Yale New Haven Health System from the days between March 23 and July 1.
A total of 969 patients were admitted to the health system who tested positive for COVID-19 across a 14-day period. All patients were required to get tested when they were admitted and may have come to the hospital for non-COVID-related reasons.
Roughly 18% (172 in total) of the patients who tested positive received at least one vaccine dose and a third of these (54) were fully vaccinated, records showed. Others were partially vaccinated or did not have the necessary time elapsed post-second dose (14 days) to be qualified as fully vaccinated.
While 46% of those fully vaccinated patients (25) were asymptomatic, 7% (four) had mild disease and 20% (11) had moderate disease. A quarter of them (14 people) had severe or critical disease and required supplementary oxygen support. Of those, four were in the intensive care unit, one on a mechanical ventilator and three died.
All of the patients with severe disease were 65 and older, with a median age of 80.5. Those people also had preexisting conditions including cardiovascular disease, lung disease, obesity and Type 2 diabetes, the researchers noted. Additionally, patients may have been on immunosuppressive drugs that could impact vaccine efficacy.
Vaccination for SARS-CoV-2 is highly effective against infection with SARS-CoV-2 or hospitalization with COVID-19, the research team noted. "In our real-world assessment of patients admitted to hospital with a positive SARS-CoV-2 PCR test, we found that nearly a fifth of patients had received at least one dose of the vaccine, and we observed that many patients had not completed the full vaccine course."
As of Sept. 7, just 14,115 of the 178,692,875 fully vaccinated people in the U.S. have been reported as being hospitalized due to COVID-19 (0.000079%) and 2,675 (0.000015%) have died. 87% of the deaths (some 2,331) attributed to breakthrough cases are in those aged 65 years and older.
In Illinois, 1,510 people have been hospitalized due to a breakthrough case (0.022% of the fully vaccinated population) and there have been 337 deaths (0.005%), according to the IDPH. Of the deaths in Illinois, 88% have been in those aged 65 and older.
"Vaccines continue to remain highly effective in preventing severe illness due to COVID-19," Chun wrote. "The likelihood of developing severe COVID-19 infection remains far lower for those vaccinated compared to those unvaccinated. Emerging data on breakthrough cases will need to be closely followed to determine the most effective strategies for booster vaccines."
The study was done before the delta variant became the predominant COVID variant in the United States. More research will be needed to determine the delta variant's effect on breakthrough cases.
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September 13, 2021 at 11:07PM
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Who could get more severe illness from breakthrough cases - The Edwardsville Intelligencer
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