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‘It doesn’t mean the vaccine is failing:’ Why vaccinated Michiganders make up an increasing number of COVID h –

Fully vaccinated Michiganders have made up a larger share of the state’s COVID-19 cases and hospitalizations in recent weeks, including 23.4% of cases and 28.1% of hospitalizations within the last 30 days.

However, doctors say there’s important context that, when paired with that data, continues to show that vaccines remain significantly effective at preventing serious illness and death from COVID-19.

“People need to realize that there’s more to the numbers, and there’s a story behind the numbers,” said Dr. Liam Sullivan, an infectious disease specialist with Spectrum Health in Grand Rapids.

“There’s more to it than just looking at the surface of that (percentage). That doesn’t mean the vaccine is failing, not by any stretch of the imagination. I would argue that, if you really start looking at the numbers closely, the numbers show the vaccine has been highly successful.”

In the last 30 days, fully vaccinated residents have made up 6,151 of the 26,272 total cases; 198 of the 704 total hospitalizations; and 10 of the 65 COVID deaths, according to the Michigan Department of Health and Human Services.

Those rates are higher than reported during a sixth-month period between Jan. 15 and July 28, when the fully vaccinated population in Michigan made up 9,718 of the 398,302 COVID-19 cases, or 2.4%; 643 of the 11,691 hospitalizations, or 5.5%; and 246 of the 4,888 COVID-19 deaths, or 5%.

Fully vaccinated people made up less than 1% of total cases in January, February and March. That number has climbed each month since, likely due to the increased presence of the delta variant, which is better at infecting its host, replicating itself and spreading from person to person.

The first traces of delta variant in Michigan came in June, the same month the rate of breakthrough cases compared to total cases jumped to 12%. In July, fully vaccinated individuals made up 21% of cases as the presence of delta variant quickly increased among sequenced test samples.

Another factor in the recent increase in reported breakthroughs could be the impact of immunosenescence, or the aging of the immune system, on vaccine responsiveness, noted Dr. Sullivan. Older individuals can sometimes see waning immunity to vaccines faster than the general public, which is why people 65 years and older typically get a higher vaccine dose for the seasonal flu shot than younger people to achieve a similar immune response.

Health officials have already begun offering booster doses to individuals who are immunocompromised. Further, the U.S. plans to begin offering third-dose mRNA vaccines in late September for recipients who got their second dose at least eight months before. The timeline is based on data from Israel and other countries on the waning of vaccines effectiveness over time, according to CDC Director Rochelle Walensky.

Looking at hospitalizations, Sullivan said the majority of in-patients who have tested positive for SARS-CoV-2 fall under one of two categories.

First are the “incidental discoveries,” which includes those who came into the hospital for a procedure or to be treated for something other than COVID-19, but tested positive for the virus while they were there.

All in-patients that come into Spectrum hospitals are tested for COVID. If they test positive, the health system has to report their case as a hospitalization and enact necessary precautions to prevent spread to other patients, including moving them to a private room and following other protocols laid out by state and federal guidelines.

The other major category, Sullivan noted, is the fully vaccinated patients who have experienced waning immunity due to their compromised immune systems. Those patients may be elderly and/or they have conditions/medications that lower their ability to fight infections.

“In the vast majority of (vaccinated and symptomatic patients), there is some underlying reason why they had a breakthrough case … they’re either immunosuppressed, on medications that affect it, their age, etc.,” he said.

In Michigan, rates of cases are increasing in both vaccinated and unvaccinated individuals, but people who are not fully vaccinated have case rates seven times that of those who are fully vaccinated, and deaths rates 30 times that of the fully vaccinated, according to the state health department.

Finally, Sullivan said it’s to be expected that as the vaccinated population grows, so would the percentage of infections belonging to the vaccinated individuals “because of the sheer numbers alone.”

“And I would say this right now, the majority of our patients in the hospital who are severely sick are definitely unvaccinated,” Sullivan said. “That has held true since the vaccines have become available.”

In that same time period, between Jan. 15 and July 28, non-vaccinated Michiganders made up 388,584 of the cases, or 97.6%, 11,048 of the hospitalizations, or 94.5%, and 4,642 of the deaths, or 95%, according to MDHHS data.

Researchers have found fully vaccinated individuals tend to more commonly report mild-to-moderate symptoms, if any, while the unvaccinated are more likely to experience severe illness upon infection.

At Henry Ford Health System, Dr. Adnan Munkarah said the majority of COVID patients in the ICU are unvaccinated, and nine out of 10 on ventilators as of Tuesday were unvaccinated. Among the vaccinated population of in-patients, most are age 60 or older and have underlying health conditions.

“There is no question that the unvaccinated individuals are showing more severe signs and represent the majority of people who are more acutely ill,” said Munkarah, executive vice president and chief clinical officer for Henry Ford Health System.

“We realize that vaccination is not 100%. We know that there are breakthrough infections, we know that these breakthrough infections are there definitely with the delta variant, but there is no question, when you compare the proportionality, the unvaccinated people continue to make up the majority of cases within our hospital, including the vast majority of people who are in the intensive care unit.”

Asked about the recent upticks in vaccinated individuals testing positive or winding up in hospitals, Munkarah said it’s important to interpret the real-life vaccine data with caution. Unlike clinical trials, where all vaccine recipients are evaluated, health officials have to rely on self-reporting and individuals getting tested on their own to come up with an accurate breakthrough case rate.

“We know that the vaccines are about 90% effective, and this is even before the delta variant,” he said. “So we know that you are going to have a 10% breakthrough based on the data that we’ve had all along.”

To date, Michigan has reported 12,121 cases in which an individual tested positive for coronavirus more than two weeks after receiving their final vaccine dose. Out of more than 4.9 million fully vaccinated residents, that’s a known breakthrough rate of less than 1%.

Vaccines are widely available in Michigan. To find a vaccine near you, visit Michigan’s COVID-19 vaccine website.

Read more on MLive:

Gov. Whitmer says local – not state – mask policies are ‘best way to move forward’

COVID-19 outbreaks increase 36% in Michigan

81 Michigan counties should mask up regardless of vaccine status, per CDC


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