Scientists try to detect why, in rare cases, even vaccinated people can contract COVID-19

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

“I was so excited that I did it,” recalled Tanya Washington, 49, of Atlanta, who works at an investment firm.

Carey received her second injection on February 4. A little over a month later, the South Carolina resident began experiencing breathing difficulties. Your doctor did not test you for the virus; after all, Carey was fully vaccinated. Instead, the doctor sent him to a cardiologist, who also didn’t test him.

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

The victim was thus part of a small proportion of people who, still vaccinated against COVID-19, later contracted the virus. The Centers for Disease Control and Prevention (CDC) specified that about 0.008% of fully vaccinated individuals have been infected, and approximately 1% died. According to public health officials, such cases were expected, and their number is very small.

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

But so-called breakthrough infections remain concerning, and the reported numbers are likely to be lower than actual cases. They serve as a warning for those fully vaccinated to get tested if they develop symptoms of the infection and to continue to follow health guidelines.

In the case of Carey Washington, her daughter wondered if she could have survived if she had been tested for the coronavirus early on, after her symptoms appeared. Did your vaccination status discourage your doctors from testing you?

As the pandemic continues, researchers want to know more about these cases, including the role that different strains of the virus can play and whether infected people share traits or behaviors that made them more vulnerable. The information could lead to modifications of the vaccine, or how it is applied to certain individuals.

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Stacia Wyman, a UC Berkeley scientist who is sequencing the virus genome in the most important cases, said there should be a central place to collect innovative genomic sequences so that patterns can be spotted and information shared.

The virus will continue to evolve and sequencing detects if it is one of the already identified variants or if a new one has emerged. “This is the information we need to fight the pandemic,” said Wyman, a computational biologist at the UC Berkeley Institute for Innovative Genomics. “It’s really very frustrating that there isn’t a lot of organization around this. We should not wait another year to just get started with these advance cases ”.

The CDC reported 7,157 infections among 87 million Americans who had been fully vaccinated as of April 20. Almost half of the cases involved adults older than 60, and about a third of those infected had no symptoms. Almost 500 were hospitalized, two-thirds due to COVID-19. 88 people died, 13% of them from causes other than COVID-19. The CDC cautioned that possibly not all cases have been reported.

In California, the state Department of Public Health identified 1,379 cases of infection among 10.7 million fully vaccinated residents, a condition that occurs 14 days after the second dose of Pfizer or Moderna, or the single dose of Johnson & Johnson. The department does not yet have information on the number of vaccinated Californians who were hospitalized or died from the disease.

To better understand emerging infections, the researchers believe that it is important to know whether the vaccines were stored correctly, what the underlying conditions and behavior of the infected “hosts” were, and the nature of the virus that affected them.

Were people taking certain medications that weakened the effectiveness of the vaccines? Were they vaccinated with little sleep or heavy drinking? Swartzberg wondered. Could these factors interfere with the vaccine? “It is pure speculation,” he replied, adding that the amount of exposure to the virus may also play a role in overcoming the immunity provided by the vaccine. “The dose produces the poison,” he said. “In many cases, if someone is exposed to a large number of viruses in an environment, the more likely they are to become infected.”

For Dr. George Rutherford, an infectious disease expert at UC San Francisco, it is not surprising that some fully vaccinated individuals have died from COVID-19. It is well known that vaccines do not offer 100% protection, he noted, and frail and elderly people are particularly susceptible.

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“You have to remember that we first vaccinate the oldest of the elderly in nursing homes, so if there were cases of advancement there, there would be mortality,” Rutherford explained.

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

Two other CDC studies of groundbreaking cases in seniors’ homes showed that vaccines protected residents, even as the virus spread through such sites.

In a specialized nursing home in Kentucky, 18 residents and four employees who were fully vaccinated were infected during an outbreak caused by an unvaccinated worker, with a variant that had never been detected in Kentucky, a rare strain not listed in CDC’s list of concerns.

Vaccinated residents and staff were 87% less likely to have COVID-19 symptoms than unvaccinated ones, the study found. Three residents died, two of whom were not immunized.

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

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

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

So far, he added, the fraction of breakthrough infections is small and that means “people shouldn’t panic.” In fact, the numbers in California look so good that people could remove their masks indoors in the summer.

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

“It’s really important that the public put this in perspective,” Swartzberg said. “The chances of someone having a breakthrough infection of any kind are tiny. And the chances that someone will contract it and become seriously ill are even more minuscule. “

But Tanya Washington wants people to remember that they are still possible. She believes that her father was infected by an unvaccinated employee, in the offices he shared with other doctors. His father contracted the California variant, as did at least one other person in the office. “He consulted many doctors and nobody noticed the COVID,” he said. “He was twice vaccinated and was in an environment that he considered safe.”

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