Breakthrough COVID deaths, illnesses mount, as boosters lag in Michigan

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Six months after most vaccinations, a quarter of all COVID deaths and hospitalizations are breakthrough cases. Most severe cases, though, are among the unvaccinated.

Earlier this year, the fully vaccinated accounted for 10 percent to 15 percent of all cases, hospitalizations and deaths. In the past month, they account for 24 percent of deaths and 28 percent of hospitalizations.

Experts say that’s partly because the delta variant is more virulent than the traditional COVID-19 strain and because, records indicate, at least 2.5 million Michigan fully vaccinated residents have yet to receive a booster shot.

Related stories:

• Aug. 18: In Michigan, the COVID increase isn’t just among the unvaccinated anymore
• Oct. 13: Michigan ER patients left on stretchers, then recliners, in swamped wards
• Nov. 17: 5 million Michiganders are vaccinated and COVID is surging. Here’s why
• Nov. 27: 85% of Michigan inpatient and ICU beds are full, some patients turned away

New research shows the vaccines’ effectiveness decreases after six months, prompting widespread calls for booster shots. Other research indicates the vaccines may be less effective against the delta strain of the virus. 

“Should you freak out? No,” said Dr. Vikas Parekh, associate chief medical officer at the University of Michigan’s hospital system.

“Should you consider getting a booster? Yes.”

The Centers for Disease Control and Prevention endorsed boosters Oct. 21 for everyone 65 and older and those 18 and older who have underlying health conditions or work in long-term care facilities or in high risk settings. Less than a month later, that eligibility was expanded to everyone 18 and older who had been fully vaccinated for at least six months.

But so far in Michigan, 1.6 million people of the more than 4.2 million who were fully vaccinated six months ago have received boosters. Many of the fully vaccinated who have contracted COVID-19 also are not eligible for the booster yet as well and officials across the state are nervous.

“We are concerned with our booster uptake by our seniors and those that are immune compromised,” said Eric Pessell, health officer for the Calhoun County

Pessell said they are urging residents — especially those 65 and older — to get the boosters and have arranged a mass clinic in Battle Creek for Tuesday.

Michigan is now enduring among the highest infection rates in the country, and hospitalizations are the highest they’ve been at any point of the pandemic.

With a higher percentage of breakthrough cases among the current surge, officials acknowledge there’s a public perception disconnect about the effectiveness of vaccines.

“I certainly have seen people misinterpret this as vaccines (are not) effective,” said Dr. Sarah Lyon-Callo, the state’s top epidemiologist with the Michigan Department of Health and Human Services.

In fact, the opposite is true, she said.

“The vaccines still make a big difference in terms of community spread and the risk of severe outcomes for individuals.”

The overwhelming amount of research backs up the contention, and vaccinations were credited with dramatically reducing nursing-home deaths among residents who were among the first to get the vaccines.

Fewer ventilators

Despite the rise in breakthrough cases, new data from the Michigan Health and Hospitals Association and other sources show that COVID patients who are fully vaccinated are less likely to be in intensive care or on a ventilator.

Although 76 percent of all COVID-19 patients are unvaccinated, they make up 87 percent of those in intensive care units statewide and 88 percent of those on ventilators, who are the most seriously ill.

National data show the unvaccinated, meanwhile, have between a six and 21 times greater risk of death.

The most recent national data indicates 8 of every 100,000 unvaccinated people ages 50 to 64 were dying from COVID-19 in mid-October, compared to 0.4 deaths per 100,000 for the vaccinated, according to the Centers for Disease Control and Prevention.

For those over 80, the rate is 38.3 deaths per 100,000 for the unvaccinated compared to 6.5 deaths per 100,000 for the vaccinated.

This year, 11,454 people have died of COVID in Michigan. 

Of those, the state has researched vaccination status of 8,574: 1,170 were fully vaccinated and the vast majority of those deaths, 1,004, were people 65 and older.

Cases spike among elderly

Beaumont Health Dr. Matthew Sims said almost all of the COVID patients he sees who are vaccinated are elderly, have compromised immune systems or serious lung ailments.

“I haven’t seen any healthy 40-year-olds get a breakthrough case,” Sims, who leads the system’s infectious diseases research.

Officials from the Henry Ford Health System said Friday that of the vaccinated who were hospitalized, 1 percent were not elderly or suffering from other health ailments. Of the unvaccinated, 11 percent had no so-called “comorbidities,” said Dr. Adnan Munkarah, executive vice president and chief clinical officer for the metro Detroit-based health system.

Parekh and Sims said they were seeing similar breakdowns among the vaccinated and unvaccinated at the U-M medical centers and at Beaumont.

At Beaumont, Sims said that of the 12 COVID-19 patients he saw recently three were fully vaccinated — and two of them did not receive a booster.

Without vaccines, many more people would be in Michigan’s hospitals, which are now at their peak since the pandemic began, he said.

“It works. It very clearly works,” he said.