COVID-19 Vaccine Breakthrough Case Investigation and Reporting
Vaccine breakthrough cases are expected. COVID-19 vaccines are effective and are a critical tool to bring the pandemic under control. However, no vaccines are 100% effective at preventing illness in vaccinated people. There will be a small percentage of fully vaccinated people who still get sick, are hospitalized, or die from COVID-19.
More than 139 million people in the United States have been fully vaccinated as of June 7, 2021. Like with other vaccines, vaccine breakthrough cases will occur, even though the vaccines are working as expected. Asymptomatic infections among vaccinated people will also occur.
There is some evidence that vaccination may make illness less severe for those who are vaccinated and still get sick.
Current data suggest that COVID-19 vaccines authorized for use in the United States offer protection against most SARS-CoV-2 variants currently circulating in the United States. However, variants will cause some vaccine breakthrough cases.
(J. Harris: The new vaccine (NOVAVAX) might be effective in immunocompromised patients.)
1. PRESS RELEASE
HHS Awards $125 Million in Workforce Grants for Community-Based Efforts to Bolster COVID-19 Vaccinations in Underserved Communities The US Department of Health and Human Services, through the Health Resources and Services Administration (HRSA) awarded $125 million to support 14 nonprofit private or public organizations to reach underserved communities in all 50 states plus the District of Columbia, Puerto Rico, Guam and the Freely Associated States to develop and support a community-based workforce that will engage in locally tailored efforts to build vaccine confidence and bolster COVID-19 vaccinations in underserved communities. These awards reflect the first of two funding opportunities announced by President Biden last month for community-based efforts to hire and mobilize community outreach workers, community health workers, social support specialists, and others to increase vaccine access for the hardest-hit and highest-risk communities through high-touch, on-the-ground outreach to educate and assist individuals in getting the information they need about vaccinations.
(J. Harris: Do we have someone working on this????)
2. DELTA VARIANT As countries around the world continue to expand vaccination efforts, there is growing concern that the Delta variant of concern (B.1.617.2; VOC) could cause significant problems before many countries can achieve sufficient vaccination coverage. The Delta variant is the most recent VOC designated by the WHO and US CDC. Reportedly, the current COVID-19 surge in southeastern China is being driven by the Delta variant, and other countries are adapting COVID-19 restrictions in order to mitigate the risk from this VOC. Emerging evidence indicates that the Delta variant poses an elevated risk for severe disease compared to others, and it is believed that the variant is largely responsible for India’s largest surge, which peaked in early May. The Delta variant also represents an increasing proportion of COVID-19 cases in the US—up to 6%, compared to 1% only a month ago—and the UK at 91% of new cases. In response to increasing prevalence of the Delta variant, the UK is extending existing COVID-19 restrictions for another 4 weeks—shifting the expected date from June 21 to July 19—which will allow for accelerated vaccination efforts before taking further steps to ease restrictions.
Emerging data indicate that existing vaccines, including the Pfizer-BioNTech and AstraZeneca-Oxford vaccines, are effective in preventing severe disease and hospitalization….”
FROM THE LANCET:
1. SARS-CoV-2 Delta VOC in Scotland: demographics, risk of hospital admission, and vaccine effectiveness
“In summary, we show that the Delta VOC in Scotland was found mainly in younger, more affluent groups. Risk of COVID-19 hospital admission was approximately doubled in those with the Delta VOC when compared to the Alpha VOC, with risk of admission particularly increased in those with five or more relevant comorbidities. Both the Oxford–AstraZeneca and Pfizer–BioNTech COVID-19 vaccines were effective in reducing the risk of SARS-CoV-2 infection and COVID-19 hospitalisation in people with the Delta VOC, but these effects on infection appeared to be diminished when compared to those with the Alpha VOC. We had insufficient numbers of hospital admissions to compare between vaccines in this respect. The Oxford–AstraZeneca vaccine appeared less effective than the Pfizer–BioNTech vaccine in preventing SARS-CoV-2 infection in those with the Delta VOC. Given the observational nature of these data, estimates of vaccine effectiveness need to be interpreted with caution.
(J. Harris: Delta makes young people sick, sometimes very sick. Vaccines worked in prevention, but it took a month to get protected: “Overall, a strong vaccine effect did not clearly manifest until at least 28 days after the first vaccine dose…”
THE EPIDEMICS IN MARSHALL. (From old notes from newspapers)
The greatest epidemic Marshall has ever had is the one recorded in a little paper, “The Marshall Sentinel”, published in 1873. This epidemic was the yellow fever. From the “Iron Age Extra” October 30 we find that “a quarantine be raised between Shreveport and Marshall so far as the freight of all description, but be continued as to the citizens of Shreveport.” They also advised that “citizens absent from this place remain absent until further notice”. From September 10th to October 30th, 1873, there were seventy deaths from yellow fever.
In 1900 Marshall had an epidemic of Small Pox.
Later in 1912 there was an epidemic of meningitis. There was no record kept of the number of cases or deaths during this dreaded epidemic, but we know that there were many cases; a few of these proved fatal. (Could this have been an Equine Encephalitis instead?)
The next epidemic that Marshall had was in 1918 and early part of 1919. This epidemic was the Influenza which is commonly known as the “Flu”. There were between six hundred and seven hundred cases in Marshall, only seventy of which proved fatal.”
Reference: Dr. C. E. Heartsill.
SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia treated with immunoglobulin and argatroban
(J. Harris: One case report — successful treatment.)
From the Washington Post:
A dispute over vaccination status is taking place in a South Dakota courtroom, where a federal judge has filed criminal contempt charges against three members of the U.S. Marshals Service. U.S. District Judge Charles Kornmann asked the three marshals whether they were vaccinated, and when a deputy marshal refused to answer, the judge ordered her out of the courtroom. The other marshals left, too, taking defendants with them. In a letter, the judge said he expects to know the vaccination status of people working in the courtroom as a matter of “protecting all of us who serve the public.”
(J. Harris: SD is always exciting)
AND LAST BUT NOT LEASED:
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