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Breakthrough COVID cases | Who is at highest risk and why?

The Louisiana Health Department tells us around 3,000 vaccinated people have tested positive for COVID. A few dozen of those died.

NEW ORLEANS — Why are you hearing about breakthrough COVID cases in vaccinated people and should you be concerned?

“With this particular virus, as compared to with the previous ones, the virus actually is at much higher numbers, 1,000 times more,” explained Dr. Julio Figueroa, Chief of Infectious Diseases at LSU Health Sciences Center.

You're fully vaccinated, and now you're hearing you should wear a mask again.

Even more concerning, you're hearing some vaccinated people still get COVID. Some even die.

So who is at the highest risk for breakthrough cases?

The Louisiana Health Department tells us around 3,000 vaccinated people have tested positive for COVID. A few dozen of those died. Why?

Let's start with those who have severe outcomes:

  • Age range: 28-97, median 73
  • 51% female, 49% male
  • 64% White, 35% Black, 1% other

That's less than 1 in 10,000 fully vaccinated who go to the hospital.  

Deaths are mostly the elderly with other health conditions, transplant patients, and those on immunotherapy treatments for cancer.

“When somebody's in their 80s and 90s, it's harder for their immune system to mount that response to the vaccine,” said Dr. Jeffrey Elder, an LSUHSC Emergency Medicine Physician, and Medical Director for Emergency Management at University Medical Center and LCMC Health.

“Those antibody levels aren't quite as high, and there's a substantial number of transplant patients who don't respond to that vaccine,” added Dr. Figueroa.

The rest of us get a good antibody response from the shot.

“Now, what's good about it is, is that the vast majority of individuals vaccinated, either have mild symptoms or no symptoms at all. So from themselves, they are protected from severe disease and death,” said Dr. Figueroa.

Even high-risk people who are vaccinated tend to do well.

“They're getting a little bit of oxygen. They get a little bit of support. They kind of turn around pretty quickly afterward and are discharged,” said Dr. Figueroa.

When asked if he is seeing some patients who are the average, healthy person, who is fully vaccinated with severe breakthrough symptoms, he replied, “I have seen one individual.”

What is so different about the Delta variant? It's 1,000 times more contagious than the original coronavirus.

“So consequently, if I get exposed today, by tomorrow I could actually be infectious with high viral load, where I could transmit to someone else before I even get sick,” said Dr. Figueroa.

That is the reason for the indoor mask recommendation. Vaccinated people may still be able to spread the virus, even if they have no symptoms. So the bottom line:

“There's absolutely no question right now, that your best ability to prevent getting sick, severely sick with COVID, being hospitalized, or dying from COVID, is to get vaccinated,” said Dr. Joseph Kanter, the Louisiana Medical Director.

Only 154 of the 1,706,544 vaccinated people in Louisiana have needed treatment in the hospital for COVID.

Doctors tell us the vast majority of their patients are not vaccinated.