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Answering your COVID-19 questions: Breakthrough cases, booster shots

Posted at 7:00 PM, Oct 12, 2021
and last updated 2021-10-13 20:13:48-04

INDIANAPOLIS — Breakthrough COVID-19 cases in Indiana account for a little more than 1.3% of all fully vaccinated Hoosiers. In terms of hospitalizations of breakthrough cases, fully vaccinated individuals account for 0.027% of the total.

WRTV spoke with two experts on breakthrough COVID-19 cases and booster shots.

Dr. Warren Gavin works at IU Methodist Hospital in Indianapolis. Since the beginning of the pandemic, he has worked with COVID-19 patients. He answered the following questions during an interview below:

Q: What are we seeing when it comes to breakthrough cases on your COVID-19 units?

A: “We are unfortunately seeing breakthrough cases here in the hospital. The majority of cases, the vast majority of cases, are in the unvaccinated population. But we are seeing some breakthrough cases. Now, the breakthrough cases seem to fare better in terms of their hospital courses. For example, a breakthrough case may come into the hospital and need oxygen for a day or two, we give them certain medications, and they seem to turn around and go home and have a better clinical course than those who are unvaccinated. When we hear someone's unvaccinated in the hospital, you get a little more nervous because they may have a rockier course and are much more likely to decompensate and go to the intensive care.”

Q: Who is at greatest risk for these breakthrough infections?

A: “If I had to name one population who is at greatest risk, it would be the immunocompromised population. And, that's why healthcare officials have stepped in and they were the first to start getting boosted [the booster shot] because we saw that that population was breaking through more frequently.”

Q: How common or uncommon are these breakthrough infections?

A: “It's an interesting question, and I took a look at some numbers from the State of Indiana. It looks like we've vaccinated over 3.3 million people, which puts a smile on my face. And only about, if you look at those who were vaccinated, 10,000 people, only about two or three of that 10,000 will breakthrough and need hospitalization. If you think about 10,000 people vaccinated, only two, maybe three will need to come to the hospital. And so that's exciting to me. Now, as a comparison, it would be, I think it's nearly 25 times as likely to be that an unvaccinated individual would need hospitalization.”

Q: Some people argue not getting vaccinated because some who are fully vaccinated are getting COVID-19. Why should they still get vaccinated?

A: “I've heard that a number of times. And going back to some of the numbers that I was talking about, I think the simplest way, even outside of numbers, the simplest way to think about it is that the vaccines [are] not perfect. No one's ever said that if you got the vaccine, you're not going to get COVID. You're not going to break through. There's no chance. But what I can definitively say is that you're much less likely to get COVID after being vaccinated and much less likely to become very ill from COVID. And so, again, this goes back to the inpatient cases. We do see breakthrough cases, those who have been fully vaccinated, unfortunately, get diagnosed with COVID, but they're faring very well in the hospital.”

Thomas Duszynski, the Director of Epidemiology Education at IUPUI’s Richard M. Fairbanks School of Public Health, shared his expertise on the effectiveness of COVID-19 vaccines and breakthrough cases during an interview with WRTV.

Q: What are we seeing with breakthrough cases in Indiana?

A: “We really have to look at the number of cases compared to the number of people that are vaccinated, right? So, the breakthrough cases are those people that are fully vaccinated and should have immunity, but still develop signs and symptoms or test positive and that's going to happen. We see this with other diseases, as well. Breakthrough cases aren't unusual. We know that. But the reality is, what percentage of those cases or breakthrough cases are fully vaccinated, and it's a really, really small percent. In other words, [just above] 1% of the cases that have been recorded in Indiana are actually fully vaccinated. When you think about it well, it's almost four million people fully vaccinated in the state. One percent is a really, really small number. The other thing to remember about breakthrough cases is that it's just that they are cases we don't know outcomes yet, right? How many of those cases are actually being hospitalized? How many of them are being put in the ICU, and how many of them are, unfortunately, dying from the disease? That number is even smaller. If you really are a breakthrough case after being fully vaccinated, you are less likely to be hospitalized, put on a ventilator, or die from the disease.”

Q: For people who got a breakthrough case, can they still get a booster shot when eligible?

A: “Yes, you could still get the booster shot. As a matter of fact, the recommendation was even if you had COVID-19 previously and you recovered, you should still get vaccinated. And that's true with the booster. If you had your vaccines and you were fully vaccinated and develop the disease, you could still get a booster shot after you've recovered. Obviously, this is a good time to talk to your doctor as to the timing of when that should occur, like when symptoms end or should I wait some time period. The booster is completely safe for those that have had the disease. And just talking on boosters a little bit, that's exactly what they do, they boost the immune system. They recharge it and help produce more antibodies, which provides a little bit more protection.”

Q: Should people be "mixing and matching" brands of COVID-19 shots when it comes to getting the booster shot?

A: “That's a really important question. Right now, the recommendation is not to mix and match. It's to just get boosted with the vaccine that you originally got. Pfizer is the only one that has a booster-approved vaccine. Moderna, Johnson&Johnson, I know have applied for the booster dose and provided data to the FDA. Hopefully, when they meet, they'll approve them, but we have to go back to what the data is really showing us now, is the booster absolutely necessary? And I think the jury's still out on that because we still have efficacy from the vaccine. The original vaccines that we received, right? It's still working, and it's working well for a greater percentage of the population. Now, if we see a variant emerge in the population, where the vaccine isn't as efficient, then there might be a little bit more urgency to get those boosters approved.”

Q: For those that are eligible right now for a booster, should they be getting a booster?

A: “No, they absolutely should. Especially if because you're in one of those categories that might put you at increased risk for a breakthrough infection, and the booster is going to help even reduce that some. If you're in one of those high-risk categories or are eligible to receive the Pfizer booster, and that was the vaccine that you originally were vaccinated with, then yes, you should get that vaccine.”