Sunday, January 29

Deaths Among the Doubly Vaccinated: What’s Behind the Australian Statistics? | Vaccines and immunizations

On Tuesday, 356 Covid-19 patients were being treated in intensive care wards across Australia. Of them, 25 were fully vaccinated.

While the data points to the extraordinary efficacy of Covid-19 vaccines in preventing people from becoming seriously ill, hospitalized, and dying, it does raise the question: why do a small number of people become seriously ill, and in rare cases , die? despite being fully vaccinated?

A specialist on the intensive care unit staff at Nepean Hospital in Sydney, Dr Nhi Nguyen, said that those who are fully vaccinated and die tend to have significant underlying health problems. Being treated in intensive care, where people can be on a ventilator and cannot move, adds to any existing frailty, especially in older people, he said.

“If we think about intensive care patients in general, whether they are due to Covid-19, pneumonia or any other infection, we know that those who have underlying disorders, those who are fragile, and those who have comorbidities will have a higher risk of die from whatever the cause of being in intensive care, “he said.

“Being fully vaccinated against Covid protects you from getting serious diseases, yes, but it doesn’t completely protect you from getting Covid. So if you are someone with chronic health conditions, which could be a mild illness or mild infection in a young or healthy person, it will have a greater impact on you. “

He said that this was the reason why the Australian Technical Advisory Group for Immunization (Atagi) had recommended reinforcements for those who are severely immunosuppressed. On Wednesday, the government said it intended the booster vaccines to be rolled out in the elderly care sector in a few weeks and available to the entire population by the end of the year.

“We don’t have the final data available yet, but there will also be a proportion of patients who have Covid, but are already dying for another reason,” Nguyen said. “They may be fully vaccinated, they have a mild form of Covid, but perhaps it has led to more severe heart failure than they had previously.”

Between June 16 and October 18, there were 61 deaths among fully vaccinated people in New South Wales, out of a total of 479 deaths from Covid. Data provided to Guardian Australia by NSW Health shows the deaths of fully vaccinated people, all of whom were 50 years or older. Of those who died, five were 50 years old, one 60, 17 70, 22 80 and 16 90.

On Friday, ABC revealed 36 of the 49 nursing home residents who died after contracting Covid during the Delta outbreak in New South Wales were fully vaccinated. All had underlying health problems or were in palliative care.

Professor Allen Cheng, director of the health care epidemiology and infection prevention unit at Alfred Health, said only a small number of deaths had occurred in fully vaccinated people.

“I understand that they have been mainly in older people over 70 years old, and some in nursing homes for the elderly,” he said.

The vaccine’s impact on reducing deaths among older people has been significant, Cheng said. Last year, before a vaccine was available, the mortality of 80-year-olds with Covid was around 30%, he said.

Cheng said it was likely that, given Australia’s extraordinary vaccination coverage, most of the people who became seriously ill or died from Covid-19 as of now would be fully vaccinated.

“At some point, there will be more people with infections who are vaccinated than those who are not,” he said. “As a simple thought experiment: if everyone was vaccinated, then the only cases we would have would be in vaccinated people.”

Nguyen agreed that with high vaccination rates, “in the future, a greater proportion of those in intensive care will be those who are fully vaccinated and fragile with other conditions, rather than people who are not vaccinated.” .

“But keep in mind that even with 95% of eligible people vaccinated, that still leaves many people unvaccinated. This is why we anticipate that by living with Covid, there will be a referral number of Covid patients in intensive care in New South Wales for the foreseeable future, and we are certainly planning that.

“We’re still not quite sure what that actual reference number is.”

Cheng said steps could be taken to further protect those at risk of serious illness despite vaccination. Atagi, which Cheng co-chairs, is still evaluating the data for the booster injections and may make further recommendations on their use.

Once the recommendation for booster shots is confirmed, additional protection for the general population would further reduce the risk of the most vulnerable becoming infected.

Australia is also using the new monoclonal antibody treatment sotrovimab, which has been shown to dramatically reduce hospitalization and the risk of death in adults who are at risk of developing severe Covid-19.

“The new monoclonal antibodies may provide additional protection, particularly in immunosuppressed people,” Cheng said. “Newer antiviral treatments may also be helpful, although they are still under evaluation.”

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