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Wisconsin not saying how many fully vaccinated residents have acquired COVID-19
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Wisconsin not saying how many fully vaccinated residents have acquired COVID-19

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Hanson vaccinating Merritt (copy)

The Benevolent Specialists Project Free Clinic received a state grant to focus its COVID-19 vaccination efforts on underserved populations. That included holding an immunization clinic this month at Madison's Jessie Crawford Recovery Center, where Mark Hanson vaccinated Morris Merritt.

Wisconsin health officials have repeatedly declined to say how many residents have acquired COVID-19 after being fully vaccinated, even though they’re tracking such “breakthrough” infections and federal officials have reported more than 7,000 cases nationally.

A new clinical study shows the Johnson and Johnson vaccine is about 66 percent effective against moderate to severe COVID-19.That also includes variants. It's the same number the company released earlier this year.Right now the Johnson and Johnson COVID-19 vaccine is on pause in the U.S. because of concerns over a possible link to rare cases of blood clots. 

The U.S. total of 7,157 cases is among more than 87 million people who have received both doses of the Moderna or Pfizer injections or the single-dose Johnson & Johnson shot, the Centers for Disease Control and Prevention said last week. That’s about 0.008%.

Some breakthrough cases are expected because no vaccine is 100% effective, but they serve as a reminder of why the CDC says fully vaccinated people should for now continue to wear masks around others except in limited circumstances, maintain physical distance, avoid crowds and frequently wash their hands.

Health officials are also monitoring how well the vaccines work against more contagious COVID-19 variants, including the B117 variant first discovered in England that accounts for a growing share of cases around the country and in Wisconsin.

Still, the relatively low tally of reported infections among those fully immunized should be taken as encouraging news, said Dr. James Conway, a UW Health pediatrician and vaccine expert.

“I think this is reassuring. Four months into this, these vaccines are working as good, if not better, than we hoped they would," Conway said. “It should be more incentive for those who are on the fence or wondering whether they should get these vaccines. ... These things work."

The state Department of Health Services is tracking breakthrough cases through its immunization registry and disease surveillance system, Dr. Ryan Westergaard, a chief medical officer with the health department, said last week. 

“All positive tests get reported to us and all vaccines are recorded in our statewide system," Westergaard said during a media briefing Thursday.

But for the second time this month, department spokesperson Jennifer Miller on Monday declined to release state figures on breakthrough cases. On April 6, after an earlier request for the information from the Wisconsin State Journal, Miller said, “While we’ve been notified of cases, the team is still working to ensure that reporting those cases into the surveillance system is working properly before they compile that data. I hope to have more information to share soon.”

Westergaard said breakthrough cases in the state are rare, as they are nationally and in other parts of the world.

“What we’re seeing seems to be in line with other countries,” he said. “Breakthrough infections are rare and the majority are asymptomatic or mild.”

The “real world” effectiveness of the COVID-19 vaccines appears to be 85% to 90%, Westergaard said. “No vaccine is perfect, but the risk of any infection and severe infection is dramatically lower among people who are vaccinated,” he said.

Nursing home cases

A report last week found 22 breakthrough cases among 14,765 fully immunized residents and staff at 78 nursing homes in Chicago, or 0.15%. Another report found 22 such cases at a nursing home in Kentucky that had an outbreak of a coronavirus variant, though those vaccinated were much less likely than those not vaccinated to have symptoms.

Nursing homes may detect more breakthrough cases because they do regular testing for COVID-19 and can more easily find cases without symptoms that might go unnoticed elsewhere, Westergaard said.

As of Monday, 42.1% of Wisconsin residents have had at least one dose of a COVID-19 vaccine, and 31.5% are fully immunized. Among residents 65 and older, who became eligible for vaccination in late January, 80.3% have had at least one shot and 73.9% are fully immunized.

Nationally, COVID-19 hospitalizations among older Americans have plunged more than 70% since the start of the year, and deaths among them appear to have tumbled as well, evidence the vaccination campaign is working, according to The Associated Press.

“What you’re seeing there is exactly what we hoped and wanted to see: As really high rates of vaccinations happen, hospitalizations and death rates come down,” said Jodie Guest, a public health researcher at Emory University.

Females had most cases

Of the 7,157 breakthrough cases nationally, there were 498 hospitalizations and 88 deaths, the CDC said. Some 31% of the cases were asymptomatic, 46% were in people 60 and older and 64% were female.

The CDC says the total is an undercount because it relies on voluntary reporting. A breakthrough case is a positive test on a sample collected at least two weeks after someone is fully vaccinated, when immune system protection is thought to have fully developed.

“For any vaccines, there are breakthrough cases,” the CDC says on its website. “With effectiveness of 90% or higher, a small percentage of people who are fully vaccinated against COVID-19 will still get sick and some may be hospitalized or die from COVID-19.”

Current data suggest that the available COVID-19 vaccines offer protection against most variants, the agency said. "However, some variants might cause illness in some people after they are fully vaccinated."

Meanwhile, the CDC said more than 5 million people, or nearly 8% of those who got a first shot of the Pfizer or Moderna vaccines, have missed their second doses, The New York Times reported Sunday. That is more than double the rate the CDC reported after the first several weeks of the vaccine campaign.

In some cases, it's because vaccine providers have canceled appointments because they ran out of supply or didn’t have the right brand in stock, the Times said.

Conway said 92% of people getting second doses is "remarkable" compared to lower rates for some other multidose vaccines. 

“We need to do what we do for most vaccines that require multiple doses, which is to call and remind people,” Conway said.

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