Vaccinated vs unvaccinated: STRONG evidence and good news
Cases, duration of symptoms, hospitalizations, deaths
The CDC just published a summary in the MMWR (the flagship publication of the CDC - Morbidity and Mortality Weekly Report) comparing cases, hospitalizations, and deaths among vax vs unvax people. And, friends, the evidence is so strong in how incredibly protective vaccinations are (still, thankfully). Let me show you:
WHO DID THEY LOOK AT?
It’s always important to look at who is in the study. Are the people in the study representative of the rest of the population? Or are the people in the study different than the rest of the population. That matters what we can conclude from the results. In this study:
A total of 569,142 cases, 34,972 hospitalizations, and 6,132 deaths were included across 13 jurisdictions. (In the epidemiology world, that’s a LOT of people). =)
They included people >18 years and compared data by age group.
They compared 2 time periods in 2021: April 4-June 19 and June 20-July 17. They chose these time periods to indicate a time where Delta accounted for <50% of cases (the April-June time) and where Delta accounted for more than >50% of cases (June-July time). So, Delta was dominant in the 2nd time period.
They compared 2 groups and this part is important. The first group included FULLY vaccinated persons. The second group included persons partially vaccianted and not vaccianted. Keep that in mind as we look at the difference because FULLY vaccinated is where we see the difference!
The main questions were: Does Delta increase hospitalizations and deaths? And, do our vaccines still protect against Delta?
RESULTS
In the Figure 2 above, the vertical blue line indicates the two time periods. (Before the blue line, Delta accounted for <50% and after the blue vertical line Delta accounted for more than 50% of cases).
Cases, hospitalizations, and deaths increased with Delta among unvaccinated individuals - dramatically and exponentially - this is because Delta is MORE infectious meaning 1 person can infect 6-9 others. HOWEVER, notice that the SLOPE of the increase for each of those metrics. For example, compare the slope of the increase of cases between fully vaxxed (light blue) and not fully vaxxed (dark blue). Yes, we did see increases in breakthrough cases during the dominant Delta period (the 2nd time period) - but the SLOPE increase of cases was MUCH steeper for unvaxxed folks.
THE BIGGEST TAKEAWAY FOR ME (AND ALL OF OUR FAMILIES) - We see the biggest difference in the slope for hospitalizations and deaths. Compare the two blue lines for the cases - and then look at the lines for hospitalizations and deaths. Do you see the nearly straight line for the light blue at the bottom (fully vaxxed) people in both time periods BUT the line increasing steeply in the Delta 2nd time period for hospitalizations and deaths? That shows the incredibly strong protection vaccines gives against severe disease requiring hospitalization and deaths. AND the increased risk of hospitalization and deaths for unvaxxed folks due to Delta.
The risk of hospitalizations and deaths increased by more than 10x if you are not fully vaccinated.
When we look by age group, we see the same story (you can see all that data in the MMWR link). Infections among older adults went up in all groups - but, hospitalizations and deaths remained largely untouched among vaccinated older adults and INCREASED with the same high slope for unvaccinated older adults.
HOSPITAL CASE STUDIES
I’m sure you all have seen graphs like the one below that show basically the same story I just described - vaccines are holding up protection against severe disease, ICU need, and ventilator need. The one I included is from 14 (of 15) hospitals in the OSF Healthcare system in Illinois and Michigan. Among the 103 hospitalized, 85 were unvaccinated. Notice that among those in the ICU, two were vaccinated (out of the 31 persons in there). None of the vaccinated needed ventilator support. If you are a healthcare worker, you are seeing these same general implications - unvaccinated folks (including younger adults) are at high risk.
Among my healthcare friends working in ERs and ICUs, the vaccinated persons being admitted in the hospital tend to be persons with immunocompromised conditions. This makes me really sad (and angry) - probably like many of you, especially if you are a family in this scenario. Protecting them (ie. loving our neighbors) is on ALL of us through our own vaccination. That’s self-less love.
SO WHAT ABOUT BREAKTHROUGH CASES?
Remember in Figure 1 we saw cases increase in the vaccinated group during the 2nd time period where Delta was dominant? Those represent breakthrough cases. These cases range from asymptomatic, mild (like allergies) symptoms, and then symptoms that put you in bed for a while - but, not near as long if you didn’t have a vaccine. Let me show you (data here).
This is the point I want to make in breakthrough cases. They are generally super mild. IF you have symptoms that make you want to be in bed because of fever, aches, etc - those symptoms lasted, on average, 5 days. In the below figure, notice the green line (representing vaccinated people with breakthrough cases) decreases pretty dramatically starting at day 5-6 - but, does NOT for unvaccinated individuals. The illnesses and feeling crummy lasted MUCH longer (on average 10-14 days) for unvaccinated individuals. The immunological reason for the divergence has to do with our own immune system. For vaccinated folks, your body already has defenses to fight against COVID - and that really kicked in at day 5. Your body had been fighting against it since day 1 of infection and you can see the vaccines work their magic starting at day 5. The study linked below also mentioned that viral loads among vaccinated individuals are generally lower than unvaccinated individuals - which also influences how sick you would get or even exhibit symptoms at all. In other words, breakthrough cases are milder and your vaccines protect strongly against you needing hospitalization, ventilator support, or an ICU - thank goodness.
The symptoms also differed between breakthrough cases and unvaccinated cases. Symptoms for breakthrough cases were less likely to include breathing problems and the more severe symptoms we see with unvaccinated cases (low oxygen, lots of coughing, etc).
THE FINAL WORD
SO, if you have not been vaccinated or have family members who haven’t - hopefully this helps show how scary Delta is AND how protective vaccines remain. Vaccines work - not ivermectin, Vit C, Vit D, melatonin, snake oil from Mercola or America’s Frontline Docs, etc. Those have not been proven and certainly do not work against Delta. Vaccines do. Don’t mess around with it, friends. Delta’s not messing around.
I’m also watching Mu and I agree with Dr. Fauci that the Mu variant is to be watched but not feared yet. We are all keeping a close eye on it and I’ll definitely keep you posted if something changes. Delta remains the dominant strain that so far is covered nicely by vaccines. If we do not continue chipping away at vaccination rates in the US and worldwide, we run the risk of a mutation evading the vaccines.
Get those vaccines, friends. FULLY vaccinated.
-FNE
My whole experience with this disease has changed over the past couple of weeks. My adult, fully vaccinated son has been sick with covid for 16 days now. He started with cold/allergy symptoms on 8/30. He believes he was exposed on 8/26. He has had O2 levels bounce up and down. He received monoclonal antibody infusion on 9/4. He isolated for the full 10 days. He was in the ER last night. This is not what we expected to see in a healthy (other than his BMI being a bit high) young man. Amazingly my daughter-in-law and granddaughter have remained well.
As an over 65 parent it’s concerning. Makes me much more intolerant of seeing people ignore the preventive and protective measures we can do.
Wondered if you have or will speak to “booster” I have associates that are saying I can go to any pharmacy and say I am immunocompromised and receive a “booster” I am not but am curious as to your take on if we should get third (Pfizer). Also like my relatives that are older (80yo) ? Thanks for your blog! I appreciate you and your perspective.
Regards,
Beth