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Yes, breakthrough infections happen. But vaccination still massively decreases the risk of hospitalization and death from COVID-19.

Data on deaths and hospitalizations in Minnesota since vaccines became widely available show how stark the gap is between vaccinated and unvaccinated when it comes to COVID-19’s most severe effects.

covid patient
The data on hospitalizations and deaths from COVID-19 in Minnesota since vaccines became available clearly show that the unvaccinated are far more likely than people with the vaccine to end up in the hospital or die of the disease.
REUTERS/Lucy Nicholson

This week, Minnesota broke its previous 2021 high water mark for COVID-19 hospitalizations.

As of Friday, there were more than 1,670 COVID-19 hospitalizations in Minnesota; 338 in intensive care. Meanwhile, the state is still reporting dozens of COVID-19 deaths per day.

With more than 60 percent of Minnesota’s population fully vaccinated against the virus, this wave is smaller, overall, than the massive one that peaked around Thanksgiving last year, just weeks before vaccines were approved. But it’s lasted longer.

“It’s a marathon. This has gone on and on,” said Dr. David Wilcox, chief medical officer for Sanford Health of Northern Minnesota.

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The rising number of people going to the hospital and dying of COVID-19 in recent months has also included some people who were vaccinated against the disease. For some, these breakthrough infections have raised alarm that the vaccines might not protect people as much as had been hoped.

That alarm is for the most part unfounded. The data on hospitalizations and deaths from COVID-19 in Minnesota since vaccines became available clearly show that the unvaccinated are far more likely than people with the vaccine to end up in the hospital or die of the disease.

Stark differences

The Minnesota Department of Health keeps data on the vaccination status of those who go to the hospital or die of COVID-19. Here are the data broken down by age groups:

COVID-19 hospitalization rate by age group for vaccinated and unvaccinated Minnesotans
Data from May 2 through October 31, 2021.
Source: Minnesota Department of Health
COVID-19 death rate by age group for vaccinated and unvaccinated Minnesotans
Data from May 2 through October 31, 2021.
Source: Minnesota Department of Health

When you look at the population hospitalized with COVID-19, “Without a doubt, it’s unvaccinated people,” said Dr. Joshua Huelster, a critical care/intensivist at Allina’s Abbott Northwestern Hospital. Huelster said the last figure he heard put the share of COVID-19 ICU patients who are unvaccinated at 92 percent.

People who are unvaccinated and hospitalized or die of COVID-19 are also, on average, significantly younger than those who are vaccinated with the same outcomes, data from the Minnesota Department of Health show. Between early May and early November, the median age of COVID-19 hospitalization for those not fully vaccinated is 61, while the median age of people who have died is 69. In the same timeframe, the median age of COVID-19 hospitalization for people who were fully vaccinated and experienced a breakthrough case is 73, while the median age of people who died was 82.

When it comes to people who are vaccinated and get very ill, Minnesota Department of Health spokesperson Doug Schultz said in an email that roughly 90 percent of vaccine breakthrough hospitalizations and deaths have at least one underlying medical condition.

Huelster said that at Abbott, the majority of breakthrough patients at Abbott have another condition that is known to prevent their immune system from mounting a strong response to the vaccine. Some of the most common are people on immunosuppressive drugs due to solid organ, like kidney, transplant. Others include those with autoimmune diseases like rheumatoid arthritis that suppress the immune system.

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For teens, the state’s data show the risk of death and hospitalization is low regardless of vaccination status relative to older populations. Still, hospitalizations and deaths are certainly not unheard of in kids, and doctors urge them to get vaccinated if eligible to reduce the spread of the disease overall in the community.

“About a third of our cases are school-aged children,” Wilcox said. “And that will continue to be a source of virus for everyone else — the mid-lifers and the grandparents, and the great grandparents, to become ill because this virus will continue to find a place to circulate.”

Long-term effects

What’s often missing from the conversation about the impact of COVID-19 is something that doesn’t show up in the state’s data, Huelster said: people, including the young, who survive COVID-19 but whose physical health is completely changed by the virus.

In the past week, Huelster said Abbott Northwestern has had as many as eight people under age 50, and several in their middle to late 30s, on ECMO (extracorporeal membrane oxygenation), an intensive treatment that adds oxygen to the blood from outside the body, allowing the patient’s heart and lungs to take a break.

“They’re living but they’re just devastated physically,” Huelster said. Some will have lifelong respiratory issues and others are listed for lung transplants due to permanent lung damage.

The best defense? Getting vaccinated.

“People want this so much to be binary: vaccines do work, or vaccines don’t work, or someone got a breakthrough on vaccine so that means I really shouldn’t get vaccinated. And there’s nothing further from the truth,” Wilcox said. “Just like the flu, plenty of people get the flu after a vaccine, but they don’t end up in the hospital or dying or being on a ventilator and all those more dramatic responses. So our one-liner is that hospitalizations, ICU care, ventilator care and death is becoming a disease of the unvaccinated, primarily.”