Who is most likely to develop serious COVID-19 even after a second jab?
Older individuals with a high rate of underlying medical conditions and immunosuppression are more likely to contract coronavirus and develop a severe case of COVID-19 even after being fully vaccinated, according to a first-in-the-world study conducted in Israel. A minority of vaccinated individuals will contract coronavirus and a small percentage of those people will end up hospitalized due to the virus, despite getting the jab. This is called a breakthrough infection. A team of Israeli doctors, led by Prof. Tal Brosh, head of the Infectious Disease Unit at Samson Assuta Ashdod University Hospital, studied 152 fully vaccinated patients from 17 hospitals who developed COVID-19 more than seven days after the second vaccine dose and required hospitalization sometime before the end of April 2021. The cohort was small because not so many vaccinated people who contract coronavirus end up developing serious cases of infection, as the vaccine is 97% to 98% effective against the standard variant  and proving to be almost as effective against the Delta variant. So far, despite a rapid spike in coronavirus cases in Israel, the number of serious cases seems to be only slowly climbing. cnxps.cmd.push(function () { cnxps({ playerId: '36af7c51-0caf-4741-9824-2c941fc6c17b' }).render('4c4d856e0e6f4e3d808bbc1715e132f6'); });  if(window.location.pathname.indexOf("656089") != -1){console.log("hedva connatix");document.getElementsByClassName("divConnatix")[0].style.display ="none";}  Overall, we can say that the main thing is that these are not healthy people, Brosh said in an interview with The Jerusalem Post. Almost all of them (96%) had comorbidities: heart disease, lung disease, renal disease, dementia, cancer or other common diseases. So, people who get breakthrough infections and get admitted are sicker than the usual person.  Of those who ended up in the hospital, 38 had what were defined as poor outcomes, meaning they were mechanically ventilated or died. Specifically, 71% had hypertension; 48% diabetes; 27% congestive heart failure; 24% chronic kidney disease; 24% chronic lung disease; 19% dementia; and 24% cancer. Only 6% did not have any underlying medical condition. Moreover, the study showed that 40% of patients were immunocompromised. If your immune system does not function well, you are at higher risk for not developing protection from vaccination, Brosh said, adding that some 35% of patients had no detectable antibodies - meaning they had failed to mount an immune response to the vaccine. The median time that elapsed from the second dose to hospitalization was 40 days. The median age of the patients was 71. In most cases the source of the patient's infection was unknown. Brosh said that although this study was conducted when the Alpha variant was active in Israel and the majority of cases had that virus strain, he said it is likely that the characteristics still apply today  to those who are infected with the Delta variant that now comprises more than 90% of infections in Israel. He said that the Delta variant seems to break through the vaccine more than its Alpha predecessor , but it is still unclear if the variant causes more severe breakthrough infections  despite some suggestions of this by the Health Ministry, Brosh said. Still, he said there is a take home message for the public:  If you are older and have comorbidities  and definitely if you have a lot of comorbidities - or are immunocompromised, you cannot assume you will be well protected by the vaccine, Brosh said. When there is a lot of transmission in the community, you should take care of yourself.