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New Beaumont Health study: COVID-19 hospitalization rare for fully vaccinated

This story appeared in The Detroit Free Press. Read more here.

A new study by Beaumont Health indicates emergency department visits and hospitalizations in fully vaccinated adults with breakthrough COVID-19 in its hospitals were rare events, and when hospitalization was needed for those immunized, it was for older patients with comorbidities.

The study looked at de-identified medical records of 11,834 patients, age 18 and older, who came to emergency rooms at the health system’s eight hospitals from Dec. 15 through April 30 and tested positive for COVID-19. It was published Thursday in The Lancet Regional Health — Americas.

There were records from 10,880 unvaccinated patients, 825 partially vaccinated patients and 129 fully vaccinated patients in the study, which indicated it was one of the first large, real-world investigations addressing the likelihood of fully vaccinated patients requiring hospital-based care in breakthrough COVID-19 cases.

COVID-19 vaccinations began in Michigan in December, and some of the patients would have come to emergency rooms during the state’s third surge and at a time when some variants — including the alpha variant, also known as the B.1.1.7 strain — were circulating.

But they would have come in before the more highly-transmissible delta variant — which is now pushing up cases, hospitalizations and deaths across the country — was in play in Michigan.

Dr. Amit Bahl, the study’s lead author who is director of emergency ultrasound for Beaumont Hospital, Royal Oak, said while the delta variant wasn’t present when the study was conducted, 10 different other variants were present in Michigan at the time.

“And the vaccine was very effective against preventing emergency visits and hospitalizations in that subset,” he said. “Delta’s not the last variant we’re gonna to see. … As a medical community, we have to continue to research this … and I’m sure that we’re gonna have more conclusions coming in the near future.

“But from whatever I’ve read, and even taking what we’ve investigated, I’m very positive that vaccination truly is effective against delta. There’s some work to be done from a scientific perspective, but all the the evidence does indicate that vaccination is protective.”

Bahl and Dr. Barbara Ducatman, chief medical officer of Beaumont Hospital, Royal Oak, also pointed to the health system’s current COVID-19 hospitalization rate, saying the majority of those hospitalized for the virus and on ventilators are those who are unvaccinated.

Dr. Barbara Ducatman is chief medical officer at Beaumont Hospital, Royal Oak.
Ducatman said out of 214 hospitalized patients across the health system, 160 are unvaccinated and 54 are fully vaccinated. Only one fully vaccinated patient was on a ventilator and that person has serious comorbidities, she said.

Ducatman said the last time health officials looked at sequencing, 96% of cases were the delta variant.

“Although breakthrough infections are more common with delta,” she said, “the serious outcomes are still, for the most part, being prevented by the vaccine.”

Ducatman said of the current vaccinated patients being treated for COVID-19, most are doing well, on less aggressive treatments and are expected to have better outcomes.

Vaccinated buttons that were available for those at Beaumont Health who began to get the second dose of the Pfizer COVID-19 vaccination.
During the more than four-month study, researchers found that emergency department encounters/hospitalizations related to COVID-19 were 96% lower in fully vaccinated patients compared with unvaccinated patients.

“The need for emergency care/hospitalization due to breakthrough COVID-19 is an exceedingly rare event in fully vaccinated patients,” according to the study.

“As vaccination has increased regionally, (emergency care) visits amongst fully vaccinated individuals have remained low and occur much less frequently than unvaccinated individuals. If hospital-based treatment is required, elderly patients with significant comorbidities are at high risk for severe outcomes regardless of vaccination status.”

The authors wrote that future studies are needed to reassess vaccination effectiveness broadly and by type of vaccine as mutations and variants evolve.

Bahl said they are “already looking into several things” and that he couldn’t say from the study which of the three vaccines was better at fighting off variants.

“We were curious, but we only had 129 patients who were fully vaccinated and so to draw a conclusion on what vaccine is better than the other, we just didn’t have enough data points,” he said.

Researchers also looked at patients who ended up in the intensive care unit, on a ventilator and died.

Of those who were unvaccinated, 384 patients died, including some as young as age 21. Patients as young as age 19 required ventilation, according to the study.

Among the fully vaccinated, all eight deaths and six intubations were in patients over the age of 65.

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