The COVID-19 vaccine works really, really well.
It only works if you get the shot.
That’s the message that jumps out from two studies of the impact of the vaccine on the lethal spread of the virus in the nation’s nursing homes.
One study proves the vaccine has dramatically reduced deaths in the most vulnerable group in the country — protecting both the vaccinated and the unvaccinated alike. Although some people who have gotten their shots can still infected — most have few symptoms.
However, the second other study proves that if only 50% of people get vaccinated we’ll still be vulnerable to lethal outbreaks of the virus – especially as new more dangerous variants spread.
Currently, only 45% of Arizona residents have had at least one shot — just below the national average of 49%.
In Navajo County, 39% of residents have been fully vaccinated. That includes 48% of those older than 12, 52% of those older than 18 and 66% of those older than 65.
In Apache County, 50% of all residents have been fully vaccinated, including 61% of those over 12, 65% over 18 and 78% older than 65.
In Gila County, 41% of all residents, 48% of those over 12, 51% of those over 18 and 62% of those over 65 have been fully vaccinated.
So first, the good news.
The push to vaccinate residents of nursing homes has nearly eliminated deaths from the disease, according to a study published in the New England Journal of Medicine.
More than 132,000 nursing home residents have died during the pandemic – accounting for nearly a third of all deaths in the US. So nursing home residents were the first in line back in December when the mass vaccination campaign started.
The latest study focused on 20,000 residents of 280 nursing homes in 21 states. Of those, some 4,000 were unvaccinated – roughly 20%. About 70% had received two shots and about 10% had gotten just one shot.
After a first dose, 4.5% still got infected by the virus. However, most of those infections were minor — often with no symptoms at all. Among those who had both shots, just 0.03 got infected, most with no symptoms.
The 80% vaccination rate protected the 20% who didn’t get vaccinated as well. The rate of infection for the unvaccinated protected by herd immunity dropped from 4.3% to 0.3 %.
However, before you start to celebrate – consider the more sobering outcome of a second study — this one focused on a cluster of new cases and deaths in a nursing home. Most of the residents were vaccinated, but only half the staff.
A single, unvaccinated staff member in the Kentucky nursing home spurred dozens of new infections — including 22 cases among employees and residents already vaccinated.
Most of those vaccinated who did get infected had only mild symptoms. But one vaccinated resident died, according to the federal Centers for Disease Control study.
All told, 26 faculty residents and 20 staff got infected from the single, unprotected staff member. The ranks of the infected included 18 residents and four staff members who had been vaccinated. Two unvaccinated residents also died.
A new strain of the virus accounted for the super spreader event – which claimed three lives in a single facility although 90% of the residents and 50% of the staff had gotten their shots.
The variant had multiple mutations in the spike protein, which meant that it could both spread faster and better evade the protections of the vaccine. The study estimated that the Pfizer vaccine was 66% effective for residents and 76% effective for staff members in preventing an infection. That compares to the normal effectiveness of 95% against the until-now dominant strain of the virus. The new variant has some mutations found in both the previously studied British variant as well as the variant that has ravaged Brazil and South Africa.
In Chicago, the routine screening of nursing home residents identified 627 infections in 78 facilities, but only 22 of those were among people fully vaccinated. Among those who’d had the shot but still got infected, two-thirds were asymptomatic. Nonetheless, two were hospitalized and one died.
Taken together, the studies prove that the currently approved vaccines work just as well in the real world as they did among the 50,000 people in the initial clinical trials.
However, those studies hold two frightening lessons.
Deadly outbreaks can take place even with vaccination rates of 50 to 60 %. Unfortunately, only about 40% of the US population is fully vaccinated and perhaps 50% have had at least one dose.
That leaves the nation well below the protection of herd immunity — and prone for the fresh clusters of cases and deaths. The spread of the new, more infectious, more lethal, more vaccine resistant variants only underscores the danger.