Corona vaccination breakthroughs: how dangerous is Sars-Cov-2 for vaccinated people?

Despite being vaccinated, you can get infected with corona.

Why is that and how dangerous can the virus be for vaccinated people?

An overview.

Berlin / Frankfurt - The news is unsettling: The incidences are increasing * - even among those who have been vaccinated.

The latest and most prominent example: Bayern coach Julian Nagelsmann, who was infected with the corona virus despite having been vaccinated twice.

And a look at the intensive care units is also unsettling: there are also more and more people with full vaccination protection.

Does the vaccination still provide reliable protection?

Are corona * vaccinated people justified in worrying?

An overview of the most important questions and answers about vaccination breakthroughs.

Corona in Germany: How can you get infected with the virus despite being vaccinated?

Vaccines, it's no secret, never offer one hundred percent protection.

The corona vaccination is also one of the so-called non-sterile vaccinations.

This means that, according to the RKI, the vaccines cannot provoke such a strong immune response that the coronavirus is eliminated immediately after entering the body.

At first it can multiply even further.

Infection cannot be ruled out.

The vaccinations only ensure that the body is prepared in the event of an infection and can fight the pathogens.

This is often enough to at least prevent the disease from breaking out after an infection.

But not always that either.

The Robert Koch Institute defines a vaccination breakthrough as a Sars-Cov-2 infection (with clinical symptoms) that was diagnosed in a fully vaccinated person.

Complete vaccination protection is assumed if at least two weeks have passed after a completed series of vaccinations. 

There are several reasons for vaccination breakthroughs:

• Weakened immune system:

  An already weakened immune system often plays a decisive role. This mostly affects cancer patients who are undergoing chemotherapy, patients with autoimmune diseases or the elderly. The Robert Koch Institute writes in a press release that the immune system no longer responds adequately to immunization, especially in the case of seniors.

• Mutations:

  Mutations also often impair the effectiveness of the vaccine. The aggressive and significantly more contagious Delta variant * reduces the effectiveness of the vaccines. This is because this insidious mutation can evade the antibodies that are formed after vaccination better than other corona variants. According to the RKI, the vaccines are also effective against the Delta variant, but more antibodies are required to neutralize Delta.

• Temporary vaccination effect:

  It is also possible that the vaccination effect wears off after a while.

  Data from mid-July 2021 from Israel suggest that the effectiveness of the Biontech / Pfizer vaccination wears off over time.

  Measurements showed that after three months the antibody concentration was reduced by about half.

  But this is not a special feature of the corona vaccine.

  Transient vaccination effects can be observed with almost all vaccines, writes the RKI in a report.

Corona vaccinations in Germany: How many vaccination breakthroughs have been registered so far?

The Robert Koch Institute counted 95,487 vaccination breakthroughs in its weekly report (as of October 21, 2021).

In the group of 18 to 59 year olds there were 73,380, in the group of over 60 year olds 21,148.

These numbers seem high, but overall significantly more unvaccinated than vaccinated people have been infected with the coronavirus since the vaccination began.

In calendar weeks 38 to 41, more than two thirds of the newly infected were unvaccinated, while in the general population only around one third is unvaccinated.

Around 31 percent of all Covid sufferers who showed symptoms were vaccinated.

The

by age group:

• 2.6 percent of the 12 to 17 year olds,

  
  

  31.6 percent of the 18 to 59 year olds,

  
  

  55.4 percent of the over 60 year olds.

Corona vaccinations in Germany: What symptoms do vaccination breakthroughs occur?

Symptoms of the coronavirus * tend to be less pronounced in infected vaccinated people than in unvaccinated people.

According to a study by King's College in London, the symptoms of sick people who have been vaccinated differ in part from the symptoms of those who have not been vaccinated.

Although many test subjects also complained of the classic corona symptom of shortness of breath, some of them also had a runny nose, which is almost never the case without a vaccination.

According to the study, many of the vaccinated people also complained of earache, which is actually not a classic Covid symptom (such as fever, cough and loss of the sense of taste and smell).

Corona vaccinations in Germany: are vaccinated people contagious if the vaccination breakthrough?

It has not yet been conclusively clarified whether vaccinated people are contagious if they have breached the vaccination. When a person becomes infected with the virus, it takes a certain amount of time for the immune system to respond and fight the pathogen. That is how long it can reproduce unchecked. It takes longer for the body's own defenses to react, which is why their viral load and thus their infectivity are likely to be higher.

But even in infected vaccinated people, the immune response lasts, if not as long.

Since the vaccination probably does not generate sterile immunity, i.e. cannot prevent the pathogen from being eliminated immediately after initial contact, transmission cannot be ruled out.

The virus can initially continue to reproduce in the immunized body.

So the cardinal question is: Is the viral load of vaccinated people enough to infect others?

In addition, the study situation is still thin.

The immunologist Carsten Watzl draws the conclusion: "The individual vaccinated is certainly much better protected than a non-vaccinated, but this in turn can no longer rely on being protected because everyone around him is vaccinated," he said, according to the German Press Agency (dpa).

Unvaccinated people could unknowingly spread the virus, especially because they might not even notice their infection because of the lack of or weak symptoms.

Experts, such as infection immunologist Leif Erik Sander from the Berlin Charité, therefore recommend that people who have been vaccinated should continue to wear masks and have themselves regularly tested if they work in critical areas, such as care for the elderly or in hospitals.

Corona vaccination breakthroughs in Germany: How many people who were symptomatic of Covid-19 had to be hospitalized?

Fully vaccinated were among all

 during this period

•  4 percent of 12 to 17 year olds,

•  15.3 percent of 18 to 59 year olds,

•  39.6 percent of people over 60.

Corona vaccinations in Germany: How many people who were symptomatically ill with Covid-19 had to go to the intensive care unit?

According to the RKI, the following were

fully vaccinated

among all

during this period:

• 0.0 percent of 12 to 17 year olds,

• 10.1 percent of 18 to 59 year olds,

•  28.8 percent of those over 60.

Corona vaccination breakthroughs in Germany: How many of the fully vaccinated and Covid-19 patients have died?

The RKI gives the following figures for fully vaccinated among all

:

• 0.0 percent of 12 to 17 year olds,

• 5.1 percent of 18 to 59 year olds,

•  34.7 percent of those over 60.

Corona vaccinations in Germany: what do the numbers tell us?

How dangerous is Corona for vaccinated people?

If you look at the proportion of breakthroughs in vaccination in all Covid-19 cases over the entire course of the pandemic, it is clear that only a small proportion of hospitalized, intensive care units or deceased Covid-19 cases were breakthroughs in vaccination.

What can be deduced from this?

If there is an infection and a Covid disease, a look at the frequency distribution of the RKI reveals: For the majority of people who are fully vaccinated but still infected with Covid, especially younger people, the vaccines continue to protect against a severe or even fatal course and thus before hospitalization.

Researchers at King's College in London, among others, have confirmed this with a study: To do this, they evaluated data from over 1.1 million British people who received a corona vaccination between December 2020 and mid-May 2021.

Among the mass of test subjects, just around 2300 people were discovered who tested positive for the coronavirus after their first vaccination.

This corresponds to a rate of 0.2 percent.

After complete immunization, only 187 people (0.03 percent) were infected.

Corona vaccination breakthroughs: Corona vaccines continue to be highly effective

The RKI also comes to this finding in its report and sums it up: "In summary, the number of probable vaccination breakthroughs and the effectiveness of the vaccines used according to the screening method confirm the high effectiveness from the clinical studies."

Another good news: It is still very rare for people who are seriously ill with Covid-19 to die.

923 people who have been vaccinated have died since the start of the vaccination campaign.

For comparison: There were a total of 11,865 corona deaths.

The proportion of vaccinated deceased is therefore very low.

The RKI does not consider the increasing number of vaccination breakthroughs surprising: "It is to be expected that more vaccination breakthroughs will be recorded over time, as more and more people are vaccinated and Sars-Cov-2 is currently spreading again." This increases the likelihood to come into contact with the virus as a fully vaccinated person, the RKI continued in its weekly report.

There are now figures on how effective the vaccines actually are.

The RKI

this "

" as follows:

• Protection against hospitalization:

   approx. 91 percent (age 18-59 years) or approx. 87 percent (age ≥ 60 years)

• Protection against treatment in the intensive care unit:

   approx. 94 percent (age 18-59 years) or approx. 92 percent (age group ≥ 60 years)

• Protection against death: 

  approx. 96 percent (age 18-59 years) or approx. 90 percent (age ≥ 60 years)

Corona vaccination breakthroughs in Germany: which vaccinated people are particularly at risk?

The RKI figures also make it clear that the risk of a vaccinated corona patient developing a severe or fatal course is high, especially among older people.

“Of the total of 817 Covid 19 cases with breakthrough vaccinations who died, 606 were 80 years of age and older,” explains the RKI.

That is around 74 percent.

In general, however, this age group has a higher risk of death, according to the RKI.

That has nothing to do with the effectiveness of the vaccines.

The RKI recommends a so-called booster vaccination with the corona vaccines *, i.e. a third vaccination for a booster, especially for these high-risk patients, who are more at risk of getting seriously ill with Covid despite immunization.

Experts assume that the immune response improves every time the immune system has to deal with the virus or the vaccination.

The Standing Vaccination Commission (Stiko) recommends that

not only seniors, but also other high-risk patients should seriously consider a

vaccination:

• Risk patients with

  severely weakened immune systems

  ,

• Residents and specialists in

  care facilities

  ,

• Employees in

  medical facilities with direct patient contact

  as well as

• People

  who got the Johnson & Johnson vaccine

  .

  Regardless of the age and condition of the immune system, members of this group should be re-immunized with an mRNA vaccine (Moderna * or Biontech *).

  These are considered to be more effective than vector vaccines, which Johnson & Johnson is one of.

  In addition, the Stiko recently rated the protective effect of this vaccine as "insufficient".

Conclusion:

A corona vaccination does not produce sterile immunity.

Vaccinated people can continue to be infected with the virus and presumably pass it on, albeit more severely.

After an infection, however, they

, if at all,

than those who have not been vaccinated.

Although severe courses cannot be ruled out, especially in risk groups,

.

In intensive care units, vaccinated patients have to be treated

and

- but never zero.

(Julian Dorn)