Infection after Vaccination?

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Specializes in Emergency Room.

We have been admitting a large amount of people who have become infected after their first round of vaccine, before they get their second. Are any others out there seeing this?  Do you think it is because they are dropping their guard too soon? Is there any evidence that they are sicker as a result? Or less sick?  Let me know your experience!

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Specializes in Emergency Department.

Where are you finding this? No-one else is.

Covid-19: US reports low rate of new infections in people already vaccinated.

(Published 16 April 2021)

https://www.bmj.com/content/373/bmj.n1000

 

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Specializes in Public Health, TB.

I do not work in acute care, but I am in public health and have heard nothing about an increase in infections/hospitalizations following first dose. I'm not sure what you mean by "a lot." Our biggest populations with infection now is college age who only last week were eligible for vaccine, and health care workers who refused to vaccinate, and the elders they infect. 

Yeah, I can guess people would let down their guard, but I live in an area where half the people can't be bothered to wear a mask, so I'm not sure what letting down one's guard even looks like. 

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Specializes in Emergency Room.

@GrumpyRN it is not something that I am finding, it is something that I am experiencing first hand at my hospital. I just wondered if others were seeing I as well.

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Specializes in NICU, PICU, Transport, L&D, Hospice.
12 hours ago, MeganMN said:

@GrumpyRN it is not something that I am finding, it is something that I am experiencing first hand at my hospital. I just wondered if others were seeing I as well.

Does your name imply that you are in Minnesota? About half of your eligible population is vaccinated and rates are dropping. 

If your facility is seeing vaccinated people who are sick with covid that needs to be reported. That may reflect a storage failure with the temperature sensitive vaccines.  There's certainly no indication on your state's reporting site of such an occurrence, so it's important to get these cases documented through the public health and covid reporting pathways. 

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Specializes in Public Health, TB.

When we do case investigations, people are asked if they are vaccinated and that data is compiled. But I haven't heard that any of the vaccinated have needed hospitalization. And certainly, not "lots", what ever that means. 

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Specializes in Public Health, TB.

a report in this morning's MMWR about infections in skilled nursing facilities in Chicago. One talks about breakthrough infections in fully vaccinated persons. 23% of breakthrough infections occurred in partially vaccinated persons.

 https://www.CDC.gov/mmwr/volumes/70/wr/mm7017e1.htm?s_cid=mm7017e1_e&ACSTrackingID=USCDC_921-DM55279&ACSTrackingLabel=MMWR Early Release - Vol. 70%2C April 21%2C 2021&deliveryName=USCDC_921-DM55279

 

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Specializes in NICU, PICU, Transport, L&D, Hospice.

@MeganMN

Have you confirmed these post vaccination covid infections and has your facility reported this phenomenon yet? I'm not seeing this situation reflected in the reporting. 

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Specializes in Emergency Room.

@toomuchbaloney I work tomorrow and will  check with our infection control nurse. I do not know the answer to your question about reporting. The patients were all in between the first and second shot, so perhaps it isn't included in the statistics about infection after vaccination, since they only co posted one? I will do more research tomorrow. 

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On 4/19/2021 at 2:14 PM, MeganMN said:

We have been admitting a large amount of people who have become infected after their first round of vaccine, before they get their second. Are any others out there seeing this?  Do you think it is because they are dropping their guard too soon? Is there any evidence that they are sicker as a result? Or less sick?  Let me know your experience!

There is some nuance here, can you give more specifics?

Are they being admitted with covid-19 symptoms/covid-19 complication...or being admitted for any reason and being tested and found positive?  Or a combination of those two scenarios?

Given that someone can test positive for months (~3) is it not possible that at least some of these people had mild symptoms not recognized as covid prior to or around the time of first vaccination and then are simply "turning up" positive now for the first time?

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Specializes in NICU, PICU, Transport, L&D, Hospice.
3 hours ago, MeganMN said:

@toomuchbaloney I work tomorrow and will  check with our infection control nurse. I do not know the answer to your question about reporting. The patients were all in between the first and second shot, so perhaps it isn't included in the statistics about infection after vaccination, since they only co posted one? I will do more research tomorrow. 

Thank you! 

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Specializes in Emergency Department.

Something else to look into is how soon after the 1st shot did a person develop symptoms. The closer one is to that 1st shot, the less protective the vaccine is. The closer one is to the 2nd shot, the more protective that first vaccine is. 

Another consideration is that during the surge times, we were sending people home that we'd usually admit, admission criteria was pretty strict. So, it's also possible that admission criteria may have relaxed a bit as well since the surge has generally abated. 

Since it is possible for partially vaccinated people (and even fully vaccinated too) to become infected and develop symptoms, and that we're seeing higher numbers of partially and fully vaccinated people now, we're going to see an increase in the percentage of people that have received at least one vaccine shot get hospitalized, even if the overall number of COVID19 positive patients that are admitted remain relatively stable. 

Since we've also vaccinated a lot of older people, we're seeing the shift in infected people toward a younger demographic. 

At my hospital, we're still seeing some elderly people get admitted with COVID19 but most of those haven't been vaccinated, but I'm just not seeing large numbers of them. I'm seeing only 1 or 2 per day (if that) where we used to see more like 10. 

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