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Infection after Vaccination?

Posted

Specializes in Emergency Room. Has 15 years experience.

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!

GrumpyRN, NP

Specializes in Emergency Department. Has 39 years experience.

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

 

nursej22, MSN, RN

Specializes in med/surg,CV. Has 36 years experience.

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. 

MeganMN

Specializes in Emergency Room. Has 15 years experience.

@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.

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. 

nursej22, MSN, RN

Specializes in med/surg,CV. Has 36 years experience.

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. 

nursej22, MSN, RN

Specializes in med/surg,CV. Has 36 years experience.

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

 

@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. 

MeganMN

Specializes in Emergency Room. Has 15 years experience.

@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. 

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?

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! 

akulahawkRN, ADN, RN, EMT-P

Specializes in Emergency Department. Has 6 years experience.

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. 

CommunityRNBSN, BSN, RN

Specializes in Community health. Has 3 years experience.

I am vaccinating full time. I had a patient arrive today for her second shot, and she told me that in between her first and her second shot, she caught Covid! A mild case though. We laughed about her bad luck. I’ve been vaccinating since Christmas Eve (primarily with Moderna although a few weeks of JNJ) and this is the first such report I’ve ever heard. 

CABGpatch_RN, BSN

Specializes in Critical Care. Has 20 years experience.

Quote

 

COVID-19 vaccine breakthrough infections reported to CDC as of April 20

As of April 20, 2021, more than 87 million people in the United States had been fully vaccinated against COVID-19.

Total number of vaccine breakthrough infections reported to CDC  7,157

Females  4,580 (64%)

People aged ≥60 years  3,265 (46%)

Asymptomatic infections  2,078 (31%)

Hospitalizations*  498 (7%)

Deaths†  88 (1%)

*167 (34%) of the 498 hospitalizations were reported as asymptomatic or not related to COVID-19.
†11 (13%) of the 88 fatal cases were reported as asymptomatic or not related to COVID-19.

 

https://www.CDC.gov/vaccines/covid-19/health-departments/breakthrough-cases.html

I started hearing about the breakthrough covid cases of fully vaccinated people a few weeks ago.  The last number I remember was ~5800 cases.  More up to date info has been added at the CDC website.  So it is happening.  I wouldn't call these large numbers however.

Edited by CABGpatch_RN

akulahawkRN, ADN, RN, EMT-P

Specializes in Emergency Department. Has 6 years experience.

Let me see: ~7,200 "breakthrough" cases out of ~87,000,000. Roughly 500 hospitalizations and roughly 90 deaths out of ~87,000,000. Looks to me like the vaccines are working quite well. 

MeganMN

Specializes in Emergency Room. Has 15 years experience.

It is interesting to think about.  I have another patient today that tested positive after vaccination (both doses).  She was asymptomatic, however, so it makes me wonder if the 'breakthrough' numbers could actually be much higher, but the vaccine is helping them to not have moderate or severe illness.  Just speculation, but wondering..... 

1 hour ago, MeganMN said:

It is interesting to think about.  I have another patient today that tested positive after vaccination (both doses).  She was asymptomatic, however, so it makes me wonder if the 'breakthrough' numbers could actually be much higher, but the vaccine is helping them to not have moderate or severe illness.  Just speculation, but wondering..... 

She must have been in the ED for another issue? Vaccination doesn't prevent us from exposure to virus, it prevents us from growing large quantities of virus or variants, getting sick and spreading it, right? This phenomenon will decrease in frequency if we can convince the vaccine hesitant to get vaccinated.  Once we achieve vaccine mediated herd immunity these cases will become evidence of new outbreaks rather than evidence of an ongoing pandemic. 

CABGpatch_RN, BSN

Specializes in Critical Care. Has 20 years experience.

11 hours ago, MeganMN said:

....but the vaccine is helping them to not have moderate or severe illness. 

This is exactly what the vaccine is intended to do.  It keeps us from serious disease or dying.  It does not mean we cannot get exposed and carry the virus.  That's why we need to be vigilant about wearing masks and being socially responsible.

Edited by CABGpatch_RN