COVID-19 vaccines will fully protect tens of millions of people. Thousands will still be infected.

Recent reports of vaccines being diagnosed with COVID-19 have sounded the alarm in places like Michigan, with a headline shouting: “246 vaccinated residents diagnosed with COVID; 3 dead. Breakthrough infections – cases where the coronavirus infects a person who has been fully vaccinated – will always raise concerns about whether the vaccines do work. And more than 200 incidents in a place where the variants are increasing? Yikes.

But without the appropriate context, statistics can lead to misconceptions or even misleading. When the headline went off, the total number of fully vaccinated Michiganders at the time was about 1.5 million. The inclusion of 246 breakthrough infections among this huge group means that the COVID vaccines are actually performing better than expected, relative to their clinical trial results. Even the Washington Post, which reports on several thousand of these cases in the United States, should not doubt the effectiveness of the vaccines.

“The numbers clearly indicate that the vaccine has a significant effect,” said Jeffrey Shaman, an epidemiologist at Columbia University’s Mailman School of Public Health. “People just have to reorient themselves and keep in mind that it’s not 100%.”

Breakthrough infections can undoubtedly have serious consequences, and city and state health officials are on their guard. A spokesman for the New York Department of Health told Gothamist / WNYC that they were actively analyzing this situation, but so far none of their evidence indicated that the original strain of the virus or its variants bypassed the vaccines.

These words were repeated by their New Jersey counterparts and the New York State Health Team in Albany.

“Although there are anecdotal reports of New Yorkers who had a positive COVID test 14 or more days after receiving their last vaccine dose, DOH is further investigating these cases to determine if it meets the formal CDC definition of the breakthrough of vaccine compliant, “the state of New York said. Health Department spokeswoman Jill Montag wrote in an email.

So, while we wait until more numbers arrive, let’s take a brief look at what’s known about the efficacy of COVID-19 vaccines – and why thousands of breakthrough infections still mean the drugs are more likely to protect you than not.

How many breakthrough infections should we expect?

A vaccine can do three things. Best case scenario: this prevents anyone from ever becoming infected. Alternatively, some vaccines may prevent someone catching the coronavirus from transmitting it to someone else. Or the drugs may just stop the symptoms, which prevent a germ from destroying your body.

Last spring, when drug companies and universities announced their intention to make coronavirus vaccinations, health regulators asked them to prioritize the third. Stopping COVID-19’s serious consequences – the lung damage, the self-attacking collapse of the immune system and death – seem to be obvious priorities. But symptoms are also easier for scientists to detect relative to infection rates, especially since 30% of coronavirus cases are asymptomatic.

“This is the thing they can easily observe,” Shaman said. “If you have symptoms, they take your swab, they find out who has COVID, and they compare the numbers in the group that got the actual vaccine versus the placebo.”

Therefore, public messages focused on how the COVID-19 vaccines fared against serious diseases. Pfizer-BioNTech, Moderna and Johnson & Johnson vaccines performed equally well in clinical trials – about 10% of the shot developed severe COVID, and no one died from the virus.

Concentrating on serious illnesses is valuable, but it’s a bit like counting only home games for your team’s baseball score. What about the times when people struck – and still got the virus?

Scientists would predict one COVID case for every 2,000 people who both take photos of Moderna or Pfizer.

When it comes to preventing the occurrence of mild or severe cases, the vaccines Pfizer and Moderna have 95% efficacy – but that does not mean that 5% of the vaccinated people will become infected. You need to consider the rate of attack of the virus – or the likelihood that you will get sick after exposure.

After doing so, scientists would predict one case of coronavirus for every 2,000 people who both take pictures of Moderna or Pfizer. For Johnson and Johnson’s single shot, that would be about one in every 300.

“Even with the 95% figure, which is quite fantastic, you still have the chance to be asymptomatic, a confirmed case, end up in the hospital or even die,” Shaman said.

Compare that to the numbers from Michigan of 246 breakthrough infections from 1.8 million shots – that’s a much lower rate of one coronavirus case per 10,000 vaccinated.

‘If you look at deaths, three people who had the vaccine died. Four thousand Michiganders have died since January 1 [of COVID-19]—When, less than one in a thousand. Shaman said. ‘The numbers we see there [in Michigan] is not beyond the limits of what you would expect, and even better. ‘

Evidence shows that the vaccines against coronavirus are cases and deaths. Health researchers in countries such as Israel and the United Kingdom report that they may have reached the threshold for herd immunity, the point at which so many people are immune that the coronavirus is no longer spreading. In the tri-state area and the US, cases and hospitalizations in preferred vaccination groups, such as in nursing homes and adults over 65, have declined.

But even if the COVID-19 shots protect 1,999 out of 2,000 participants (or 9,999 out of 10,000), no one wants to be the stranger.

Who gets breakthrough infections and is it worse?

Breakthrough infections occur with all vaccines, including the best performers for diseases such as measles. When media outlets like the New York Post repeatedly tell stories about breakthrough infections, it can make the issue seem more problematic than it actually is.

“There is primary vaccine failure, if the body does not actually have an adequate immune response for several reasons,” said Dr. Anthony Fauci, White House medical adviser, said Monday at a COVID-19 Task Force briefing. “Secondary vaccine failure can occur if immunity fades over time … even if a vaccine does not protect against infection, it often protects against serious diseases.”

The clinical trials for the COVID-19 vaccines have recruited large and demographically representative groups of volunteers to mimic the real-world performance of the drugs. But even then, these tests can give a rough prediction of what might happen.

“You’re talking about a particular environment and a situation where everything is well controlled,” said Bruce Y. Lee, a public health policy expert at City University of New York and executive director of Informatics, Accounting and Public Works. Health. Research. “The likelihood exists that people who choose to participate in a clinical trial are those who are more aware of the virus and may be more cautious in general.”

This is because someone who does not believe the virus is a problem is likely to sign up to be part of a clinical trial. There is also the so-called Hawthorne effect, in which people change their behavior and become self-conscious simply because they know they are being studied. Lee says both trends can affect how often a volunteer encounters people with the coronavirus during a clinical trial.

Exposure is one of the most important factors that determines whether you will catch a germ even after you have been vaccinated.

And exposure is one of the most important factors that determines whether you catch a germ, even after you have been vaccinated. This is because your body’s immunity works like the deflection screens in Star Wars. Hit once with a small bump of virus particles, then your spaceship will survive. But bombard your nose and mouth with too much virus over a short period of time, and you are more likely to become infected.

‘If you are a health worker and are exposed to people who shed large amounts of viruses in the hospital, you get much greater exposure than someone who is very careful, takes social distance and makes people in the area wear masks. ”

The real-world real-world efficiency will usually be better than a lab test because of other variables, Lee said. Maybe your vaccine provider’s freezer is slightly warmer than it should have been on the day of your appointment, and so your lap is losing some strength? Maybe the nurse is not sucking every last drop in the syringe?

This is why Shaman, Lee, the CDC and other public health experts are appealing to people who are being vaccinated to continue to follow guidelines when in large crowds of strangers. Although the chances of catching the coronavirus are greatly reduced, the chances are not zero.

It also takes time to conduct actual investigations, and we are still awaiting the effectiveness results of the Johnson & Johnson sting. To date, international studies of the Pfizer and Modern vaccines show that it is also approximately 90% effective against coronavirus infections among the general public.

The only exception was a large group of residents of old age homes in Denmark who saw only 64% protection. What gives? Well, the average age of these long-term caregivers was 84 years old, which indicates another characteristic of human immune systems: your individuality.

“The protection afforded by the vaccine depends on your immune response,” says Lee. “Most older adults sometimes do not get enough response from the flu vaccine, which is why they introduced things like flu vaccines with a higher dose.”

In clinical trials against COVID-19, the efficacy of the vaccine has decreased by approximately 20 percentage points in people with cancer, who are more likely to deal with immune suppression.

“If you use steroids, or use immunosuppressive drugs, or if you have chronic medical conditions, your immune response may possibly decrease,” Lee said. ‘There’s [sic] questions about whether people with a high body mass index also have less response to vaccine. ‘

When can we stop wearing these Dang masks?

Everyone wants this to be a pandemic. In the US alone, we have lost more than 550,000 friends, fathers, mothers, brothers, sisters, daughters, sons and cousins ​​in just over a year. Many of us usually sit inside just as long. Spring is here. The vaccines are here. We are ready for the country to fully reopen and to change the rave scene The Matrix (although preferably above ground in the sunshine).

Breakthrough infections are the reason why the safest move is still to wear a mask, have social distance and use good hygiene when you are in public or traveling – even if you have been vaccinated. Although it is very unlikely that you will get sick, there is little chance that you can catch the virus and spread it to people who did not get shots.

“We have to keep it going until we’ve really got the virus going and greatly reduced the number of cases in the community,” Shaman said, explaining why people should still wear masks and avoid gathering in large crowds until the country hits the herd. immunity. “There are 50,000 cases a day in the US. It would be much better if we were 500 or 600.”