Why the fact that vaccinated people die from covid-19 does not mean that vaccines are ineffective

(CNN) – Former US Secretary of State Colin Powell died Monday of complications from Covid-19. His family announced that he was fully vaccinated. He was 84 years old and had multiple myeloma, a blood cancer.

Health officials are concerned that anti-vaccine activists are taking advantage of Powell’s death to claim that vaccines don’t work. If you can still die after being vaccinated against covid-19, what is the point of getting vaccinated?

What is the answer to that question? I spoke with Dr. Leana Wen, CNN medical analyst, emergency physician, and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also the author of a new book, “Lifelines: A Doctor’s Journey in the Fight for Public Health.”

CNN: When we see vaccinated people dying from covid-19, how do you explain that it is still worth getting vaccinated?

Dr. Leana Wen: We need to start with the science and what the research shows. Covid-19 vaccines are extraordinarily effective in preventing disease and especially serious illnesses. The most recent data from the US Centers for Disease Control and Prevention (CDC) shows that they reduce the probability of testing positive for COVID-19 by six times and the probability of death by 11 times.

That means that if you are vaccinated, you are six times less likely to get COVID-19 than someone who is not vaccinated. And you are 11 times less likely to die from COVID-19 compared to an unvaccinated person. That is really excellent.

However, covid-19 vaccines do not protect 100%. No vaccine does, virtually no medical treatment is likely to be 100% effective. That doesn’t mean the vaccine won’t work or that you shouldn’t get it.

CNN: Are some people more likely to have severe COVID-19 results despite vaccination?

Wen: Yes, and from what I have learned, General Powell fell into that category. We know that people who are older and have underlying medical conditions are more likely to suffer serious illnesses and die after post-vaccination infections. Those at particular risk are immunosuppressed people. Having multiple myeloma would place General Powell in this category and, in addition to his advanced age, would increase the level of risk.

Keep in mind that this is one of the reasons that booster doses are recommended. In August, federal health officials recommended that people with moderate or severe immunosuppression, who had the Pfizer or Moderna vaccines, receive a third dose. They cautioned that even with the extra dose, immunosuppressed people should take extra precautions. That’s because this is a category of people who are particularly susceptible to serious results.

CNN: You’ve said before that vaccines work best when everyone gets them, right?

Wen: Exactly. Think of the covid-19 vaccine as a very good raincoat. It works very well to protect you in the event of a drizzle. But if you are in a storm and then a hurricane comes, there is a much better chance that you will get wet. That does not mean that your raincoat is faulty. It means that there is bad weather and that the raincoat alone cannot always protect you.

If you are around a lot of viruses, that increases your chances of getting infected. The problem is not the vaccine, it is that there is too much virus around you.

So the key is to vaccinate as many people as possible. That reduces the overall rate of infection and ends up protecting everyone. And, if you are in an area with a lot of viruses, wearing a mask in confined spaces with a lot of people adds an extra level of protection.

And let’s not forget that we also get vaccinated to protect the most vulnerable among us, who are at the highest risk of serious outcomes.

A study of 13 states over six months showed that fully vaccinated people accounted for just 4% of all COVID-19 hospitalizations.

Unvaccinated people are 17 times more likely to be hospitalized for coronavirus than fully vaccinated adults, according to that CDC study. Those who end up with post-vaccination cases that result in hospitalization are more likely to be older and have multiple underlying medical conditions, as we discussed.

CNN: What other things would you say to those who don’t believe the vaccine is effective?

Wen: I would ask you to think about other aspects of medicine. Let’s say someone has heart disease. There are medications to treat heart disease, but they are not 100% effective … nothing is. Just because someone ends up with an exacerbation of their illness and in the hospital does not mean that medications are not worth taking.

Or let’s use an example of prevention. Let’s say someone who eats a healthy diet and exercises a lot still ends up with high blood pressure and diabetes. That does not mean that diet and exercise are not good. It just means that you can take all the right steps to prevent a disease, but sometimes you could still get the disease.

One of the main enigmas of public health is that the work we do has to do with prevention. While you see the bottom line if prevention fails, you don’t see all the lives saved through prevention.

A modeling study supported by the National Institutes of Health found that covid-19 vaccines prevented more than 139,000 deaths in the first five months they were available. By May 9, there had been about 570,000 deaths from Covid-19 in the United States. Without vaccines, 709,000 deaths could have occurred.

The bottom line is that vaccines work. They reduce the chance of getting sick and getting very sick and dying. They are not 100% because nothing is.

CNN: Can vaccines also prevent a resurgence of the virus this winter?

Wen: Yes. It is encouraging that the COVID-19 infection figures are falling from the terrible delta wave that consumed the country this summer. Yet another wave of infections is possible, especially with only 57% of the US population fully vaccinated.

I agree with Dr. Anthony Fauci, who said this weekend that “it will be within our ability to prevent that from happening … The degree to which we continue to go down that slope will depend on how well we do to get more people vaccinated. “

Ultimately, the key to reducing the risk of COVID-19 for everyone, and to ending the pandemic, is for everyone to get vaccinated. This protects us and those around us.