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Breakthrough COVID-19 cases for those with underlying problems
Colin Powell's death due to complications from COVID-19 is shining a spotlight on breakthrough cases in those who have had underlying health problems. Powell had been treated over the past few years for multiple myeloma, a blood cancer.
When the news broke General Colin Powell had died at 84 from complications of COVID-19 despite being fully vaccinated, Dr. Jeffrey Metts, chief medical officer of Cancer Treatment Centers of America in Atlanta, says it felt like a "wakeup call."
"The first thing that came to my mind was healthy people need to get vaccinated," Dr. Metts says. "Because we cross paths, we come into contact with folks. And, many people, even though they've been vaccinated, and they're trying to get that third shot, sometimes their immune system just can't get that level that we need, or that they need. And, the best way to put this past us is to get our vaccination rates as high as we can."
General Powell, had reportedly been treated for the blood cancer multiple myeloma, which may have made it more difficult for his immune system to fight off the virus and may have kept his body from mounting a full response to the vaccine.
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General Powell reportedly got infected before he could receive a scheduled third shot last week.
"In his case, as he was waiting to get the booster, and wasn't able to, he contracted COVID," Dr. Metts says. "So, my mind shifts to the healthy people in the population. Where can we stop COVID in its tracks?"
Dr. Metts says multiple myeloma is more common in men and people over the age of 65, affecting about 30,000 Americans a year.
"Multiple myeloma is a proliferation of your plasma cells," he says. "When the plasma cells start to proliferate in your bone marrow, then that can cause harm to you."
The cancer can cause bones to become brittle and dampen down the immune system, he says.
"It makes you much more susceptible to infections and things like that, and you have a much higher incidence of dying of an infection in someone who has multiple myeloma," Metts says.
Dr. Gavin Harris, an assistant professor in the Department of Infectious Diseases at Emory University School of Medicine, says breakthrough infections are more common in people with weakened immune systems and seniors.
"Unfortunately, it's not surprising that people who are immunocompromised, who have an underlying condition such as cancer, such as diabetes, such as other autoimmune diseases, are at greater risk, whether they're vaccinated or unvaccinated," Dr. Harris says. "And the older people get, the more likely they are to deal with these conditions. It's harder for their immune systems to generate responses to vaccines and even to repeat infections."
Dr. Harris says no vaccine can offer 100% protection against infection.
Still, he says, those who are vaccinated are at much lower risk of getting severely ill, needing hospitalization or dying than those who are unvaccinated.
"So, I think message is clear here: we still need to get people vaccinated, we still need to mask up at times, and we still need to be really careful about our daily lives," Dr. Harris says.
Dr. Metts encourages healthy people to get vaccinated as a way to protect more vulnerable people around them.
"It's not for you," Dr. Metts says. "It's what you can do for your neighbors, for your aunts and uncles and fathers and grandparents."
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