Majority of MN COVID cases are now among the vaccinated. Here's why the shot is still worth it.

Feb. 13—More than half of the Minnesotans who tested positive for COVID-19 in December were vaccinated, the latest evidence that waning vaccine protection and the highly-contagious omicron variant have altered the fight against the pandemic.

Roughly a third of those who were hospitalized for COVID-19 or died during that month also were vaccinated. The Minnesota Department of Heath breakthrough case data does not indicate if people had received boosters shots.

"We know omicron was a big part of it," Daniel Huff, assistant commissioner at the Minnesota Department of Health, said of the growth in breakthrough infections. "We know omicron was immune-evasive, much more so than delta. Even those who were vaccinated, even though they had protection against infection, it was less protection than they had against delta infection."

Nevertheless, health officials say vaccines, particularly the mRNA versions from Moderna and Pfizer, along with a booster dose remain the best way to protect against severe illness and to slow the spread of the coronavirus.

But health officials acknowledge that expectations about the protection vaccines provide continues to evolve. Vaccination was never a promise of total protection, but now, as the coronavirus has evolved through different variants, health officials acknowledge there's an increased risk the vaccinated can still contract and spread COVID-19.

"The vaccines were initially designed and continue to do an excellent job at preventing severe disease — keeping people out of the hospital, keeping them out of the ICU and keeping them from dying," said Dr. John O'Horo, a Mayo Clinic infectious diseases expert. "I think we have lost focus on what vaccines are designed to do, which is make this disease manageable."

WHO IS GETTING SICK

As omicron began spreading in Minnesota in December, age-adjusted state data shows that residents who were vaccinated were almost as likely to test positive for COVID-19 as those who had no vaccine protection at all. In fact, raw data on infections from Dec. 5 through Jan. 2 shows that 59 percent of the nearly 183,000 people who tested positive were vaccinated.

Mary and Andy Coulter, of Minneapolis, were two of those breakthrough cases. They tested positive right around Christmastime, upending their plans to spend time with family.

Luckily, their symptoms were mild, something both credit to being vaccinated and having a booster.

"We were super disappointed because it screwed up our Christmas," Mary said. "We were bummed, but we also thought, 'everybody is going to get it.'"

Huff noted that as more of the population is vaccinated, breakthrough cases will inevitably rise. Roughly 70 percent of the eligible population is fully vaccinated and about 10 percent of them, nearly 330,000 people, have reported a breakthrough infection.

Yet, while breakthrough cases rose, there was not as large of a corresponding increase in hospitalizations and deaths among the vaccinated. State data shows in December unvaccinated residents were almost 11 times more likely to be hospitalized with COVID-19 and 20 times more likely to die.

Furthermore, all the state's data on breakthrough cases does not currently measure whether a person received a booster. Multiple studies in the U.S. and across the globe have found the protection provided by vaccines wanes considerably after six months and boosters are now recommended for anyone 12 and older.

A recent national study by the Centers for Disease Control and Prevention found that unvaccinated people were 97 times more likely to die if they contracted COVID-19 than those who had been fully vaccinated with a booster shot.

"The trends nationwide have been most of the hospitalized are unvaccinated or vaccinated but without a booster," O'Horo said. "What I try to remind people is there is being sick and there's being sick in the hospital."

He added that the vast majority of the sickest patients who need oxygen support or are in the intensive care unit are unvaccinated.

WHAT'S NEXT FOR VACCINES

Minnesota health officials say they will continue their exhaustive campaign to get as many people vaccinated as possible. That includes still trying to convince holdouts as well as encouraging everyone who is eligible to get a booster.

Health officials are also focused on vaccinating children as they become eligible. Kids ages 5 to 11 currently have the lowest rate of vaccination, with just 39 percent completing their two-dose series.

The vaccination campaign includes working to answer questions of people who are hesitant and dispelling misinformation that continues to circulate online. Much of that has to do with vaccine safety.

"I think it's really unfortunate when folks inadvertently or deliberately misconstrue the data," Huff said. "Vaccines are probably the safest consumer product in the entire United States."

Additionally, more doses of vaccine will likely be needed in the coming months and years because SARS-CoV-2, the coronavirus that causes COVID-19, is not going anywhere.

Even if it becomes endemic, or essentially everywhere, rates of infection will rise and fall and mitigation measures may need to be taken to protect the most vulnerable and preserve hospital capacity.

Vaccines remain the best way to do that, health officials say.

"It is reasonably easy to guess we will be seeing new variants, just like we do with the flu every year, which would mean having not so much a booster as a seasonal injection that's tailored to that," O'Horo said. "I don't think this is three shots and done."