Powell’s death raises questions on vaccine

He had breakthrough case, underlying risks

Although dying from COVID-19 is extremely uncommon among the fully vaccinated, health experts say age and preexisting medical conditions may increase the odds of breakthrough infection, severe disease and even death.

Newly released data from the Centers for Disease Control and Prevention shows fully vaccinated people 80 and older are about as likely to die from a COVID-19 infection as unvaccinated people in their 50s and early 60s. As of Oct. 12, the U.S. has recorded 7,178 deaths among vaccinated people; 85% of the deaths were people 65 and older.

At 84, health experts say, Colin Powell fell into this high-risk group. He died Monday from COVID-19 complications.

“As we get older, our immune system is weaker and it is less likely to respond appropriately to vaccinations, and we’re more likely to get ill when we do get exposed to infection,” said Dr. Kristin Englund, an infectious disease expert at the Cleveland Clinic. “That’s why very early on we targeted vaccines for our elderly population.”

Because older people were some of the first Americans to get vaccinated, she said, it’s possible Powell’s immunity may have waned over time, although it’s not clear exactly when he got his first shot.

Research suggests that may be happening among other populations, too. A study in August from the CDC showed vaccine effectiveness decreased among health care workers who were fully vaccinated since the time the delta coronavirus variant became widespread.

But the odds of dying are still much worse if the person is unvaccinated. Unvaccinated people 80 and older are about six times more likely to die from a

COVID-19 infection than vaccinated people in the same age group, CDC data shows.

Powell may have also had multiple myeloma, a type of blood cancer that affects the immune system. Health experts say that would have played a role in his ability to fight off infection.

Myeloma is more commonly seen in people over 60, said Dr. Don Benson, hematologist-oncologist at The Ohio State University Comprehensive Cancer Center.

Roughly 35,000 cases of myeloma are reported in the U.S. each year. Although it’s considered an incurable cancer, most patients don’t die from the disease itself.

“Far and away the most common cause of death is actually infection,” Benson said. “Both the disease and the treatments that we use will either suppress or dysregulate their immune function and make them more susceptible to not just COVID but bacterial and other viral infections.”

The Food and Drug Administration authorized a third Pfizer-BioNTech vaccine shot in August for people with severely weakened immune systems. The FDA also authorized a Pfizer booster in September for people 65 and older, younger adults with underlying health conditions and those in jobs that put them at high risk. More than 8.8 million people have received a Pfizer booster since its authorization.

Last week, an FDA committee voted to support a half-dose booster of the Moderna vaccine for similar populations, and decided the Johnson & Johnson vaccine should be considered a two-dose shot.