Could comorbidities & medications make some people more susceptible to breakthrough COVID infections?

Unvaccinated people account for most COVID-19 hospitalizations
Published: Aug. 4, 2021 at 8:39 PM CDT
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COVID cases have hospitalizations surging.
COVID cases have hospitalizations surging.(WBRC)

NEW ORLEANS (WVUE) - While the overwhelming majority of the people with COVID-19 who are filling up Louisiana hospitals are unvaccinated the state is seeing some hospitalizations due to breakthrough COVID infections in vaccinated people.

And during an appearance on CNN’s Cuomo Prime Time Governor John Bel Edwards talked about the fact that 90% of the hospitalized have not been vaccinated but that invited a quick follow-up question from the show’s host Chris Cuomo.

“So that means 10% are vaccinated?” asked Cuomo.

Edwards replied, “Yes, that’s right.”

Cuomo then said, “That’s high.”

And Edwards replied, “It is high. But I will tell you, a lot of that I believe has to do with the prevalence of comorbid health conditions here in Louisiana that may be a little more pronounced than elsewhere.”

Local doctors explained the dynamic of comorbidities, certain drugs, and vaccine effectiveness in some people.

Dr. Shantel Hébert-Magee is the Louisiana Department of Health’s Region 1 Medical Director. The region includes the Greater New Orleans area.

“When it comes to vaccine immune response, we know there’s great variability amongst people and there are a number of factors, some are intrinsic and some are extrinsic, so intrinsic factors are age, sex, genetics, comorbidities. Extrinsic factors are things such as your behavior,” said Hébert-Magee.

Louisiana has a high prevalence of cancer, diabetes, asthma, obesity, and some other conditions.

“So, for people who have been vaccinated if they have any of these comorbidities or if they are of advanced age, this may lead to their vaccination response not being as robust as others, so because these comorbidities may actually impact how their immune system COVID-19 even though they may have been fully vaccinated,” Hébert-Magee stated.

And some prescription medications can affect vaccine response, as well.

Dr. Julio Figueroa is Infectious Diseases Chief at LSU Health in New Orleans.

“Certainly, certain medications are going to affect your vaccine response, so in general, people on steroids and other sorts of immuno-suppressant agents that affect the body’s immune system are going to give you a less robust response to any vaccine,” he said.

“Which is one of the reasons why we ask individuals to confer with their physicians if they have a certain course of steroids or other drugs that would suppress their immune response to make sure that when they do get vaccinated that they don’t have these medications in their system which would prohibit them from getting the robust response, meaning that they’re going to create enough antibodies in order to be able to attack COVID-19 if it was to be transmitted,” said Hébert-Magee,

The environment can affect one’s immune system as well.

Dr. Thomas LaVeist is Dean of Tulane University’s School of Public Health and Tropical Medicine.

“And we have high levels of environmental health risks which also interact with our respiratory system and make you more susceptible if you are infected with this virus, so we are a region of this country that has many risks,” said LaVeist.

Hébert-Magee agrees and she also pointed to lifestyle.

“So, toxins, smoking, do you get enough sleep, exercise? And when it comes to comorbidities, in particular, the things that we look at when it comes those who are hospitalized currently with COVID, age is a factor and so is obesity, as well as diabetes and asthma and a number of other conditions,” she said.

But they say no one should use medical conditions, or medications as excuses not to get vaccinated. They say the vaccines will still provide immune-suppressed people some protection.

“Vaccination is always better than not vaccination,” said Figueroa. “What I would say is, first of all, get the vaccine because I think that vaccination still provides protection even in those situations. As the governor said we have a decent number of individuals who are breakthrough cases, but a lot of people have gotten vaccinated and haven’t had a case.”

And Figueroa says because of immunocompromised people and young kids who are not yet eligible to be vaccinated, it is important that everyone else be vaccinated to help protect them.

“If they don’t have a very good immune response, so we try to immunize around that individual as well,” he said.

All the doctors say it is important to wear masks, wash hands frequently, and social distance where possible as the state experiences a fourth surge in COVID-19 infections and hospitalizations.

“It’s been, you know, a part of the CDC’s recommendations as well as on the LDH website is that people who have certain medical conditions, who are immuno-suppressed, who are vulnerable, they should still adhere to mitigation measures, so they should continue to wear their mask, ask others who are in their environment to also mask up and try to social distance,” said Hébert-Magee.


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