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More of the vaccinated, boosted winding up in NC's hospitals with COVID. Why?

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RALEIGH, N.C. News — It’s been a cornerstone message during the pandemic recovery: Get the COVID-19 vaccine, and you are much less likely to wind up in a hospital.

But according to the latest numbers from state public health leaders, that might not be as true as it used to be: In North Carolina’s hospitals, fully vaccinated people now nearly outnumber the unvaccinated.

The phenomenon also is showing up in other states, and one leading infectious disease specialist has a simple explanation for it — and in no way is it an indictment of how effective the shots are.

“We don’t want this to sound like the vaccine doesn’t work,” said Dr. David Weber, an infectious disease specialist at the University of North Carolina’s School of Medicine.

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According to the most recent numbers from the state Department of Health and Human Services, a total of 52 percent of COVID patients in hospitals were at least fully vaccinated.

That’s a massive drop in the four months since the state started breaking those hospitalization rates into three groups: unvaccinated, fully vaccinated and boosted.

And with cases and hospital admissions on the rise and North Carolina potentially on the verge of yet another COVID wave, the explanation from Weber goes back to the omicron surge in the winter.

“So many people got infected with that that they have short-term, at least, natural immunity,” Weber said.

“Therefore it’s driving those rates down in the unvaccinated and making it seem as though a higher percentage of vaccinated people are ill,” he added. “But keep in mind that’s with a much, much reduced rate of hospitalizations.”

That’s certainly showing up in the numbers now.

When NCDHHS started releasing that breakdown in late January, unvaccinated people accounted for nearly 70 percent of hospitalized patients.

But two weeks ago, there were more people in hospitals who had been vaccinated than who hadn’t been.

And the rate of boosted people going to hospitals has more than quadrupled since January — with nearly a quarter of the hospitalized now having at least one extra shot.

Dr. Lisa Pickett, the chief medical officer at Duke University Hospital, said she is seeing “a fair number who are vaccinated” at her facility.

But it’s important to keep in mind that a big chunk of the people who have gotten boosters are the ones who were already at high risk.

“Those are chronically ill, immunocompromised people who may not have had a full response to the vaccines that they received,” she said.

It’s also worth noting that not all hospital stays are the same.

They tend to be shorter for vaccinated and boosted patents, and less likely to wind up in intensive care.

“The severity of illness of these patients, even those who are immunocompromised, is lower,” Pickett said.

It’s a trend worth keeping an eye on now that we appear to be in the middle of yet another surge: NCDHHS numbers show North Carolina is averaging more than eight times more new cases per day than it did in late March — and that’s certainly an undercount because so many tests are being done at home and don’t factor into those figures.

The state’s latest patient count is nearly a week old, and the 524 hospitalized people on May 14 is up 50 percent from where it was a month ago. 

But Weber says it’s all a matter of perspective. The current count is still about one-tenth of what it was during the worst of omicron.

“Keep in mind that number of people hospitalized is way down,” he said. “Small numbers make big percentage changes.”



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