Last winter, as COVID-19 vaccines were first being rolled out, a number of states set a 70% vaccination goal for people ages 16 years or older, including Michigan. President Joe Biden and the Centers for Disease Control and Prevention set the same goal for the nation in May, which was reached in early August.
This week, Michigan reached that goal, but it is also in the midst of another wave of COVID-19 cases. In fact, Michigan leads the pack nationally for the most cases in the last week.
So, where did the 70% goal come from and what does it actually mean for the ongoing pandemic?
“Seventy percent was given as a goal, like getting to the moon. It is a goal, it is not a magical fix,” said Dr. Arnold Monto, a professor of epidemiology and global health at the University of Michigan School of Public Health.
He also currently serves as acting chair of the Vaccines and Related Biological Products Advisory Committee, which provides advice to the Food and Drug Administration (FDA) on the authorization and licensure of vaccines to prevent COVID-19.
When Gov. Gretchen Whitmer unveiled her “Vacc to Normal” plan in late April, she used the 70% vaccination rate for Michigan’s nearly 10 million residents, excluding those under 16, as a metric in order to drop the state’s gathering limitations and face mask mandates.
However, the CDC announced in mid-May that fully vaccinated people no longer had to wear masks in social settings. So on June 22, Whitmer rescinded the statewide mask and social-distancing mandates, even though at that time only 61% of residents had received at least one dose and just 52% of residents were considered fully vaccinated.
Vaccines are now available to more people than ever. On Nov. 3, the CDC recommended the Pfizer-BioNTech’s COVID-19 vaccine for children ages 5 to 11. Children ages 12 to 15 were approved for the vaccine in May. Additionally, the FDA on Friday expanded access to booster shots for all adults who are 18 and older and at least six months out from being fully vaccinated.
State officials are hoping that these changes will quell the current surge of cases.
“We are very excited that we did reach our initial milestone of 70% of eligible Michiganders getting one at least one dose of the vaccine. However, as we are seeing, that is not achieving herd immunity,” said Michigan Department of Health and Human Services (DHHS) Director Elizabeth Hertel on Friday. “Our goal of the DHHS is to try to support everybody in this state who is eligible to have access to getting one of the three safe and very effective vaccines and we will continue our work to do so.”
Gov. Gretchen Whitmer takes the Pfizer vaccination at Ford Field | Ken Coleman photo
‘Seventy percent is not going to cut it’
Even with 70% of Michiganders ages 16 and older having at least one shot of a COVID-19 vaccine and about 54% of eligible Michiganders fully vaccinated, test positivity rates, case rates and the percent of inpatient beds occupied by individuals with COVID-19 have been increasing for weeks.
As of Wednesday, the state reported a total of 1,224,273 total cases and 22,862 deaths.
In June, Michigan, like many other states, was thrown a curveball when the first confirmed case of the Delta variant was reported in the state, which now makes up nearly 100% of COVID-19 cases in Michigan.
To reach true herd immunity, Dr. Matthew Sims, the director of infectious diseases research at Beaumont Hospital, Royal Oak, said “we need vaccination rates in the 90%” range.
“Seventy percent is not going to cut it,” Sims said. “When the virus spreads more, the virus mutates more and you get a higher chance of variants.”
The Delta variant is more contagious and spreads faster than the original strain of COVID-19, something that health officials weren’t expecting when they set the 70% vaccination goal, said Monto.
“The bigger issue is that 70% assumes random distribution of the 30% who aren’t vaccinated. And that’s not what happens. You have clusters of unvaccinated people where you can get transmission going,” said Monto.
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‘The overall goal is to keep people out of hospitals’
The spike in breakthrough cases, or fully vaccinated people who are contracting the virus, has reduced the impact of the 70% vaccination goal, another issue that wasn’t anticipated by health officials.
The state has just barely hit its vaccination goal more than seven months after vaccines were made available to all Michiganders over 16, and Michigan is now reporting the highest number of COVID-19 cases in the country, according to a Tuesday report from the DHHS.
While the number of breakthrough cases are increasing, these aren’t the majority of the cases in Michigan and very few breakthrough cases are landing Michiganders in the hospital.
The state data shows that cases, hospitalizations and deaths from COVID-19 since January are significantly higher for people who are not fully vaccinated. From Jan. 15 to Nov. 5, 88% of cases, 88.2% of hospitalizations and 87.7% of deaths are people who were not fully vaccinated.
“We have these vaccinations that are keeping the majority of people out of the hospital. Even if they are hospitalized, they are not getting as sick [as unvaccinated people],” said Monto.
State data from that same time frame shows approximately 1.5% of fully vaccinated people in Michigan have been infected, about 77,985 cases. Of those cases, there have been 944 breakthrough deaths, 823 of which were people 65 years or older, and 2,009 breakthrough cases were hospitalized.
Seventy percent was given as a goal, like getting to the moon. It is a goal, it is not a magical fix.
– Dr. Arnold Monto, a professor of epidemiology and global health at the University of Michigan School of Public Health
As the fully vaccinated population has increased, so have the percent of breakthrough incidents; but breakthrough burden remains lower, according to the DHHS.
“The messaging needs to be: Get vaccinated. Using 70% was a useful goal when [the vaccination rate] was at 20%. I’m not so sure that it’s currently a useful goal given the fact that we want to get those who are already vaccinated a booster shot,” said Monto. “The messaging also needs to say that transmission is unlikely to be extinguished completely, but we have to do what we can to keep people out of hospital, which the vaccines clearly do.”
With the 70% vaccination goal, many people expected herd immunity to be reached once more than two-thirds of the population was vaccinated — which would largely stop COVID’s spread.
But herd immunity is more difficult to achieve for a disease that mutates and can reinfect individuals, like COVID-19, and the best way to prevent infection is through vaccination.
Less than .1% of fully vaccinated people in Michigan have been hospitalized for COVID-19, according to state data, and the symptoms of fully vaccinated people who contract COVID-19, especially those under age 65, are much more mild than unvaccinated people.
A recent study, published in the journal Science, found the effectiveness of the different vaccines wanes over time. Moderna’s vaccine effectiveness dropped from 89% in March to 58% effective by the end of September, Pfizer’s effectiveness dropped from 87% to 45% in that same time period and the Johnson & Johnson single-dose vaccine dropped from 86% to 13%. The decrease in effectiveness has sparked the need for eligible fully vaccinated people to get the booster shot.
“The overall goal is to keep people out of hospitals,” said Monto. “We will, with this tricky virus, never be able to get to the point where we don’t have cases.”
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authored by Allison R. Donahue
First published at https%3A%2F%2Fmichiganadvance.com%2F2021%2F11%2F19%2Fthe-state-set-a-vaccination-goal-of-70-then-came-the-delta-variant%2F
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