How Some States Report Breakthrough COVID-19 Hospitalizations May be Misleading, Experts Warn

States are reporting breakthrough case hospitalizations differently, leading some experts to warn it can undermine vaccine confidence

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Amid growing reports of breakthrough COVID-19 infections among vaccinated people, News4 found inconsistencies in how states track whether these people are subsequently hospitalized because of the coronavirus or something else.

Specifically, some states don't distinguish between the number of people hospitalized due to COVID-19 and those hospitalized for another condition but who also test positive for the virus around the same time -- a problem some health experts say can undermine confidence in life-saving vaccines.

"What it does is it makes people think that this vaccine isn't working, which may make them only all the more resistant to getting vaccinated," said Dr. Paul Offit, a renowned virologist who serves on the Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee. 

D.C., Maryland and Virginia are all tracking the number of vaccinated people who later test positive for COVID-19, with at least 33,700 cases reported and at least 1,900 people hospitalized as of late August. 

However, they differ on how they parse out whether a vaccinated person was subsequently hospitalized because of COVID-19 or due to something else. D.C. and Virginia attempt to make the distinction, while Maryland does not. 

The District’s data separates those hospitalized “due to Covid” and those “not due to Covid.” As of late August, data show 86 vaccinated people with breakthrough cases were hospitalized, but less than a quarter were known to be hospitalized because of a COVID-19 infection. The District marks the majority as “unknown.” 

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Virginia health officials told News4 they only post the number of people for whom COVID-19 is "the reason or a significant contributing factor" for why they're in the hospital. As of late August, the Commonwealth reported 17,256 breakthrough cases, with 4.4 percent -- or 760 people -- hospitalized due to the coronavirus. 

But in Maryland, the picture is less clear as the state doesn’t distinguish among the vaccinated people hospitalized because of a Covid infection versus those with Covid hospitalized for something else. As of this week, the state reported 14,006 breakthrough cases among the vaccinated and 1,060 people with breakthrough cases who were hospitalized -- about 7.4 percent.

A spokesman for the Maryland Department of Health said that when the state receives a report of a lab-confirmed COVID-19 case, it’s compared to the list of known vaccinated people. Then the state checks hospital data to see if that person was hospitalized within seven days prior to the COVID-19 test or 28 days following the test. When people fall within that range, they are counted among the COVID-19 positive vaccinated people who were hospitalized.

The MDH spokesman said the state is working with hospitals to get more detailed information on how many of their COVID-19 patients have been fully vaccinated, and added the state is “continuously evaluating its data and reporting systems and will make updates as more data becomes available.”

Offit, who argues a true breakthrough case is only when a vaccinated person later becomes hospitalized due to a COVID-19 infection, called for hospitals and states to report the data in the same way to eliminate confusion.

“Until we can get those data across this country in a fair and logical and even-handed way, then we're just going to be confused and we're going to be confusing the public,”  he said. 

Data show the number of fully-vaccinated people who become severely ill or die from Covid remains very low and the overwhelming majority of COVID-19 patients in hospitals are unvaccinated. 

Offit says the message should be clear to vaccine holdouts: the shots work as intended by protecting most people from severe COVID-19 illness and death. 

“We need to get past this pandemic,” he said. “The only way we're going to get past this pandemic is if we're vaccinated.”

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