Epidemiologically, the vaccinated is the same as the unvaxxed

In brief, this letter says that there is no difference between the vaccinated and unvaccinated regarding the source of COVID-19, peak viral load, and the severity of illness. The author (and me) suggest that public health policymakers should also factor in the vaccinated people when making public health control measures. (Me: And not to blame the unvaxxed all the time).

This article is a repost from The Lancet Regional Health and is by Professor Günter Kampf of the University Medicine Greifswald, Institute for Hygiene and Environmental Medicine Germany.

It is consistent with the topics on this website. That is why I reposted. I also reformatted and added emphasis. The original title is The epidemiological relevance of the COVID-19-vaccinated population is increasing.

Introduction

High COVID-19 vaccination rates were expected to reduce transmission of SARS-CoV-2 in populations by reducing the number of possible sources for transmission and thereby to reduce the burden of COVID-19 disease. Recent data, however, indicate that the epidemiological relevance of COVID-19 vaccinated individuals is increasing.

United Kingdom

In the UK, it was described that secondary attack rates among household contacts exposed to fully vaccinated index cases were similar to household contacts exposed to unvaccinated index cases (25% for vaccinated vs. 23% for unvaccinated). 12 of 31 infections in fully vaccinated household contacts (39%) arose from fully vaccinated epidemiologically linked index cases. Peak viral load did not differ by vaccination status or variant type [[1]].

Germany

The rate of symptomatic infection among vaccinated individuals increases week by week.

In Germany, the rate of symptomatic COVID-19 cases among the fully vaccinated (“breakthrough infections”) has been reported weekly since July 21, 2021, and was 16.9% at that time among patients 60 years and older [[2]]. This proportion was increasing week by week and was 58.9% on October 27,  2021 (Figure 1) providing clear evidence of the increasing relevance of the fully vaccinated as a possible source of transmission.

Figure 1. Vaccination rates and proportions of fully vaccinated people among symptomatic COVID-19 cases (≥ 60 years) in Germany between July 21 and October 27, 2021, based on the weekly reports from the Robert Koch-Institute [[2]]

A similar situation was described for the UK. Between weeks 39 and 42, a total of 100,160 COVID-19 cases were reported among citizens of 60 years or older. 89,821 occurred among the fully vaccinated (89.7%), 3,395 among the unvaccinated (3.4%) [[3]].

One week before, the COVID-19 case rate per 100,000 was higher among the subgroup of the vaccinated compared to the subgroup of the unvaccinated in all age groups of 30 years or more.

Israel

A nosocomial outbreak was reported in Israel involving 16 healthcare workers, 23 exposed patients, and two family members. The source was a fully vaccinated COVID-19 patient.

The vaccination rate was 96.2% among all exposed individuals (151 healthcare workers and 97 patients). Fourteen fully vaccinated patients became severely ill or died, and the two unvaccinated patients developed mild disease [[4]].

The US Centres for Disease Control and Prevention (CDC) identifies four of the top five counties with the highest percentage of the fully vaccinated population (99.9–84.3%) as “high” transmission counties [[5]].

Many decision-makers assume that the vaccinated can be excluded as a transmission source. It appears to be grossly negligent to ignore the vaccinated population as a possible and relevant transmission source when deciding about public health control measures.

My take: This letter was published on November 19, 2021, before the Omicron variant became dominant. Since then, the Omicron has infected both vaccinated and unvaccinated. Fortunately, the majority get a mild disease. Omicron outbreak in triple jabbed health care workers, Higher number of COVID-19 cases but no change in death rates. The South African omicron experience

And this is why Multinational study shows why the Omicron variant has low fatality and high infectivity