Age and underlying health have been a ‘double blow’ for Colin Powell, experts say

Fatal Breakthrough Covid-19 infections in fully vaccinated people, like former Secretary of State Colin Powell, are rare. But experts say the deaths show the need for society as a whole to protect its most vulnerable: those in old age and those with weakened immune systems.

Powell, who died of complications from Covid on Monday, met both criteria. The pioneer official was 84 years old and suffered from multiple myeloma, a cancer of the blood in which malignant plasma cells exceed the space usually reserved for normal infection-fighting plasma cells.

His cancer may have made him particularly vulnerable: not only does multiple myeloma rob the body of its ability to resist infections, it can also interfere with the effectiveness of a vaccine. Research published in the journal Nature in July on patients with multiple myeloma found that only 45% had developed an “adequate response” to Covid mRNA vaccines.

“Covid has been our worst nightmare,” said Dr Paul Richardson, clinical program manager and director of clinical research at the Jerome Lipper Multiple Myeloma Center at the Dana-Farber Cancer Institute.

“Patients are not only vulnerable to infection even despite vaccination, but when infected their immune systems are so dysfunctional that they suffer the worst of both worlds.”

Compared to the number of deaths among unvaccinated people across the United States, which now exceeds 722,000, groundbreaking deaths are just a blast. Of the more than 187 million people who have been fully vaccinated in the United States, there have been 7,178 deaths, according to the Centers for Disease Control and Prevention, with 85% of deaths occurring in people 65 and older.

Age has always been a contributing factor to the severity of Covid and many other infections, said Dr William Schaffner, professor of infectious diseases at Vanderbilt University School of Medicine and medical director of the National Foundation for Infectious Diseases.

“As we age, our physical cells become less robust. They become more fragile, and this can also happen to our immune system,” he said. “If you add to that, of course, the underlying disease, it’s a double blow to the immune system.”

The hope, Schaffner said, is that Covid booster shots in people 65 and over will increase the number of antibodies they have, giving them longer protection. Currently, booster shots are available for people 65 years of age and older and others at high risk who have received the Pfizer-BioNTech vaccine; booster shots for other vaccinees 65 years of age and over are expected to be approved shortly.

It was not clear whether Powell had received a booster, but experts said he would likely have qualified for the extra dose of vaccine the Food and Drug Administration cleared for use in some immunocompromised people in August.

“We have a responsibility”

Powell’s death reflects why everyone has a responsibility to do their part to end the pandemic, said Dr Khalilah Gates, associate professor of pulmonary and critical care at Northwestern University Feinberg School of Medicine.

“When we talk about immunization, it’s not just about us as individuals. It’s about those of us in our communities and in our society who are most vulnerable: it’s our elderly. and our children, ”she said, referring to children under 12 for whom the vaccine has not yet been approved. “We have a responsibility to protect those who cannot protect themselves.”

The function of vaccines is not only to protect the individual, but also to create a “protective cocoon” around viruses so that they cannot find vulnerable people, Schaffner said.

Not getting the vaccine, he said, “is like someone walking up to a traffic light and crossing a red light. Yes, they do take some degree of risk to themselves. , but they put others in danger “.

Powell’s death shouldn’t deter anyone from getting the vaccine if they haven’t already, Schaffner said, adding that more than 90% of people admitted for Covid to his hospital are not vaccinated.

“Vaccines are not perfect,” he said. “But the vaccine shifts the odds in your favor for serious illness to be protected against serious illness.”

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