Covid breakthrough Infections and the elderly
A breakthrough infection is when a vaccinated person still gets the disease. Study suggests that the elderly are LESS affected by breakthrough infections. The study authors were Chinese but their data was international, not Chinese
Published in the journal of Infectious Disease by Jing et al., “SARS-CoV-2 vaccine breakthrough infection in the older adults: a meta-analysis and systematic review,” as the durability challenges of the COVID-19 vaccines lead to waning vaccine effectiveness, associated breakthrough infections tend to rise.
The study authors, affiliated with the Tianjin University of Traditional Chinese Medicine in the northern coastal metropolis of about 14 million people, come to the bombshell conclusion contrary to popular understanding: elderly persons face far less risk for breakthrough infection than is popularly understood, and that the risk of severe COVID-19, hospitalization and death due to breakthrough infection remains perhaps even lower risk than for breakthrough infection alone.
Do these findings alter the risk-benefit calculus for vaccination? Could these results be because of vaccination or natural Immunity? These are important questions. While TrialSite doesn’t anticipate that this important meta-analysis will be picked up by mainstream press in the West the outcomes, limitations aside, are important for further consideration.
The study, published in BMC infectious Diseases and represented by corresponding author Xiaohui Jing with the Tianjin University of Traditional Chinese Medicine in Tianjin, China raises significant questions. Much of the data generated by U.S. public health sources points to far more COVID-19 risk associated with older individuals. Yet this study out of China points to an opposite conclusion.
Designed as a systematic review or meta-analysis, from November 2, 2022, the study team reviewed 30 studies published across English language journal platforms from PubMed and Embase to Cochrane Library and Web of Science. Employing the use of a random-effects model the team calculated pooled estimates of the prevalence and occurrences of COVID-19 breakthrough infections in elderly persons.
Mindful of the influence of bias, the study team employed use of funnel plots, Egger’s regression test, as well as sensitivity analyses while following standard guidelines for this class of study-- Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
The study authors report across 30 publications reveals a pool prevalence of COVID-19 breakthrough infection among the elderly at 7.7 per 1,000 individuals (95% CI, 4.0-15.0), with pooled incidence equaling 29.1 per 1000 person-years (95%CI 15.2–55.7).
The China-based researchers take away from their meta-analysis that the prevalence and incidence of SARS-CoV-19 breakthrough infection in older adults was low. But more eye opening was the finding associated with the risk of hospitalization, severe disease and death associated with the elderly and breakthrough infections, which was even lower than the risk of breakthrough infection.
Jing and colleagues disclosure a handful of limitations including 1) study data restricted to publications in English, 2) the inclusion of studies with a sample size greater than 500 may result in the loss of small eligible studies; 3) Lots of heterogeneity was observed in the included studies; 4) most of the studies included in this study were observed within six months of vaccination; 5) some studies provided little information about the potential influencing factors such as vaccine type, vaccine dose, gender, prior infection, time from vaccination to breakthrough infection, comorbidity, and lifestyle of the included older adults on the prevalence and incidence of COVID-19 breakthrough infection and finally 6) It was also impossible to conduct meta-analyses among some groups due to the less information from studies assessing those factors. Clearly more research is required.