General Colin Powell’s tragic death from COVID-19 is not indicative of a vaccine rejection, but the failure of his fragile immune system to protect him from the unvaccinated, according to one of the leading doctors in National Health Policy.
“No matter how good our vaccines are, if we have a raging wildfire of infections among the unvaccinated, it will spread and kill vulnerable vaccinated people,” written by Dr. Ashish Jha, Dean of the School of Public Health at Brown University, on Twitter.
Powell, 84, the first black US secretary of state to help shape American foreign policy, was reportedly suffering from a form of white blood cell cancer.
This cancer, called multiple myeloma, damages the immune system. Thus, despite being fully vaccinated, his body was unable to produce enough antibodies to defend against the COVID-19 virus.
People with weakened immune systems, such as Powell, rely on herd immunity for protection. As long as some people remain unvaccinated, the virus continues to circulate and can cause infection in the most vulnerable.
They are isolated only when so many other people are fully vaccinated that the virus cannot find enough people to infect and then stops spreading.
Infections among vaccinated people are much less common than infections among unvaccinated people, and when these so-called “breakthrough” cases occur, they tend to be easier. People have fewer symptoms that are less severe, and they get sick for fewer days.
This is because vaccines train the immune system’s white blood cells to fight infection. The job of these cells, our first line of defense against a pathogen, is to create antibodies.
Soon after infection, the cells begin to work at full strength. Most people do not develop severe illness and recover within a few days.
Only 0.006% of the 185 million vaccinated Americans die from breakthrough infections. Many of them, such as Powell, suffer from other immune-related illnesses. They can take immunosuppressants for conditions like rheumatoid arthritis. They may have been born with a defective immune system.
For these vulnerable people, vaccines are beneficial. To protect those who do not respond to the first batch of vaccines, the FDA has approved third doses of Pfizer-BioNTech and Moderna vaccines for people with weakened immune systems. It is not known whether Powell received a “booster” defense.
But the vaccine is often not enough. How well a booster works may depend on the general immunosuppression status of each patient.
“They need us to protect them the way we protect ourselves,” said Dr. Kelly Moore of the Immunization Action Coalition, which works with the US Centers for Disease Control and Prevention to disseminate information about vaccines.
In Powell’s disease, plasma cells become abnormal or depleted, which reduces their ability to make antibodies. Powell was also treated for Parkinson’s disease.
His wife Alma also contracted COVID-19 despite being vaccinated, but responded well to treatment with Regeneron monoclonal antibodies, CBS News reported.
One recent study found that most elderly patients with multiple myeloma have impaired response to COVID-19 vaccination. Only 45% of these cancer patients developed an adequate response to the COVID-19 vaccine; According to a study published in the journal Blood by Dr. Evangelos Terpos, professor of hematology at the Department of Clinical Therapy of the Kapodistrias National University of Athens, 22% answered partially.
In addition, there is growing evidence that chemotherapy and other cancer treatments reduce immunity. One study of people hospitalized with COVID-19 found that those who had some type of cancer or had previously had cancer are several times more likely to die or need ventilation.
Seniors with heart or kidney disease are also at risk, Jha said.
“Those two days of fever can trigger a heart attack or kidney failure,” he wrote. “And this heart attack or kidney failure could kill them.”
When transmission is high from unvaccinated people, “even a small percentage of vaccine breakthrough infections will be severe,” Jha said. “A small percentage of the very large number is still large.”
“Protecting vulnerable people means … reducing the spread of the virus in society,” he wrote.
