Breakthrough COVID-19 Infection Kills Colin Powell

More frequent testing and continuation of mitigation measures such as masking would better help to protect the more vulnerable among us such as Colin Powell, a study concludes.

The United States today mourns the passing of one of the country’s most famous veterans, former Secretary of State Colin Powell. Powell, a four-star general whose long list of accomplishments embellish a storied career, died yesterday of complications from COVID-19. The 84-year-old Powell had been fully vaccinated against SARS-CoV-2, but was also fighting underlying health conditions, including multiple myeloma and Parkinson’s disease. Powell’s death at Walter Reed National Medical Center in Bethesda, Maryland, resulted from a breakthrough infection.

Coincidentally, an article in the American Journal of Infection Control (AJIC) published last week looks at veterans in an attempt to refine methods of determining level of vulnerability to

breakthrough infections. Investigators with the Veterans Affairs Ann Arbor Healthcare System (VAAAHS) conducted an observational case series report on 10 veterans admitted to the facility with breakthrough infections between March 15, 2021, and April 15, 2021, because they wanted to add to the limited data on breakthrough infections.

“Given the variability of vaccine breakthrough infections requiring hospitalization, serologic testing may impart clarity on timing of infection and disease prognosis,” the study concludes. “Individuals at risk of diminished response to vaccines and severe COVID-19 may also benefit from selective serologic testing after vaccination to guide risk mitigation strategies in a post-pandemic environment.”

All 10 of the veterans were older than 70 and, like Powell, suffered from multiple comorbidities. The mean time between when the veterans had gotten their second dose of the COVID-19 vaccine and the breakthrough infection was 49 days.

“In the seven individuals with acute infection, none had observed serologic response to mRNA vaccination, five developed severe disease, and one died,” the study states. “Three individuals had anti-N IgG antibodies and a high polymerase chain reaction cycle threshold (Ct) value, suggesting resolving/resolved infection.”

As the Hill and other news outlets report, Powell—who’d gotten his second shot of the Pfizer-BioNTech vaccine in February—had been scheduled to receive a booster shot this week, but was too sick to get it.

Investigators with the AJIC study note that the Food and Drug Administration currently says that routine antibody testing to determine immunity after someone’s been vaccinated for COVID-19 isn’t necessary.

“However,” the AJIC study states, “without a better understanding of vaccine response, many high-risk individuals could be at even greater risk as mitigation measures are relaxed (e.g., mandatory masking) for the fully vaccinated. For high-risk individuals, the selective use of antibody testing for anti-S IgM and IgG may be useful to identify those that would benefit from enhanced precautions to SARS-CoV-2 exposure.”

VAAAHS vaccinated over 25,000 veterans between December 30, 2020, and April 1, 2021.

Our experience with Michigan veteran patients demonstrates that despite higher-than-average vaccination rates within this population, surging case counts within the community will lead to an increase in breakthrough infections and hospitalizations,” the AJIC article states. “As the Delta strain and other highly virulent strains become more prevalent, this report reinforces the need to not only rapidly vaccinate entire communities, but also practice other risk mitigation strategies if local COVID-19 case volumes are high.”