Alberta Health is reporting that 88 per cent of COVID-19 deaths – or 628 people – in the province since the start of 2021 to June 3 have been in Albertans who were unvaccinated or within 14 days of their first dose.
Meaning that 12 per cent of COVID-19 deaths – or 85 people – from January 1 to June 3 have been in Albertans who were partially or fully vaccinated.
“It is a higher number than a lot of us expected,” said Dr. Tehseen Ladha, a physician with a Master of Public Health as well as an assistant professor in the Faculty of Medicine at the University of Alberta.
But Ladha said there could be several reasons for this data point, including that clinical trials, which showed high efficacy in preventing hospitalization and deaths, don’t necessarily reflect the real-world experience.
“When these vaccines were trialed, they’re trialed in a large number of people but not millions and millions of people.
“Once you start to vaccinate millions of people, you tend to see the real world efficacy of the vaccine, which tells us how effective it is in real life against serious illness, hospitalization and death,” she said.
Ladha said new variants also play a role, adding that the vaccines may not be as effective against some of the variants that have emerged.
Dr. Noel Gibney, a critical care physician and co-chair of the Edmonton Zone Medical Staff Association Pandemic Response Committee, said it may also boil down to the individual.
“I think it probably relates to individuals and their immune response so it’s possible they’re simply not able to mount a full immune response,” he said.
Of the 85 deaths in those who were partially or fully vaccinated, Alberta Health said 59 of them were in Albertans who were more than 14 days past their first dose; 26 were fully immunized.
Gibney said the numbers show why a full vaccination series is critical.
“It brings the point very clearly why we need two shots and why it’s important everybody should be fully vaccinated,” he said.
Gibney further points to the B.1.617 variant, also now known as the Delta variant, to emphasize why two doses are important.
According to Public Health England in a tweet on May 27, one dose of Pfizer or AstraZeneca COVID-19 vaccine was 33 per cent effective against the Delta variant. After two doses, that effectiveness increased to 88 per cent and 60 per cent, respectively.
However, doctors stress that the deaths in those vaccinated are the minority of deaths in the province.
“That really shows us vaccines do work. The group that was experienced the worst outcome, which is death, is those people who weren’t vaccinated or didn’t have acquired immunity yet,” Ladha said.
Alberta Health said that no vaccine provides 100 per cent protection but they had significantly reduced the severe effects of COVID-19 for Albertans.
“Even with the remarkably effective COVID-19 vaccines, a small percentage of people who are partially or fully vaccinated will still get COVID-19 if they are exposed to the virus and this can lead to severe outcomes, including death,” said spokesperson Tom McMillan.
McMillan also said that the number of deaths is a “much smaller’ sample size than that for cases and hospitalizations and thus has the highest variability.
He said that the vast majority of vaccinations have occurred in the last six weeks and it’s likely that the figure will evolve in the coming weeks.
Re-opening plans
With that said, Ladha said vaccines are not the sole ticket of this pandemic. The province has introduced a reopening plan that will see it move into Stage 2 on June 10. Stage 3 will trigger two weeks after 70 per cent of those eligible have received at least one dose of vaccine.
“They’re certainly one of the key pillars in the exit strategy for the pandemic but they need to be combined with public health restrictions in order to get community transmission low,” she said, pointing to masking and restrictions on gathering limits.
Ladha said there’s a chance this summer will allow Albertans more of a sense of normalcy.
“But the worry is, by doing this too quickly, we’ll incite a fourth wave despite having vaccines at hand,” she said.
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Gibney is also concerned that the province’s reopening plan, which is based on first doses, moves too quickly and should only move further into reopening when the majority of population has received two doses.
On Thursday, chief medical officer of health Dr. Deena Hinshaw said second doses were embedded in calculations for reopening.
“We estimated that our second dose coverage would be relatively stable and increasing over time… We wanted to make sure as we were communicating to Albertans, we were using very understandable metrics and again wanted to use that leading edge metric of those first dose coverage pieces knowing that the second dose would be coming along behind,” she said.
-with files from Gaby Rodrigues