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What’s the best way to track ‘breakthrough cases’?

Ohio isn’t tracking the number of fully vaccinated people who have contracted COVID-19. Instead, the state collects data about how many people with these “breakthrough” infections have been hospitalized or died.

At first glance, it may seem like something here is missing, but Ohio’s chief medical officer says less is actually more. He also said the CDC takes the same approach.

“When you think about this from an information- or data-gathering point of view, it is much more reliable to look at those endpoints of hospitalizations and deaths,” Dr. Bruce Vanderhoff said. “Endpoints which really and truly tell us if the vaccination is doing what it was designed to do or not.”

Indiana is taking a different approach. The state tracks the number of breakthroughs to compile a total number of cases, but the method is somewhat non-traditional.

The data is pieced together in a painstaking way by comparing two separate databases. Staff members look at a registry of every vaccinated Hoosier and a spreadsheet of daily positive COVID test results. Then they crunch the numbers and post weekly totals for the public online.

Dr. Thom Huth, who works for Reid Health in Wayne County, Indiana, said he can see how having separate ways to track these cases can be confusing.

"It unfortunately may create the impression that authorities don't know what they're doing,” Huth said. “But that's not the case. It's just that the needs are changing so quickly. It's hard for anybody to keep up.”

He also said tracking individual breakthrough cases is tricky and can be unreliable.

"One recent day, 10% to 15% of the patients in the hospital had been previously vaccinated,” Huth said. "But that number goes up and down."

Ohio Governor Mike DeWine said he supports the way Ohio gathers its data on these breakthrough cases and fear of discouraging vaccination plays no part in how the state collects numbers. DeWine said top health advisors, including those at the CDC, think it’s more important to track hospitalizations and deaths of fully vaccinated people.

Dewine said the focus should remain on boosting vaccination numbers, a sentiment former Cincinnati health commissioner Dr. O’dell Owens agrees with.

"The key part is to keep people out of the hospital,” Owens said. “We’ve got to stay focused on one thing. If everybody's vaccinated, there are no breakthrough cases.”




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