Jun 01, 2021 11:00 AM

Author: Kylene Metzger


The impact of COVID-19 among older adults in Utah looks a lot different today than in the fall and early winter of 2020. The number of COVID-19 cases, hospitalizations, and deaths have dramatically dropped among adults aged 70 and older since February 2021 following the rollout of COVID-19 vaccines. More than 80 percent of older adults have now been vaccinated in Utah. 

Mark Supiano, MD, chief of the Division of Geriatrics at University of Utah Health and Emily Spivak, MD, associate professor of medicine in the Division of Infectious Diseases at U of U Health answer questions about older adults and current information about COVID-19 vaccines.

What are the current trends in Utah among older adults?

Supiano: In January 2021, hospitalizations for adults aged 85 and older were not very high, but the death rate was dramatically higher. However, with the rollout of COVID-19 vaccines starting in late January, there was a drop in death rates for this group. The other data that parallels this is the rate of COVID-19 infection and death in long-term care facilities and nursing homes. The case rates that were an epidemic this time last year have now basically gone away thanks to nearly 100 percent vaccination rates among nursing home residents and staff. This has shown that COVID-19 vaccines work, keeping people out of the hospital and keeping older adults from dying from the virus.

Why has there been an increase in COVID-19 cases and hospitalizations among adults younger than 50?

Spivak: The majority of people who are getting hospitalized because of COVID-19 are not vaccinated. If you look at the state data, since the end of March, there has been a flat COVID-19 infection rate. This means there is a stable level of community virus transmission. While we have made significant strides that have helped drop COVID-19 hospitalizations and deaths, as long as community transmission is still happening, we will continue to see hospitalization and death from the virus.

This is why it’s important for young people to get vaccinated. Getting vaccinated will help protect others who may not be able to get vaccinated or don’t have strong vaccine responses because they are immunosuppressed. COVID-19 also doesn’t just kill people—it can cause some terrible, long-term, debilitating side effects. This is just an argument to protect your long-term health, even if you aren’t at risk of severe disease and death from COVID-19.

What are some long-term health and ‘long-hauler’ symptoms people infected with COVID-19 are experiencing?

Supiano: More of the younger population are experiencing persistent COVID-19 symptoms after their infection, even if they weren’t hospitalized. For older adults, there’s a significant overlap with cognitive symptoms, also known as brain fog. One of the common presenting symptoms among older adults with COVID-19 is an altered mental status, also known as delirium. There’s a high concern for people who present with delirium that it will continue to cause problems with memory and other cognitive symptoms for months—if not longer—after surviving a COVID-19 infection.

Spivak: Younger adults are also experiencing similar symptoms to brain fog or difficulty thinking clearly. Other symptoms include lower respiratory infections such as chronic cough, debilitating fatigue, difficulty sleeping, body aches, joint pains, arthritis, and headaches. These symptoms can go on for many months, as well.

What can older adults who have been vaccinated do safely now that they couldn’t do before?

Supiano: The benefit of vaccination is extremely liberating. You can now hug and visit your grandchildren. The Centers for Disease Control and Prevention (CDC) have released guidelines on what you can start to do after you’ve been fully vaccinated. You can now safely gather together with friends and family. I encourage all families to have conversations about COVID-19 vaccines so they can gather safely again.

How have COVID-19 virus variants impacted case counts in Utah?

Spivak: The Utah Department of Health is currently tracking several virus variants, including the United Kingdom (UK), South Africa, Brazil, and two from California. The UK variant is making up 40-50 percent of strains in Utah. This variant is more transmissible, infectious, and contagious. There have been some reported outbreaks in schools in Utah, which look to be driven by this variant. Even with health measures in place such as masking, smaller class sizes, and physical distancing, these variants are making an impact. This is why it’s even more important to wear a well-fitting mask.

What is known about the impact of virus variants on COVID-19 vaccines?

Spivak: The three vaccines that are available in the U.S. look to be just as effective at preventing severe disease and death. The South Africa and Brazil variants have been detected in the U.S. but are less common.

Can a person get infected with COVID-19 after getting vaccinated?

Spivak: The chance of getting infected with COVID-19 after vaccination is not zero. If you look at studies of the clinical trials, there is a 3-5 percent chance of reinfection. In real world data that has come out of Israel and some data in the U.S., it looks to be even lower. In Utah, the estimated reinfection rate for those who are fully vaccinated (two weeks after your last dose of your COVID-19 vaccine) is less than one percent. Even if you get reinfected after getting vaccinated, it will help prevent you from getting severely sick and becoming hospitalized.

Can herd immunity still be reached if vaccine reluctancy continues?

Spivak: The concept of herd immunity is that a large majority of the population becomes immune to infection so that the virus or disease could no longer spread from person to person—or occur at extremely low levels so that it would no longer be a public health threat. The percentage of people needed to reach herd immunity or for COVID-19 to go away is not yet known.

Now we have more vaccine than people willing to get it, so we may be getting to a point where COVID-19 won’t go away. The goal is to get to a less severe manner. Whether the vaccine hasn’t yet reached enough people or not enough people are willing to get the vaccine, there will always be a low level of transmission. That means we will always have a susceptible population that can get infected and suffer severe outcomes from it. As time goes by, hopefully enough people will get vaccinated so that COVID-19 becomes a routine yearly respiratory virus that keeps people home from school or work.

Another reason we may have trouble reaching herd immunity is through the global impact. I have seen people from India who have come to Utah and tested positive. I’m sure Americans have also taken it elsewhere. Until we can get vaccine distribution shared globally and controlled around the world, there will always be a problem knocking on our door.


Kylene Metzger

Public Affairs

coronavirus COVID-19 geriatrics infectious disease older adults vaccine

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