Most vaccinated people entering ICU have impaired immune systems, says senior doctor

People fully vaccinated against Covid who have become seriously ill with the disease are largely suffering from conditions that impair their immune systems, a senior doctor has said.

Catherine Motherway, an intensive care consultant at University Hospital Limerick, was speaking after HSE data showed that up to a quarter of current coronavirus cases were in people who had been inoculated against Covid-19.

“I would imagine that the vast majority of those people are probably asymptomatic and had been picked up because they had been close contacts of an index case essentially or part of an outbreak. They’re very likely to be asymptomatic,” she said.

The latest HSE data shows that 47 per cent of close contacts traced this week to people with the disease were fully vaccinated.

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“Covid vaccination will reduce your chances of getting Covid but does not prevent it. You will still potentially get Covid but it very significantly reduces your chances of being ill or hospitalised,” Dr Motherway said.

Most of those who then became very sick with Covid were suffering from significant underlying conditions, she added.

More than three-quarters of the patients admitted to intensive care with coronavirus since April had no vaccination. “Only about 12 per cent of them were fully vaccinated. What that really shows you is that being vaccinated is very, very useful.”

People with “breakthrough” coronavirus infections despite being fully vaccinated comprised less than 10 per cent of intensive care admissions.

“We know from the ICU data that the vast majority of people who are coming into the ICU are unvaccinated, or if they are vaccinated they are people with significant underlying conditions, particularly patients who have immune systems that don’t respond as well to vaccination as those of us who have no problem with our immune system.”

Harm factor

The HSE said this week that 20-25 per cent of current verified Covid-19 cases were in people who have received the jab.

Paul Reid, the HSE chief executive, said the organisation expects the overall proportion of vaccinated people with Covid to continue rising as more and more of people receive vaccinations.

“The issue is: how much harm does it do? The obvious answer right now is, from what we’re seeing in hospitalisations and ICU, it causes more harm in people who are not vaccinated,” Mr Reid told a Thursday press conference.

The US government cited data that pointed to diminished protection from vaccines over time when it resolved in recent days to make booster shots widely available in late September.

Asked whether there was anything to suggest vaccinated people in Ireland were being hospitalised because of diminished vaccine efficacy, Dr Motherway replied: “I don’t think that we have that evidence to give you.”

She added: “What we can tell is that those people who are vaccinated and who are very ill in the ICUs have significant underlying conditions which affect predominantly their immune system.

“That cohort of patients would include people with immunological diseases like leukaemia, transplant recipients who are immunosuppressed, and people who are on other immunosuppressant drugs, which we use a lot and are really wonderful for people. That means that you don’t benefit as much from being vaccinated.”

Being vaccinated, although “wonderful”, is not perfect solution, she says. “But it’s considerably better than being not vaccinated.”