Colin Powell, Four-Star General and Former Secretary of State, Dies of COVID-19 Complications

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Photo credit: Paul Morigi
Photo credit: Paul Morigi

Former U.S. Secretary of State Colin Powell has died of complications from a breakthrough COVID-19 infection, his family announced on Facebook Monday.

“General Colin L. Powell, former U.S. Secretary of State and Chairman of the Joint Chiefs of Staff, passed away this morning due to complications from COVID-19. He was fully vaccinated,” the statement reads. “We want to thank the medical staff at Walter Reed National Medical Center for their caring treatment. We have lost a remarkable and loving husband, father, grandfather and a great American.”

Powell, 84, was previously diagnosed with multiple myeloma, a type of blood cancer that makes it difficult for the body to fight infections, according to CNBC. He also, in the early 2000s, underwent treatment for prostate cancer.

Twitter was quickly flooded with comments from people who said that Powell’s death from COVID-19 while being fully vaccinated shows that the COVID-19 vaccine doesn’t work. “If he was ‘fully vaxxed’ and still died of C0VID, what does that say about these vaccines?” one person wrote.

But experts say those are inaccurate conclusions. If you’re fully vaccinated against COVID-19, it’s understandable that Powell’s death from COVID-19 complications might make you pause. Here’s what you need to know.

How effective are the COVID-19 vaccines?

You probably know at least some of this information, but it doesn’t hurt to go over it again. There are currently three COVID-19 vaccines available for people in the U.S.: The Pfizer-BioNTech vaccine, Moderna vaccine, and Johnson & Johnson vaccine. The Pfizer-BioNTech vaccine, also known as Comirnaty, is the only vaccine currently approved by the Food and Drug Administration (FDA) to prevent COVID-19.

The other vaccines are available under an emergency use authorization (EUA) from the FDA. Efficacy varies by vaccine. Here’s a breakdown:

According to the FDA and Centers for Disease Control and Prevention (CDC), efficacy of these vaccines wanes over time. That’s why a booster shot is now recommended for people who have received the Pfizer-BioNTech vaccine who meet certain criteria and are considered high risk. Booster shots for Moderna and Johnson & Johnson vaccines are currently being reviewed by the CDC’s Advisory Committee on Immunization Practices (ACIP), and a decision on them should come within weeks.

How can someone still die of COVID-19 after being fully vaccinated against the virus?

Experts stress that, while the COVID-19 vaccines are effective, they’re not perfect. “The vaccines aren’t force fields, but they are designed to protect against severe illness,” says infectious disease expert Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security.

The CDC specifically says online that people who are immunocompromised, either from an underlying health condition or because they’re elderly, may need to have more than the standard dose of a COVID-19 vaccine for optimal protection. Unfortunately, Powell was both elderly and immunocompromised, points out Thomas Russo, MD, professor and chief of infectious disease at the University at Buffalo in New York. It's unclear if he received a booster shot.

“We’ve known all along that our vaccines are outstanding but not perfect,” Dr. Russo says. “And they’re most imperfect in the immunocompromised and elderly. The 75 to 80+ age group doesn’t necessarily have an optimal response with the initial vaccine series. That’s why it’s so important to get a booster to provide more protection.” Dr. Russo also notes that the efficacy of the Johnson & Johnson vaccine is much lower that that of the other two vaccines, which can make efficacy even trickier if someone already is high risk.

Richard Watkins, MD, an infectious disease physician in Akron, Ohio, and a professor of internal medicine at the Northeast Ohio Medical University, points out that the data clearly show that the vaccine protects most people. The CDC doesn’t track all breakthrough COVID-19 cases, but it does keep data on people who have been hospitalized with COVID-19 while vaccinated, as well as those who have died. It is a little complicated, though: The data includes people who did not have symptoms of COVID-19 when they were hospitalized or died (i.e. they simply tested positive while they sought medical attention for another health issue).

According to CDC data, 24,717 people have been hospitalized with COVID-19 breakthrough cases and 7,178 people have died. By comparison, 722,212 people have died of the virus in the U.S. since the pandemic began, per CDC data—with the vast majority being unvaccinated.

“Colin Powell died because someone else made the choice not to get vaccinated,” Dr. Watkins says.

Dr. Adalja stresses that the vaccines are effective in the vast majority of people who receive them. “When a celebrity who was vaccinated dies, people seize on it,” he says. “But it doesn’t change the overall statistics about the vaccine.”

What can you do to be as protected as possible against COVID-19?

The best thing you can do to be as protected as possible from COVID-19 is to be vaccinated, Dr. Adalja says. And, if you live in an area where COVID transmission is high, it’s a good idea to wear a mask in public spaces and when you’re around people from outside your household who are unvaccinated, Dr. Russo says.

If you meet the qualifications for a booster shot, getting it will help provide you with maximum protection, Dr. Russo says. “Even then, it’s a good idea to mask up in public spaces and avoid any scenarios in public where masks would be down, like indoor dining,” he adds.

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