Why Colin Powell was vulnerable to COVID

Despite being vaccinated against COVID-19, Colin Powell remained vulnerable to the virus due to his advanced age and history of cancer, highlighting the continuing risk for many Americans until most of the population is immunized.

Powell, a four-star general who became the first black secretary of state and chairman of the Joint Chiefs of Staff, died Monday from complications from COVID-19. Powell, 84, has been treated for the past few years for multiple myeloma, a blood cancer that reduces the body’s ability to fight infections and respond well to vaccines.

COVID-19 vaccines are very effective against hospitalization and death, and the probability of death from coronavirus in unvaccinated people is about 11 times higher. But they are imperfect, and experts emphasize that widespread vaccination is critical to provide an additional layer of protection for the most vulnerable.

“The more people are vaccinated, the less viral we have in society, the less likely people like him will get infected from the start,” said Dr. Mangala Narasimhan, chief of the intensive care unit at Northwell Health in New York.

What’s more, people with weakened immune systems from diseases such as cancer or cancer treatments do not always get the same level of protection from vaccines as healthier people. Several studies have shown that as few as 45% of people with multiple myeloma after vaccination can develop protective levels of antibodies that fight the coronavirus.

Age also poses a risk, especially several months after the first vaccination. The Centers for Disease Control and Prevention is monitoring declining levels of protection, especially among older Americans, who were among the first people to get vaccinated last winter. Decreased defenses are the result of either weakened immunity or the extra-infectious delta variant.

Dr. Ed Lifshitz, medical director of the New Jersey Department of Health’s Infectious Disease Service, disagreed with those who could point to Powell’s death to oppose vaccinations.

“My answer is actually the exact opposite,” he said. “You can help the most vulnerable people by preventing the virus from reaching them, and the best way to do that is to go and get vaccinated.”

The US government has allowed an additional dose of Pfizer or Moderna vaccines to be given to people with weakened immune systems to try to improve their response.

And last month, US health authorities called for booster doses of Pfizer vaccine to be given to everyone aged 65 and over after at least six months after the initial vaccination, as well as to other high-risk people. Boosters are also being considered for Moderna and Johnson & Johnson vaccine recipients.

It was unclear if Powell received an additional dose.

Katie Giusti, founder of the Multiple Myeloma Research Foundation, recalled meeting Powell when he spoke to the advocacy group about his diagnosis in 2019 and he “contacted every patient, nurse, and doctor on the ward.”

In a statement, she said that in addition to vaccinations, cancer patients should consider other precautions, such as using masks and avoiding crowds.

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