Holes in reporting of breakthrough Covid cases hamper CDC response/ Politico

This is a very long article from Politico, but the meat is below and it is worth your attention.  For those who ask why the US data show few breakthrough cases, and reasonable vaccine efficacy, while the data from the UK and Israel show practically no vaccine benefit at this point in time, and possibly a negative benefit (which does happen occasionally for flu shots and has happened in other vaccines) the reason is simple.  CDC made sure to direct its massive grants to the states in ways that would maintain haphazard and variable reporting by states, hospitals, etc.  Furthermore, it was obvious on May 1 that CDC instituted a policy designed to minimize reporting of vaccine failures. 

 The Centers for Disease Control and Prevention is using outdated and unreliable data on coronavirus breakthrough infections to help make major decisions, such as who gets booster shots, according to three officials with direct knowledge of the situation.

The agency originally tried to track all infections in vaccinated people, from mild to severe. But in May it decided to focus on the most severe cases, saying that would allow it to better monitor overall conditions and make more informed, targeted policy decisions.

Forty-nine states are now regularly sending CDC information on hospitalized breakthrough patients. But more than a dozen told POLITICO that they do not have the capacity to match patients’ hospital admission data with their immunization records. Instead, those states rely on hospital administrators to report breakthrough infections. The resulting data is often aggregated, inaccurate and omits critical details for teasing out trends, such as which vaccine a person received and whether they have been fully vaccinated, a dozen state officials said.

The gaps in this crucial data stream raise questions about the Biden administration’s ability to spot and respond to changes in the virus’s behavior — such as the rapid spread of the Delta variant, which crowded out other strains — or vaccines’ performance. It also underscores the extent to which the CDC and public health departments across the country are still struggling to collect and study critical Covid-19 information 18 months after the pandemic began.

“I think it would be really challenging [for the CDC] to interpret the results or to interpret the data when you have only some jurisdictions reporting [breakthrough infections],” said Theresa Sokol, lead epidemiologist for Louisiana’s state public health department, which is working closely with the CDC on studies of breakthrough infections. “I know that there are some jurisdictions that don't even have access to their vaccination data. They don't have the authority or their permission.”

Many of the hurdles facing CDC and state officials trying to gather data during the age of the Delta variant are the result of the patchwork of public-health agency data systems, many of which cannot communicate with each other. For more than a decade, states have pleaded with the federal government for money to make it easier to gather and study disease trends electronically. The pandemic has overloaded those arcane systems, revealing the disorganized nature of public health reporting and case investigation...