Letter from the Health Officer: Addressing Questions on COVID-19 Topics

By Dimyana Abdelmalek, the Thurston County public health officer
Posted 7/1/21

Hello Thurston County. I really enjoy receiving questions from the community each week. In this week’s letter, I will address many questions on a variety of COVID topics you have sent …

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Letter from the Health Officer: Addressing Questions on COVID-19 Topics


Hello Thurston County. I really enjoy receiving questions from the community each week. In this week’s letter, I will address many questions on a variety of COVID topics you have sent in.

COVID-19 Vaccination Progress

I also wanted to update you on COVID-19 vaccinations here in Thurston County and Washington state. As of June 30, 68.8 percent of Washingtonians aged 16 and older had received at least one dose of a COVID-19 vaccine across the state of Washington. In Thurston County, 61.6 percent of those 16 and older have received at least one dose of a vaccine. While we have made immense progress since December 2020 when COVID-19 vaccines became available, we still have a way to go as a county.

Have there been any deaths from the COVID-19 vaccines reported in our county, state, or nationally?

Analyzing the data on vaccination related deaths is tricky. Providers are required to report any death after COVID-19 vaccination to the Vaccine Adverse Event Reporting System. The Centers for Disease Control and Prevention (CDC) then investigates whether there is a possible linkage. To date, the only deaths determined to have a linkage to a COVID-19 vaccine are those associated with thrombosis with thrombocytopenia syndrome (TTS), a rare adverse event associated with the Janssen vaccine. In Thurston County there have been no reported deaths as a result of receiving a COVID-19 vaccine. 

What can you tell me about vaccine breakthrough cases?

As of June 26, in Washington state we have had a total of 2,382 breakthrough cases identified out of the more than 3.8 million Washington residents who are fully vaccinated. A vaccine breakthrough case is someone who has been diagnosed with COVID-19 from either a PCR or antigen test and is two weeks past the completion of the COVID-19 vaccination series.

Of the 2,382 breakthrough cases, 37% percent were from the B.1.1.7 variant, 17 percent from the P.1 variant, 15 percent from the B.1.429 variant, 5 percent from the B.1.617.2 variant, 2 percent from the B.1.526 variant, 1 percent from the B.1.427, 1 percent from the B.1.351 variant. Seventy-nine percent of these breakthrough cases were people who had symptoms of COVID-19. Ten percent were hospitalized, and 43 people died from COVID-19 related illness. People who died ranged in ages, 26 people were associated with a long-term care facility and 30 people had underlying conditions. This is in sharp contrast to the 5,911 Washington residents who have died from COVID-19 in total. With any vaccine, breakthrough cases are expected and the vaccines we have so far are performing well and offering good protection from COVID-19. For more information, visit the Department of Health Sequencing and Variants Report.

I got the Janssen vaccine, should I get a dose of Pfizer or Moderna?

If you got the Janssen COVID-19 vaccine you are considered fully vaccinated and no additional vaccinations are recommended. The currently available COVID-19 vaccines are not interchangeable as the safety and effectiveness of mixed dosing has not yet been studied. Individuals who had an immediate allergic reaction to the first dose of an mRNA vaccine should discuss with their health care provider whether a dose of Janssen can be safely used to complete the series in a controlled clinical setting.  

What can you tell me about the need for booster doses?

The CDC has not established a need for booster doses for COVID-19. At this time the CDC is monitoring vaccine breakthrough cases and vaccine effectiveness studies. Vaccine manufacturers and the National Institutes of Health are conducting studies on booster doses as well. If booster doses are needed for the COVID-19 vaccine, they will need to be approved by the Food and Drug Administration and recommended by the CDC’s Advisory Committee on Immunization Practices.

Is the delta variant here in Thurston County?

As of June 29, the Department of Health Sequencing and Variants Report showed a sample containing the B.1.617.2 variant or the delta variant was isolated from a Thurston County resident. Statewide the delta variant accounted for 9.2 percent of sequenced specimens during that same time period. Since the delta variant is significantly more transmissible than many of the other strains, we anticipate seeing more of these cases in our county. We are still learning about how the delta variant impacts disease severity.

How does being vaccinated for school aged children and quarantine guidance work in the schools?

The Pfizer vaccine is approved for anyone ages 12 and older. One really important reason to get your child vaccinated before the next school year starts is because asymptomatic close-contacts who are considered fully vaccinated for COVID-19 (two weeks  after their second dose in a two-dose series, such as the Pfizer-BioNTech or Moderna vaccines, or two weeks after a single-dose vaccine, such as Johnson & Johnson) have such a low risk of contracting and spreading COVID-19 that they do not need to quarantine after being exposed to COVID-19, as long as they have not tested positive for COVID-19. If a fully vaccinated close-contact develops symptoms following an exposure, then they should isolate and get tested for COVID-19 as soon as possible.  

Should I keep wearing my mask?

People who are not fully vaccinated (more than two weeks out from completion of a COVID-19 vaccine series) need to continue wearing masks in indoor public spaces and continue to maintain six feet or more between themselves and non-household members in those spaces as well. I continue to recommend that all Thurston County residents continue to wear masks in public indoor spaces where vaccination status is not verified, even if fully vaccinated. We know masking and distancing are effective ways to prevent COVID-19 transmission in addition to receiving the COVID-19 vaccine when eligible to do so.

Great questions this week! Keep them coming to tcphss.pio@co.thurston.wa.us.


Dimyana Abdelmalek, MD, MPH, is the Thurston County health officer.


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